Live 8 Plus 1

Saturday, July 15, 2006

ONE YEAR ago, the Group of Eight summit in Britain took place against a background of Live 8 concerts demanding greater action against poverty. The summiteers have since delivered most of what they promised on debt relief, little of what they promised on expanding foreign aid and nothing of what they promised on global trade talks. At this year's G-8 gathering in Russia this weekend, the rich world's leaders may make a last-ditch effort to revive the faltering Doha trade round. But they should also remember past promises on global health, which could use more energetic backing.

One successful legacy of last year is the upgrading of global purchasing of vaccines. Traditionally, donors' willingness to buy vaccines has been hostage to shifting development fads, dampening incentives for pharmaceutical firms to invest in production facilities. The Bill & Melinda Gates Foundation made a start on fixing that problem by injecting $1.5 billion into a purchasing fund, enough to create steady purchasing power and to draw vaccine makers into the market. The G-8 summit built on this achievement in two ways. It called for donor governments to make long-term commitments to the purchasing fund, enabling it to plan future procurement. And it gave the purchase fund the ability to borrow in the capital markets, so that procurement could be front-loaded and irregularities in aid flows could be smoothed out. France, Italy, Norway, Sweden, Spain, Britain, Brazil and South Africa have since come through with long-term commitments. The purchasing fund is expected to issue its first bonds later this year.

This strengthening of incentives to manufacture vaccines must be followed by stronger incentives to develop new ones. Last year's summit aired an elegant idea to have donors commit in advance to buying certain new vaccines if private firms bring them to market. Donors would express a desire for a medical innovation -- for example, a vaccine for malaria -- and promise to buy a set number of doses at a set price, thus creating a financial carrot for pharmaceutical research establishments.

In April the G-8 finance ministers resolved to test the purchase-commitment idea on the pneumococcus virus, a cause of deadly pneumonia and meningitis. But the plan needs another push from this weekend's summit in Russia, and health officials don't seem confident about getting it. It is hard to think of a worthier experiment. Unlike most aid programs, advance purchase commitments cost nothing unless they succeed. And if they do succeed -- if they accelerate the development of vaccines for pneumonia and meningitis and later for malaria and AIDS -- they will be more than worth paying for.

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