Vaccines for All

A new equation to bridge health and wealth
Feb 01, 2009

The first time Margaret McGlynn heard about the brother she never met, it was the 1960s, and she was with her mother at an immunization clinic in Buffalo, NY, waiting to be injected with a brand new measles vaccine.

Margaret McGlynn, President, Merck Vaccines & Infectious Diseases
As the line moved slowly forward, four-year-old Margie grew frightened watching the needle sink into the arm of child after child. That's when her mother took her aside and told Margie the story of this other child, who died a decade earlier of the same disease this vaccine would protect her from.

The 18-month-old had been suffering from measles when he spiked a high fever. McGlynn's mother called the doctor. Wrap the baby in cold towels, the doctor told her. Helplessly, McGlynn's mom pressed the towels around the baby, only to see him get worse. Eventually, she rushed the baby to the hospital, where she learned that he had contracted pneumonia as a complication of measles. He didn't survive the day.

Merck's Dr. Mark Feinberg (center) administers RotaTeq to an infant in Nicaragua. The rotavirus vaccine marked the first time a vaccine reached a poor nation in the same year it was licensed in a rich one.
"After hearing how my brother died, I didn't ask any more questions as to why I needed to get this shot," remembers McGlynn.

In the course of her lifetime, McGlynn has seen the elimination of many diseases—measles among them. She's even done her part in exterminating them. McGlynn was senior director of marketing for Merck's MMR (measles, mumps, and rubella) vaccine. Now, she heads Merck's recently reorganized vaccine group, which fights childhood and early mortality through products such as the cervical cancer vaccine, Gardasil (human papillomavirus quadrivalent, types 6, 11, 16 , and 18) and RotaTeq (rotavirus vaccine, live, oral, pentavalent) which prevents rotavirus, a potentially fatal diarrheal disease.

Rotavirus disproportionately affects the developing world, where citizens have the least access to vaccines.
Vaccination rates have long been dismally low outside of rich countries. Vaccines that have already been developed and cost pennies per dose could prevent some 20 percent of the seven million child deaths each year, according to the World Health Organization (WHO), but fail to because they don't reach the people in need.

But in the last few years, in some places, things have started to change: Deaths from measles worldwide fell 74 percent between 2000 and 2007. The rate of polio, which afflicted 350,000 people per year as recently as 1988, has dropped 99 percent (the disease is expected to be eradicated within five years). And countries that have introduced mumps vaccination have seen cases drop from between 100 to 1,000 per 100,000 population to less than one per 100,000.

The emerging country dilemna
All this comes at a time when pharmaceutical companies are entering back into vaccine research, after largely abandoning the field for two decades. Small-molecule pills for chronic diseases offered higher margins and less legal liability. But now, new science has caused many of the world's biggest pharma players—like Merck, GlaxoSmithKline, Sanofi-Aventis, Wyeth, Roche, and Novartis—to come back to the field. It appears that vaccines will again be a major driver in the industry.

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