Abstract
Three million children die every year in poor countries from diseases that can be prevented by vaccination.1 Millions more die from diseases—like malaria and AIDS—that should be preventable by vaccines if they were developed. Unfortunately existing vaccines are not reaching these children because of failures in delivery systems, lack of resources, and the high price of some newer vaccines. Moreover, new vaccines may not be developed because private companies can't foresee a good return. The same story of huge need and market failure applies to drugs: of 1223 drugs developed between 1975 and 1997 only 11 were for tropical conditions.2 The problems seem huge. Yet there was an upbeat end to a meeting on the problem in Carmel, California, last month organised by the Institute of Global Health and the Global Forum for Health Research. The issue is rising up political agendas around the world, and new public-private partnerships are being devised to increase access to vaccines and drugs and develop new ones. Reducing deaths from communicable diseases would be a rich prize because these account for three quarters of the mortality gap between the rich and the poor world.1 Although the meeting ended optimistically, …

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