IAVI Report - March / April 2002
Emily Bass

It is 2007 and NewVaxCo, a hypothetical company, has just announced that its HIV vaccine proved highly effective in Phase III trials. The road to this great success has been bumpy: NewVaxCo spent grants and internal funds to develop the vaccine, and lost money along the way. In anticipation of public demand, it transferred intellectual property rights for the vaccine to four large developing countries—and is now worried about recouping its losses. More hurdles loom, including the time-consuming process of applying for separate licenses in countries around the world. And even though a tiered pricing scheme that charges poor countries much less than wealthy ones is in place, it still leaves the vaccine out of reach for many. What should NewVaxCo—and the world—do?

This scenario was the starting point for a workshop, entitled “Delivering an AIDS Vaccine,” attended by nearly 100 participants at the World Economic Forum (31 Jan - 5 Feb 2002). The session was the only disease-specific event at the five-day meeting that brought the well-known annual gathering of world leaders from its usual home in Davos, Switzerland to New York. (A well-attended discussion on global public health took place two days earlier). A background document, “Delivering an AIDS Vaccine: A Briefing Paper” (www.iavi.org/pdf/wef2002.pdf), prepared by IAVI in cooperation with the WEF, was distributed on the Internet and at the workshop. The session began with IAVI President Seth Berkley introducing the scenario, placing it in a broader context by noting that “an AIDS vaccine is not the only International Public Good we need. We need female-controlled microbicides, simpler diagnostics, better drugs. The principles discussed here can be used for these other public good approaches, as well as to help develop new tools for malaria, TB and other diseases of poverty.”

In addition to Berkley, discussion leaders included Gro Harlem Brundtland, (Director-General of the World Health Organization (WHO), Peter Piot (Executive Director, UNAIDS), Carol Bellamy (Executive Director, UNICEF), Jacques-François Martin (President of The Vaccine Fund), Chris Hentschel (CEO of Medicines for Malaria), Jose Serra (Minister of Health for Brazil), Kiran Mazumdar-Shaw (Chairman and Managing Director of Biocon, India), Gillian Gresak (Director of AIDSLink, South Africa), Pascoal Mocumbi (Prime Minister of Mozambique) and Hank McKinnell, Chairman and CEO of Pfizer.

The session’s participants were a mix of business leaders from the pharmaceutical, finance, media and mining sectors, among others. Working in small groups, discussants considered the scenario as it related to one of three topics: capacity-building, with a focus on local vaccine manufacturing; financial, legal, and tariff issues; and improving distribution and delivery systems. Following the small group discussions, there was a lively report-back session, with one of the tables inviting Brundtland—a rapporteur from another table—to be part of its proposed activist movement, which would march in the streets for an AIDS vaccine.

Overall, participants advocated coordinated activity across many sectors. Key issues for the proposed action agenda include technology transfer, regulatory reform, process development for manufacturing large amounts of vaccine, and building or enhancing basic healthcare infrastructure for vaccine delivery. At the core, they said, is the need to overhaul the usual “trickle-down” paradigm, in which developing countries receive vaccines long after they are licensed in rich countries.

To achieve this unprecedented goal, participants sketched possible new business models. Key components include: incentives and pricing mechanisms to increase private sector involvement in developing an AIDS vaccine; global harmonization of regulatory policies; and increased funding for projects that link health and development. They also emphasized the importance of approaching AIDS as a development issue requiring input from business, NGOs, philanthropic groups, UN agencies, governments and grass roots organizations.

To help move this agenda forward, the WEF Global Health Initiative and IAVI are adapting the workshop for use at WEF regional meetings in South Africa (5-7 June) and India (27-29 November) later in 2002. These meetings will highlight AIDS-related issues of importance to businesses in the developing world including workforce health and stability. Participants from these meetings will then convene at the 2003 global WEF meeting for a follow-up session to build on the accumulated momentum, and develop future activities.  •

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©2002. The IAVI Report.

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