That people in the US and other Western markets can access these promising vaccines there is little doubt. But the real opportunity
to prevent human suffering is in the developing world. For that to happen, pharma needs not just next-generation vaccines,
but a whole new approach to R&D and access for the poor. In coming years, vaccine makers will be called upon to help define
the new rules of global access, and what new progress in science and technology will mean to the 90 percent of the world that
can't afford it.
A confluence of political will, funding, and innovation have made these goals more possible than ever. For example:
» In 2000, 192 United Nations member states and more than 20 international organizations agreed to eight Millennium Development
Goals—including the goal of reducing mortality of children under five by two-thirds before 2015. That has rallied the global
health community behind vaccines, since they are the most cost-effective way to prevent death among young children. President
Obama expressed support for the Goals during his campaign, and with strong familial roots in Kenya, it is hard to doubt that
he is in alignment with them.
With a multitude of donor commitments, market-based incentives, and new science, vaccines for some of the worlds leading killers
of children will reach millions in need.
» The field of vaccines has been transformed in recent years by the GAVI Alliance (formerly known as the Global Alliance for
Vaccines and Immunizations), which has worked with stakeholders from NGOs—including the Bill and Melinda Gates Foundation—pharma
companies, and governments to increase the use of underutilized vaccines and introduce new ones. "The GAVI Alliance is providing
the direct financial support that, once countries recognize the problem and the availability of the solution, gives them the
means to move forward," says John Wecker, who directs the immunization activities for the nonprofit group PATH (formerly known
as the Program for Appropriate Technology in Health).
» Part of GAVI's approach is to educate developing nations on the burden of disease, and to ensure they pay copays on vaccines.
This process has bred a new recognition in government officials that health equals wealth, and that investment in preventive
medicine makes economic sense, even for a relatively poor country.
A vaccine diverged
» The battles pharma has fought with the developing world over AIDS drugs and intellectual property have been damaging to
the industry—and have taught it a lesson. "The attention that's paid to access will continue to increase, and so being global
'actors' rather than 'tourists' is going to be increasingly important for how companies do business," says Kate Taylor, vice
president of global vaccine policy at GlaxoSmithKline Biologicals.
The economic crisis threatens to slow or reverse this progress. But for the moment, even these poor economics have not dampened
the promising developments that can stop millions from dying. There's an "if" to that promise, of course, and it's a big one:
Companies and other stakeholders need to learn how to reverse a long term trend and ensure that medicine goes to those who
need it most and can least afford it. That means solving not just technical problems but finding a way to align moral and
ethical principles with the demands of good business.