Viruses are out there, waiting to strike, and vaccinations are our best defense. But that defense is a man-made system, and therefore subject to breakdowns.

In a talk titled “The Significance of Vaccines in Global Health,” Merck CEO Raymond V. Gilmartin (MBA ’68) told an HBS audience in February that policymakers concerned with global public health must pay “dramatically greater” attention to vaccine-related issues. He pointed out that 3 million children worldwide die each year from diseases for which vaccines already exist. Even when companies like Merck offer vaccines at discount, millions still die as a result of poverty, poor distribution systems, and lack of trained personnel.

The business community and policymakers must work together to improve access to existing vaccines, Gilmartin declared. In addition, they need to join forces to create a research-conducive environment for pathogens for which there are currently no vaccines: familiar maladies such as malaria, tuberculosis, and HIV, as well as newer threats, such as SARS, anthrax, and ricin.

Today, Gilmartin noted, Merck is one of only five global companies making vaccines. In the 1970s, some 25 firms manufactured vaccines but most have been driven away by fears of liability and government discount price-setting. “No one company or handful of companies can undertake all the research” necessary to produce needed vaccines, he said. Incentives must be introduced, so as to attract more participants to the industry, thereby increasing competition, development, and production. Some of this activity, Gilmartin observed, could be stimulated by private-public partnerships and judicious government involvement in funding basic research and making binding purchase commitments where natural markets do not exist.

If these changes could be made, Gilmartin concluded, the result might be “the most dramatic improvement in global public health in history.”

The preceding is based on an article in HBS Working Knowledge. To read the full article, visit www.workingknowledge.hbs.edu.

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