Summary: A legacy of our generation

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This generation has a unique opportunity to leave a legacy of which we can be proud. Current and near-future scientific knowledge can be used to conquer diseases that kill millions of people each year and disable millions more. In the development of vaccines, in particular, scientific breakthroughs have the potential to transform the health of the developing world much as they have been instrumental in almost eliminating the burden of life-threatening infectious disease among children in affl uent nations. The most significant challenges are ahead: we have not yet developed effective vaccines against diseases of the poor, such as malaria, HIV and tuberculosis.

Governments and private foundations have made enormous strides in recent years toward establishing arrangements that will facilitate investment in R&D needed to develop new vaccines for these diseases. Now the resources and talent of the private sector are needed to translate those investments, and the scientific breakthroughs they are producing, into new vaccines, which once developed would be manufactured in adequate quantity. Unfortunately, the absence of an adequate market for those vaccines makes it impossible for the private sector to make investments in these diseases on a commercially viable basis.

We could make it worthwhile for the pharmaceutical industry to invest much more in R&D on vaccines for diseases occurring mainly in developing countries—and in the mass production of those vaccines when they have been developed. This can be done simply and cheaply by ensuring that there is a market for the vaccines if and when they become available.


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