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Nature Magazine on Public Private Partnerships

June 23, 2005
NatureNature Magazine looks at the way that public private partnerships are contributing to the development and use of vaccines in developing countries.
"Unless we develop a step-by-step program to understanding the disease burdens and the benefits of vaccination programs, we're going to get less-than-optimal results," says Adel Mahmoud, president of Merck & Co.'s vaccine division. More information could help fix the perpetually fractured cycle of supply and demand, which has long stymied the availability of new vaccines. For decades, UNICEF and others estimated need simply by counting the number of children who could be immunized. But that practice could inflate the demand by more than 50% and, if the medicine went unused, leave manufacturers with sizable losses. This inability to accurately predict global demand prompted producers to vastly limit their production quantities. Curtailed supply then kept prices inflated, which further discouraged the countries from committing to the vaccines. "You may talk about demand -- but if there's no assurance that the product will be purchased, then that demand is only theoretical," says Mahmoud. "The difficulty has always been, how can a company like Merck assist the demand of the global marketplace and be assured of getting a fair return on our investment?"

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