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New Vaccines for Developing Countries: Will it Be Feast or Famine?

Published online by Cambridge University Press:  06 January 2021

Jon Kim Andrus ,
Ciro de Quadros ,
Cuauhtemoc Ruiz Matus ,
Silvana Luciani  and
Peter Hotez
Jon Kim Andrus
Affiliation:
Comprehensive Family Immunization Project, Pan American Health Organization, Washington, D.C.
Ciro de Quadros
Affiliation:
Sabin Vaccine Institute, Washington, D.C.
Cuauhtemoc Ruiz Matus
Affiliation:
Comprehensive Family Immunization Project, Pan American Health Organization, Washington, D.C.
Silvana Luciani
Affiliation:
Chronic Disease Prevention and Control, Pan American Health Organization, Washington, D.C.
Peter Hotez
Affiliation:
Sabin Vaccine Institute, Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, D.C.
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Abstract

The Revolving Fund of the Pan American Health Organization (PAHO) has an almost 30 year track record of providing access to essential vaccines for the entire population of Latin America and the Caribbean region. The activities of the PAHO Revolving Fund, coupled with the provision of high-quality technical assistance, were crucial to the successful control, elimination, or eradication of most of the region's great childhood killers, including measles and polio. Today, however, the Revolving Fund faces new challenges in the form of procuring a new generation of vaccines for human papillomavirus infection, rotavirus, and pneumococcal disease, which are priced orders of magnitude higher than the traditional childhood vaccines. The high cost of these essential new vaccines may require the PAHO Revolving Fund to establish innovative financial mechanisms for procuring these products at prices affordable for national immunization programs in Latin America and the Caribbean. The alternative, namely to bypass the Revolving Fund, could severely threaten the health of the region, especially Latin America's poorest people.

Type
Article
Information
American Journal of Law & Medicine , Volume 35 , Issue 2-3 , June 2009 , pp. 311 - 322
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 2009

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References

1 Tambini, Gina, Andrus, Jon K., Fitzsimmons, John W. & Periago, Mirta Roses, Regional Immunization Programs as a Model for Strengthening Cooperation Among Nations, 20 Pan Am. J. Publ. Health 54 (2006).CrossRefGoogle ScholarPubMed

2 Jon K. Andrus & Ciro A. de Quadros, Global Access: Deployment, Use, and Acceptance, in AIDS Vaccine Development: Challenges and Opportunities 133-37 (Patricia Khan, Ian D. Gust & Wayne C. Koff eds., 2007).

3 Andrus, Jon K., Dietz, Vance, Fitzsimmons, John W., Castillo-Solorzano, Carlos, Accelerating Policy, Deployment, and Access to New and Underutilized Vaccines in Developing Countries, 7 Harv. Health Pol’y Rev. 91, 91 (2006).Google Scholar

4 See generally Andrus, Jon K. & Fitzsimmons, John W., Introduction of New and Underutilized Vaccines: Sustaining Access, Disease Control, and Infrastructure Development, 2 Pub. Libr. Sci. Med. 939 (2005)Google ScholarPubMed.

5 Peter Carrasco, Ciro de Quadros, & Walter Umstead, EPI in the Americas Benefits from the Revolving Fund, 37 WHO Chron. 81 (1983).

6 Id.

7 See generally Tambini et al., supra note 1, at 55-57.

8 Denise DeRoeck, Saleh Bawazir, Peter Carrasco, Miloud Kaddar, Alan Brooks, John W. Fitzsimmons & Jon K. Andrus, Regional Group Purchasing of Vaccines: Review of the Pan American Health Organization EPI Revolving Fund and the Gulf Cooperation Council Group Purchasing Program, 21 Int’L J. Health Plan. Mgmt. 23, 25-27 (2006).

9 Andrus & de Quadros, supra note 2, at 133-37.

10 Jon K. Andrus & John W. Fitzsimmons, Abstract, Introduction of New and Underutilized Vaccines: Sustaining Access, Disease Control, and Infrastructure Development, 2 Pub. Libr. Sci. Med. 939, 939 (2005).

11 Jon K. Andrus, John W. Fitzsimmons & Alan Crouch, Abstract, Sustaining National Immunization Programs in Latin America and the Caribbean in the Context of Introducing New and Underutilized Vaccines, in Protecting the Health of the Americas: from Child to Family Immunization, Abstract Book of the 17th Technical Advisory Group Meeting on Vaccine-Preventable Diseases 41 (Pan American Health Organization ed., 2006), http://www.paho.org/English/AD/FCH/IM/EPI_Tag.htm.

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13 Id.

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15 Alba M. Ropero, The Status of Influenza Vaccine Use: Regional Perspective and Preparedness Planning, Presentation at the 25th Caribbean EPI Managers’ Meeting (Nov. 17-21, 2008).

16 Jon K. Andrus & John W. Fitzsimmons, Introduction of New and Underutilized Vaccines: Sustaining Access, Disease Control, and Infrastructure Development, 2 PLoS Med. 939, 940 (2005).

17 Immunization Newsletter, Pan American Health Organization (Pan American Health Organization, Washington, D.C.), Apr. 2006, at 5-6 (analyzing vaccine-related legislation in the Americas).

18 Immunization Newsletter, Pan American Health Organization (Pan American Health Organization, Washington, D.C.), Aug. 2008, at 1-2 (analyzing vaccine laws in the Americas, pertaining to achieving equity and access for all).

19 Gina Tambin, Jon K. Andrus, John W. Fitzsimmons & Mirta Roses Periago, Regional Immunization Programs as a Model for Strengthening Cooperation among Nations, 20 Pan. Am. J. Pub. Health 54, 54-59 (2006).

20 Id.

21 Id.

22 Id.

23 A. Martin et al., Tropical Infectious Diseases: Principles, Pathogens, & Practice 797-812 (Richard Guerrant et al. eds., 2nd ed. 2006) (1999).

24 Pan American Health Organization, Control of Yellow Fever: Field Guide (2005), http://www.paho.org/English/AD/FCH/IM/Fieldguide_index.htm.

25 Expanded Program on Immunization in the Americas, EPI Newsletter (Pan American Health Organization, Washington, D.C.), Aug. 1992, at 6, available at http://www.paho.org/english/ad/fch/im/sne1404.pdf.

26 Id.

27 Jon K. Andrus, The Elimination of Neonatal Tetanus in the Americas, Presentation to the 26th Meeting of the Technical Advisory Group on Vaccine-preventable Diseases (Nov. 2004), available at www.paho.org/immunization.

28 Tambini, supra note 19, at 54-59.

29 Jon K. Andrus et al., Human Papillomavirus Vaccine Policy and Delivery in Latin America and the Caribbean, 26S Vaccine L80, L80-L87 (2008).

30 J. Ferlay et al., Globocan 1: Cancer Incidence and Mortality Worldwide (IARC CD-Rom, 2004).

31 Id.

32 Id.

33 Andrus, supra note 29, at L80-L87.

34 Jon K. Andrus et al., A Model for Enhancing Evidence-based Capacity to Make Informed Policy Decisions on the Introduction of New Vaccines in the Americas: PAHO's ProVac Initiative, 122 Pub. Health Rep. 811 (2007).

35 Silvana Luciani & Jon K. Andrus, A Pan American Health Organization Strategy for Cervical Cancer Prevention and Control in Latin America and the Caribbean, 16 Reprod. Health Matters 59, 59-66 (2008).

36 Jon K. Andrus, John W. Fitzsimmons et al., The Revolving Fund of PAHO: Sustaining immunization programs of the Latin America and the Caribbean in Vaccines, Sera, and Immunizations in Brazil 405-11 (Paulo M. Buss, José G. Temporão, José da Rocha Carvalhiero eds., 2005).