Global Health Ideas

Finding global health solutions through innovation and technology

LA Times: A vaccine development ‘renaissance’

This Sunday’s LA Times has a story about a so-called A vaccine development ‘renaissance’. This resurgence in vaccine development is being led by improved scientific knowledge, increased government research funding and interest among global drug companies, innovative financing schemes and purchase guarantees and finally better delivery mechanisms. Vaccines have done much to improve global health in the modern era, but it is clear the dynamics of vaccines have changed significantly. As described by Rachel Glennerster, Michael Kremer, Heidi Williams in their article Creating a Market for Vaccines (MIT Press journal -Innovations Case Discussion, PDF):

Vaccines are perhaps the paradigmatic example of a cheap, easy-to-use technology that can have tremendous health impacts even in very poor countries with weak health care infrastructures. Vaccines (relative to drug treatments) require little training or expensive equipment to implement, do not require diagnosis for use, can be taken in a few doses instead of in a longerterm regimen, and rarely have major side effects. They can be prescribed and delivered by health care workers with very limited training, and resistance rarely develops against vaccines.

However, it is clear to many that the market for vaccines has a large role to play in the dearth of progress developing vaccines for the prickly and prevasive diseases, such as HIV, malaria and tuberculosis. Glennerster, Kremer and Williams further state,

Poor countries have benefited enormously from such vaccines, but these benefits have for the most part been a fortunate byproduct. Little public- or private-sector R&D is targeted toward developing new health technologies for diseases concentrated in poor countries.

Of the 1,233 drugs licensed worldwide between 1975 and 1997, only 13 were for tropical diseases; of these 13, five came from veterinary research, two were modifications of existing medicines, and two were produced for the U.S. military—only four were developed by commercial pharmaceutical firms specifically for tropical diseases of humans.

According the to LA Times article:

Prevnar, a vaccine introduced in 2000 to treat pneumococcal pneumonia — the cause of up to a quarter of all community-acquired pneumonia cases each year — runs about $250 for a four-shot series. It became the first vaccine to clock $1 billion in annual sales, giving it so-called blockbuster status.

This potential for blockbuster sales has facilitated the return of drug giants to the market, but does this change the story for diseases centered in the Global South. The answer is unequivocally NO! but not to be disheatened, this rennaissance has ushered in mechanisms to create markets for vaccines targeting diseases found mostly in the Global South. Perhaps most famous of these initiatives is the International AIDS Vaccine Initiative. Read the recent case study on the IAVI by Seth Berkley – Ending an Epidemic: The International AIDS Vaccine Initiative Pioneers a Public-Private Partnership.

The Global Alliance for Vaccines and Immunisation (GAVI alliance) has also played a seminal role in distributing and administering vaccinations in those regions of the world with barely functioning health care systems.

At the World Economic Forum in Davos, Switzerland, last week, GAVI announced it would commit an additional $500 million over three years to strengthen healthcare systems in poor countries, a key problem in implementing vaccine programs in many locales. The organization says it has prevented 2.3 million deaths from disease since its inception, including 600,000 last year.

Finally, another major piece of the puzzle is reducing uncertainty regarding effective demand for vaccines. The most often discussed mechanism for ensuring effective demand of vaccines has been advance purchase commitments. see the article cited above for detail on this mechanism. Another issue addressed in the following recent post – Vaccine Demand Forecasting: Creating Markets and Incentives – is the issue of demand forecasting. Though the benefits of vaccines are clear, we must refrain from reductionist thought about the nature of human behavior. Much work needs to be done educating and advocating for the immunization of children and adults. Under the current circumstances it can be quite challenging to forecast demand for vaccines. As the recent issue in Northern Nigeria illustrated, sometimes cultural, religious and other factors often trump sound health practices. The history of development in the Global South has created much acrimony and distrust. As professionals, academics, and practitioners of technology, health and development must always realize the complexity of technological interventions – the case of vaccines is especially illustrative of this fact.

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Written by Mahad Ibrahim

January 28, 2007 at 2:11 pm

One Response

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  1. You can read about side effects of vaccines and drugs in general at http:\\www.patientsville.com. We have >100000 real patient stories.

    John

    February 1, 2007 at 4:06 pm


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