But take a closer look and one might see some blips punctuating what many fear may be a flat-line in the landscape of our regional economy.

"It is important to remember that mergers and acquisitions are not always a downside," RCGA President and CEO Dick Fleming wrote Monday in his weekly memo. Fleming went on to cite several cases, including Boeing, the legacy of McDonnell-Douglas, remaining the region's second largest-employer, and Nestle witnessing a net increase in jobs from Ralston Purina, with employees moving to St. Louis from around the world.

"Companies get sold," observed Dr. William Peck, director of the Center for Health Policy, and past dean, at Washington University School of Medicine. "What we need to have is a steady supply of innovative and entrepreneurial activity that will grow to sometimes very large and significant companies."

And perhaps particularly so in the arenas of health and science. "We have only recently begun to fully understand our potential as the Bio-Belt; a center for plant and life science," Fleming said in an interview.  "We have great resources here, developed over long periods and major international companies to show for it: Monsanto, Sigma-Aldrich, Pfizer..."

And noting the largest employer in St. Louis, BJC Healthcare, it's fair to consider whether St. Louis could make the transition from beer mecca to health care mecca.

"One of the issues is that no one region, community or city can call itself "the mecca of health care"," said Peck. But, "what we have are multiple meccas that provide the best health care and best science in the world. St. Louis is one of those meccas."

A mecca leading in several areas, including genome sciences. "About 1/3 of the genome was sequenced here at Washington University," said Peck. "The impact of that is tremendous."

And the buck doesn't only stop at Wash U, according to Peck. "The program in vaccine development at SLU; there's none better. And when you think about nutrition as a health issue, we lead there, too, from the standpoint of application of science by example of Monsanto and the Danforth Plant Science Center."

Big Pharma: New Jersey, RTP ... St. Louis?

Several pharmaceutical and other affiliated development companies are either based in St. Louis (KV and Fleming Pharmaceuticals, Sigma-Aldrich), or have significant representation here (Pfizer Inc.-St. Louis Labs).

Pfizer is on track with the major expansion of a nearly $250 million research building, a facility that will allow consolidation of all of the St. Louis region's researchers to one location in Chesterfield. Pfizer has also broken ground on another, nearly $50 million expansion that will double its ability to produce quantities of new biotherapeutic medicines for early human clinical trials.

"Biotherapeutics are protein-based medicines which offer us an alternative approach to attack diseases and complements our emphasis on traditional small molecule medicines," said Dr. Dan Getman, director of St. Louis Laboratories and vice president of Pfizer Global Research and Development. "We work closely with our disease area experts at other sites to apply this exciting technology."

Indeed, "One of the great benefits of having major Pfizer activity here is that it provides opportunity for collaboration between industry and academia," said Peck. Perhaps other big pharma will follow suit and set up camp here as well.

Still in the Oven

St. Louis can also stand proud with the emerging life sciences companies being home grown on our soil. "We have two of the strongest incubators in the country: the Centers for Emerging Technologies and the Nidus Center," said Fleming.

"We are leading in national efforts to produce incubators," Washington University's Peck said. "Incubator space here is the envy of many communities. We have also engaged with many who see value in funding these ventures, such as the St. Louis Arch Angels."

Also among those funding these start-ups are several of the local, health-related or health-inclusive venture capital firms such as RiverVest, led by Tom Melzer, and Advantage Capital, led by Scott Zajac.

And Still We Rise

Fleming reports that the number of Fortune 1000 headquarters in the St. Louis region has actually increased from 17 to 21 over the past eight years -- nine of which are Fortune 500 companies. And a number of these, such as the pharmacy-benefits management company Express Scripts, weren't even on the radar 10 years ago. Express Scripts ranks at number 135 and is now the second-highest St. Louis company on the list, behind Emerson Electric, at 111.

"While St. Louis is a relatively new entry in national and international development in life sciences, we have quickly become recognized as a leader by objective standards," said Fleming. citing an indication that St. Louis has made greater progress in plant and life science strategy than any other market in the last 10 years.

And not to forget about those in the health care trenches: the doctors, nurses and other health care professionals who also set St. Louis in a class apart: "Health care delivery here is as good as anywhere in the country," said Peck.

And research? "The opportunities here are outstanding," he said.

Both Washington University and St. Louis University Schools of Medicine are in the process of constructing new research developments, or have recently completed the projects. These include the new Edward A. Doisy Research Center at St. Louis University and BioMed 21, which is about to house the future of science and medicine at Washington University.

"We've come a long way in the last six or seven years and have laid a good foundation to leverage our strong science base in advancing life sciences," said Getman. "Now it's time to take our collective efforts to the next level and many people, organizations and government officials are all working together to make that happen."