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BOX A4-1

Possible Components of a Global Access Framework

  • Mechanisms to increase global vaccine and antiviral production capacities, both in aggregate terms and in geographical diversity;

  • Provisions to increase interpandemic demand for seasonal influenza vaccines and antivirals;

  • Means to improve preparedness and response capabilities (potentially through strategies that link up with implementation of the IHR 2005);

  • Approaches to stimulate research and development of new vaccine and antiviral manufacturing technologies and techniques and to improve other scientific knowledge (e.g., concerning use of adjuvants); and

  • Demarcation of clear “triggers” for preparedness and response actions in the pandemic alert system.


This paper has highlighted that calls for creating a global framework to increase equity, solidarity, and justice through improved access to vaccines and antivirals for poor countries face serious obstacles. In the context of the current “mild” H1N1 pandemic, the rhetoric of “equity, solidarity, and justice” is not necessarily very convincing with respect to this public health problem, especially when compared to other, more serious global health problems also plagued by health resources being allocated on the basis of ability to pay. Unfortunately, no good models, templates, or precedents for a global access framework exist in international law specific to health or in general international law on allocation and creation of resources. Political incentives not to create a global access framework are significant whether a pandemic threat is mild or severe. These sobering conclusions suggest that proponents of a global access framework, who draw on the harsh lessons of the 2009-H1N1 influenza A pandemic, need to devise a sophisticated political strategy, as well as an epidemiological one, to achieve this goal.


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Agence France-Presse. 2009 (October 29). Americans first before U.S. gives H1N1 flu vaccine, (accessed January 5, 2010).

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