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Commentary: From scarcity to abundance: Pandemic vaccines and other agents for "have not" countries.
Journal of Public Health Policy. 2007; 28(3):322-340.The recent impasse between the Indonesian Ministry of Health and the World Health Organization (WHO) over sharing H5N1 viruses in return for access to affordable pandemic vaccines highlights slow progress in defining an antigen sparing vaccine formulation, developing licensing requirements that meet the needs of populations and obtaining government funding for vaccine trials. Currently, vaccine-producing countries would have difficulty producing enough doses for their own people and few doses would be left over for non-producing ("have not") countries. Yet within a few months of the onset of a new pandemic, several billion doses of live-attenuated and recombinant hemagglutinin H5 vaccines could be produced for "have not" countries, provided a new and disruptive system of "top down" management could be organized. In its absence, a "bottom-up" alternative that uses widely available and inexpensive generic agents like statins must be considered. The "have not" countries must continue to put pressure on WHO and leading countries to ensure that they will have access to the interventions they will need. (author's)
Bulletin of the World Health Organization. 2006 May; 84(5):338.The context for this theme collection is the publication of the report of the Commission on Intellectual Property Rights, Innovation and Public Health. The report of the Commission -- instigated by WHO's World Health Assembly in 2003 -- was an attempt to gather all the stakeholders involved to analyse the relationship between intellectual property rights, innovation and public health, with a particular focus on the question of funding and incentive mechanisms for the creation of new medicines, vaccines and diagnostic tests, to tackle diseases disproportionately affecting developing countries. In reality, generating a common analysis in the face of the divergent perspectives of stakeholders, and indeed of the Commission, presented a challenge. As in many fields -- not least in public health -- the evidence base is insufficient and contested. Even when the evidence is reasonably clear, its significance, or the appropriate conclusions to be drawn from it, may be interpreted very differently according to the viewpoint of the observer. (excerpt)
Washington Post. 2000 Jul 5; A1.This article describes the political infighting, quiet racism, and overall neglect that have impeded the industrialized world’s reaction to the AIDS epidemic. It is noted that less than 20 years after physicians first described its symptoms, HIV has now infected 53 million people and has claimed the lives of 19 million people. In wealthy nations, effective drug therapies against AIDS became available, such as zidovudine in 1987 and then combinations of antiretroviral agents in 1996. But according to AIDS experts, combating the disease requires governments to interpose themselves into controversies of sex, injected drugs, and other taboos. It also requires people in the developed world to make Africa and Africans a priority. Even the WHO has had trouble confronting such realities. In addition, combating AIDS requires costly change in economies and national cultures. In this perspective, the US government, African governments, the World Bank, WHO, and the Joint UN Programme on HIV/AIDS (UNAIDS) are still struggling to agree on, and implement a prevention program in sub-Saharan Africa that would include hundreds of million of dollars in youth- focused education, intensive counseling of sex workers, provision and "social marketing" of condoms and much more aggressive treatment of lesser venereal disease. Some are waiting for a vaccine, but it is noted that it took 183 years between the discovery of a smallpox vaccine and the disease’s eradication.