NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Wednesday, April 27, 2016

Vaccines and antibiotics occupy a privileged position in the history of medicine. They are humanity’s “magic bullets” — categories of intervention so effective and easy to deliver that they have the capacity to single-handedly eradicate entire diseases from human history. But just as the heady utopia of an antibiotic age has given way to the cold, evolutionary reality of antibiotic resistance, we must now also confront the pervasive problem of vaccine failure in the global South.

Vaccines fail for many reasons. Years of effort have failed to deliver a vaccine for HIV. In many cases the best solution may simply be to focus resources on alternative therapies, much as antiretroviral drugs have reduced the burden of HIV in the absence of an effective vaccine.

What is more immediately concerning is the existence of vaccines that are known to be completely effective in industrialized nations, but that show reduced efficacy when introduced to impoverished communities in the global South.

Oral polio vaccine: Booster doses for the ultrapoor

The 20th century witnessed concerted humanitarian efforts to introduce polio vaccines to the poorest corners of the world, with the hope of eradicating the disease entirely. It was during these efforts that someone first observed reduced vaccine efficacy in ultrapoor communities.