creates indigenous capacity where none existed before. Technology transfer frequently involves partnerships between the public and private sectors—and these collaborations can cut across the boundaries of developed and developing nations. For example, with support from the public sector, U.S. vaccine and biotechnology companies may work with developing-country scientists to create products of potential interest to the developing world. At a point farther down the product-development pipeline, the private and public sectors can work together to transfer already proven production technology and expertise to developing-country manufacturers. Workshop participants discussed both of these approaches to technology transfer.

A member of the workshop with experience setting up agricultural research partnerships between U.S. industry and developing-country scientists stressed the importance of involving the U.S. private sector early on in such efforts. Industry is much less likely to stay engaged through the entire product-development cycle if it does not have a vested interest in the outcome from the start, this participant noted. Industry also is not likely to pursue technology transfer if there is little evidence of market opportunity for a potential product.

An essential outcome of research partnerships is a product that is affordable to purchasers in poor nations. This can be accomplished if profits from sales to the private sector in that country are used to offset lower-cost sales to the public sector. One U.S. agency involved in providing contraceptive technologies to the developing world requires its industry partners to sell products to the public sector in a developing country at a “preferential” price. (There are no restrictions on the sale price to private-sector customers.) At this agency, if a company given federal funds to develop a technology does not transfer it to the developing world, the firm must pass the product on to a firm that will.

Technology transfer can be fraught with difficulties. One common problem, according to a former developed-country vaccine company official who now advises developing-country vaccine makers, is excessively complex instrumentation. Often, such equipment, designed for developed-world settings, is unsuitable for developing-world applications, where water supplies may have significant impurities, there may be surges or breaks in electrical power, and sterile environments are difficult to maintain. (Indeed, noted one participant, if some of these fundamental problems cannot be resolved, the country may be better off buying the vaccine it needs from other sources.) In addition, much of the most sophisticated equipment is delivered without spare parts, is not supported by service contracts, and is accompanied by instructions that are nearly unintelligible, even for native English speakers (Box 6).

Good manufacturing practices guidelines and validation more appropriate to the needs and conditions of the developing world might alleviate some of these problems, according to the consultant. Also, at least for countries making any of the current EPI vaccines, the purchase of simpler manufacturing equipment should be encouraged. In addition, vaccine equipment manufacturers should be required to provide engineering follow-up for machines that they sell. No matter how simple and well supported a piece of equipment is, without someone



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