BOOKS & ELECTRONIC MEDIA
The vaccine book
Richard T. Mahoney
Arizona State University, PO Box 874501, Tempe, AZ 85287, USA (email: richard.mahoney@asu.edu)
Editors: Barry Bloom, Paul-Henri Lambert
Publisher: Academic Press (Elsevier Press), New York; 2002
ISBN: 0-12-107258-4; hardback; 436 pages; price US$ 59.95
As pointed out by John D. Clemens & Hye-Won Koop in their chapter of this book entitled "Phase 3 studies of vaccines", the National Institutes of Health Jordan Report 2000: Accelerated Development of Vaccines documented approximately 350 vaccine candidates at some stage of research and development in 2000. A similar enumeration carried out a decade earlier came up with a total of about 170 candidates. Thus in 10 years we have seen a doubling in the number of possible new vaccines that could be introduced to control infectious diseases, cancers, allergies, and other human maladies.
This comprehensive book, consisting of 10 chapters written by leading experts in almost all facets of the vaccine research and development enterprise, should be a standard reference work for anyone from student to senior professional interested in the current challenges in and prospects for the science of vaccines. What becomes acutely clear from reading this volume edited by two of the world's most influential experts, Barry Bloom & Paul-Henri Lambert, is that the rate of progress in bringing new vaccines to the marketplace is frustratingly slow. Vaccines represent some of the most cost-effective interventions to improve human health on a global scale. Some of the most desperately needed vaccines such as those against human immunodeficiency virus (HIV), tuberculosis, and malaria seem yet distant hopes. Bloom & Lambert address this frustration directly in their closing chapter entitled "Future challenges for vaccines and immunization." They identify ten high priority challenges ranging from dealing with antigen diversity to public acceptance of vaccination. This book should be seen as a challenge to those concerned with public health, both in their own countries and worldwide, to increase the intensity of effort in vaccine research and development.
The recent new and greatly welcomed funding of vaccine research and development by the US National Institutes of Health, the Bill and Melinda Gates Foundation, and the European Union will help move the field forward more aggressively. But these new funds represent only a valuable down payment on the full investment that is required. For example, a proposal to establish an HIV vaccine enterprise with annual funding in the order of hundreds of millions of dollars is already on the table.
These are the kinds of funds that are both needed and justified by the opportunities described so well in The vaccine book. The book itself could serve as a potent tool to help justify substantial increases in funding for vaccine research and development. However, the vaccine community, itself, as pointed out in the chapters by Amie Batson, Sarah Glass & Erica Seiguer and by Kim Mulholland & Bjarn Bjorvatn, needs to effectively address a fundamental issue: the challenges to introducing a large number of additional vaccines to immunization programmes. The efforts of scientists and industrialists to bring vaccines through the research and development process and obtain licensure will require heroic efforts. However, the success of those efforts would represent only a portion of the monumental work that will be required. There will be the continuing need to buy and distribute those vaccines in both developed in developing countries to those individuals who need them. Particularly with respect to developing countries, there is a need to invest substantial resources now to develop comprehensive plans for the introduction and sustainable procurement and use of vaccines, especially those needed by the poor. In addition, an urgent challenge is to ensure the continued support for the Global Fund for Children's Vaccines. By sustaining the Global Fund, the world will be meeting a wonderful opportunity to improve human health. On the other hand, failure in this effort could very well substantially delay long-term success in the vaccine enterprise resulting in unnecessary death and disease. We should all agree that failure is not an option. 