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[NEW DELHI] Vaccines against common diseases are still not reaching the poor despite new collaborations with drug companies and injections of donor funding, according to a report.

Although plenty of vaccines are being developed, their deployment in the developing world is lagging, said international charities Médecins Sans Frontières (MSF) and Oxfam International, which released the report this month (11 May).

The report, which MSF says marks its move into 'access to vaccines' advocacy, said inaccessible vaccines include those against rotavirus, which kills nearly 600,000 children every year in developing countries, and pneumococcal disease — a bacterial infection that claims more than 1.6 million lives a year.

Emerging developing countries that provide cheap generic drugs, such as Brazil, China and India, could drive down the price of newer vaccines and break the monopoly of a handful of drug companies, said the report.

But although these countries are investing more in research and development (R&D) — which is closing the technology gap — their capability still does not match that of multinational companies, especially in the early stages of R&D, said the report. This slows down or even prevents the development of generic and new vaccines.

Although these countries are cheaply producing generic versions of older vaccines, for example, against polio, measles and hepatitis B; they lack the skills for more the complex procedures and the larger number of quality control steps needed to develop newer, more complex vaccines, such as those against pneumococcal meningitis — a bacterial infection of the brain.

The report calls for new ideas on research collaborations that could help bridge this vaccine technology gap between emerging developing countries and multinational firms.

"There is a great opportunity to exploit and expand developing country capacity to develop needed vaccines," the report says. Rebuilding public sector capacity to develop and test needed vaccines may be an important element of a public health strategy.

It also highlights alternative models of research collaboration to provide cheaper vaccines. For example, the US National Institutes of Health licensed its meningitis vaccine technology to the Serum Institute of India, Mumbai, which agreed to make the vaccine at no more than 50 US cents a dose under a Meningitis Vaccine Project.

"The Serum Institute model is a very interesting way to delink the cost of R&D with the cost of the final product," Leena Menghaney, project manager of the MSF Campaign for Access to Essential Medicines in Indiatold SciDev.Net. "It is a good illustration of how to develop affordable vaccines."

Other options for better access to newer vaccines include a pooled procurement mechanism; regional exports by government-owned producers such as Brazil's Bio-Manguinhos, and tiered pricing acceptable to middle-income countries.