June 16, 2000

Last year the world's three deadliest infectious diseases - AIDS, tuberculosis and malaria - killed more than five million people.

Some 95 percent of the 33 million people worldwide infected with HIV live in developing countries, where AIDS has orphaned 11 million children and will orphan 40 million more by 2010. Tuberculosis will kill close to two million people this year alone. One person dies from malaria every 30 seconds.

Vaccines are the most cost-effective weapon in the arsenal of modern medicine to stop the spread of contagious diseases. Yet in a nation where drugs from Viagra to Prozac reap billions in profits, drug companies are not investing in such lifesaving vaccines. The World Bank estimates that worldwide AIDS vaccine research last year totaled roughly $300 million. Of this amount, less than $50 million came from private-sector research and development budgets. Fewer than 200 scientists in the private sector worldwide are dedicated to work related to AIDS vaccine; the numbers for malaria and tuberculosis even more dismal.

Amazingly, of the 1,200 new drugs commercialized between 1975 and 1997, only 13 were for tropical diseases, including malaria and tuberculosis.

Pharmaceutical companies invest little because they fear they will be unable to sell enough to cover the risk and expense. Malaria and tuberculosis, for example, hit the poor most cruelly in countries where public-sector health-care spending per capita is barely what it takes to pay for a cab ride from North Miami Beach to Miami International Airport.

The answer is not to decry the profit motive in a free-market system, nor should we allow the market to leave millions of human beings behind. We should explore new strategies to stimulate private-sector vaccine research.

It's time to pursue a comprehensive solution that harnesses market incentives to lower the cost of research and development and guarantees a market. We can do that with innovative legislative incentives - tax credits and purchase funds - that encourage the pharmaceutical and biotechnology sectors to engage in areas they previously have neglected.

The impact internationally would be significant if Congress increased the research-and-development tax credit for vaccines for AIDS and other global killers, provided a significant contribution to international vaccine purchasing programs, and contributed to global, nonprofit organizations that provide venture capital for industry research and development efforts.

Working to buoy other non-government organizations, Congress could enact "matching tax credits" that would double the purchasing power of nonprofit organizations buying vaccines for developing countries.

These financing mechanisms - relying on new public-private partnerships - are the most efficient means of addressing the world's health-care pandemic. It is critical that we embrace them immediately.

Our collective conscience will not permit us to turn our back on these diseases or dismiss their victims as casualties of the free market. Nor can we pretend that the United States can lead this effort on its own by simply dumping billions into new government bureaucracies. Creating the market incentives to encourage investment in vaccines may well yield high returns - and for the world's developing countries, especially sub-Saharan Africa, this investment may well be their only hope for survival.