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Vaccine Man

Chris Hartlove

Vaccine Man (con't)

Why not just go with the lowest bid you get from the manufacturers?

Well, there are two things. One is you get greater supply security when you have more than one supplier. When we have only one supplier and then suddenly something happens to their manufacturing plant, we’re totally without vaccine. The other is you put a ceiling on the price. I mean the AMC says we’ll buy these from you, but you will not ever charge more than $3.50 a dose to the poor countries that are going to buy this.

Is it better to give vaccines to developing countries free or charge a small amount?

I think people are surprised to hear it but one of the major groups that pushed GAVI to charge a small amount for vaccines was developing countries themselves. If you give vaccines to them for free, they say, sure we’ll take it but they won’t be invested in it. Even a small charge for vaccine means developing countries’ governments have skin in the game. That helps to improve sustainability. It says, “We’re invested in this. We value this.”

How will things be different with future vaccines like dengue or malaria?

When we have a strong immunization system that includes financing and delivery systems and surveillance and those kinds of things, you can draw in the innovations that are coming out of research and development and deliver them rapidly. Those are vaccines that we will be able to slip into existing programs.

PneumoADIP is winding down. So you founded IVAC to apply the same ideas to other vaccines?

Within a week of our announcement of IVAC in October 2009, the phone started ringing. All these people called to ask if we would work on dengue, or malaria, or flu. It was really kind of amazing.

What are you working on now?

We are continuing to see work on pneumococcal vaccines through and adding to that some work on other vaccines. One is a vaccine against rotavirus, which is the most important cause of fatal diarrhea worldwide. We expect rotavirus vaccines to be rolling out this year and next. Another is dengue. We’re excited because we’ve got a few years before dengue vaccines are expected to be licensed. We can start coordinating and lining up, and maybe if we’re successful, we can see the launch of these vaccines in the most affected populations first, not just the ones that can afford it. We’re also trying to figure out how to use technology to improve vaccine coverage—how to use cell phones to improve the timeliness and coverage of all vaccines. You can potentially use it to track the deliveries of vaccines to the clinics. On the demand side, you can send reminders to parents that it is time to come in or that there are vaccines in the clinics.

You really have to push to get the donors, manufacturers and others to get things done. Some researchers aren’t comfortable being seen as advocates.

When we get involved in advocacy, we start with the evidence. We think that evidence-based advocacy is important because we know it is not enough for public health to generate new evidence. That evidence has to lead to changes in political will and a whole bunch of other things. We know the people who know the evidence best should be in a position to advocate for it if the evidence says that intervention should be a priority.

You’re obviously busy, yet you make time to blog for The Huffington Post. Why?

I’m coming up on a year with Huff Post. I really like it. It’s been remarkably well picked up by big groups like the Gates Foundation, GAVI, Kaiser Family Foundation and daily digests of global health stuff—those reach the people I want to reach. The thing about a blog is, when it works, it starts a conversation that was not there before.

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