A Rationale for U.S. Participation in the CVI

called developing countries. Yet it has been demonstrated in many different settings that enhancing child survival leads to a decline, not an increase, in the birth rate. Families that can be assured that a child will survive are more likely to have fewer children.

Although most of the attention of the global Children's Vaccine Initiative (CVI) is focused on the needs of children in the developing world, most of the vaccines and technologies that will be developed are of importance to children in the United States. Vaccines that are effective in a single dose—either through enhanced immunogenicity or the use of technologies such as sustained release—will be of great value in the United States. The reemergence of a number of dangerous infectious diseases poses new challenges. New and more effective vaccines against pneumonias, measles, meningitis, and tuberculosis are needed in both the United States and developing countries.

By supporting global efforts at health promotion, an initiative like the CVI clearly has indirect economic benefits for the United States. There are direct benefits too. A significant number of scientists working on new and improved vaccines are based in the United States—in universities, in government laboratories, in biotechnology firms, and in vaccine manufacturing companies. Many of the world's most innovative vaccine manufacturers are U.S.-based. Thus, supporting the CVI will, to a large extent, support the U.S. scientific and biotechnology enterprise and can advance the development of vaccines for the public health needs in the United States. And investing in and supporting vaccine development and immunization programs will have guaranteed and lasting dividends to us all.



 This proposed mechanism resembles the defense procurement process. During the 1950s and 1960s, DOD procurement played a critical role in launching a number of small, start-up firms in the semiconductor and computer electronics industries. By providing large purchase orders to producers of semiconductors that met its specifications, the DOD enabled fledgling producers to expand their revenues. These producers would have found it more difficult to enter commercial markets for their devices, because these markets are associated with much higher marketing and distribution costs. Analyses of the semiconductor and other high-technology industries have argued that the effects of DOD procurement were more important than the effects of DOD research and development contracts on the entry and growth of new firms.


Institute of Medicine. 1992. Emerging Infections. Washington, D.C.: National Academy Press.

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