The global governance of communicable diseases: the case for vaccine R&D

Fighting communicable diseases such HIV/AIDS, tuberculosis (TB, and malaria has become a global endeavor, with international health authorities urging the development of effective vaccines for the eradication of these global pandemics. Yet, despite the acknowledged urgency, and given the feasibility of effective vaccine development, public and private research efforts have failed to address a response adequate to the magnitude of the crisis. Members of the academic community suggest bridging this gap by devising research pull mechanisms capable of stimulating private investments, confident that competition‐based market devices are more effective than public intervention in shaping scientific breakthroughs. With reference to the economics of innovation, the paper argues that, whilst such an approach would lead to a socially suboptimal production of knowledge, direct public intervention in vaccine R&D activities would represent a far more socially desirable policy option. In recognition of the current financial and political fatigue affecting the international community towards communicable disease control, the paper resorts to the theories of global public goods (GPGs) to provide governments, both in the North and in the South, with a powerful rationale for committing to a cooperative approach for vaccine R&D. The paper encourages the creation of a Global Health Research Fund to manage such exercise and proposes enshrining countries’ commitments into an International Health Treaty. The paper ends by providing a number of policy recommendations

Workforce Resources for Health in Developing Countries

With increased globalization and interdependence among countries, sustained health worker migration and the complex threats of rapidly spreading infectious diseases, as well as changing lifestyles, a strong health workforce is essential. Building the human resources for health should not only include healthcare professionals like physicians and nurses, but must take into consideration community health workers, mid-level workers and strengthened primary healthcare systems to increase coverage and address the basic health needs of societies. This is especially true in low and middle-income countries where healthcare access is a critical challenge. There is a global crisis in the health workforce, expressed in acute shortages and maldistribution of health workers, geographically and professionally. This massive global shortage, though imprecise quantitatively, is estimated at more than 4 million workers. To respond to this crisis, policies and actions are needed to address the dynamics of the health labour market and the production and management of the health workforce, and to strengthen the performance of existing health systems. Schools of public health need to develop the range of capacity and leadership in addition to the traditional training of healthcare managers and researchers. Countries should first identify their health problems in order to properly address their health worker needs, retention, recruitment and training, if they are to come close to reaching the Millennium Development Goals (MDGs) for health