Report

The first workshop, held in February 1997, set out to learn what has been done and what is needed for the public and private sectors to collaborate effectively and productively for the public's health. Emphasis was on cooperation in those product areas where returns from the market were too small or too complicated by other factors to compete in industry portfolios with other demands for investment. Quintessential examples of such products are vaccines, and in some instances, therapies for the diseases of children, for malaria, and for HIV/AIDS. Each of these offers lessons that can be applied to deal systematically with emerging infectious diseases.

In learning these lessons, the workshop recognized that while there are differences between the public health requirements of developing countries and industrialized countries, the growth of the middle class in the former and the vulnerability of the latter to diseases once thought to reside permanently 'offshore' are doing much to narrow those differences.

The workshop studied these issues in more detail through a primary case study of the Children's Vaccine Initiative (CVI), formally established in 1991 as the first comprehensive effort to yoke public- and private-sector scientific advances to a global public health priority through purposive intersectoral collaboration. The workshop integrated the lessons learned from the CVI with other experiences from disease-focused efforts, notably malaria and HIV/AIDS.

The purpose of the first workshop report was to combine the CVI experiences and the tasks the lessons suggest as points of reference for further action. The report focused on the issue of those constraints that have left undefined groups of 'urgently needed medical products in an orphaned condition which demands special attention.' The lessons learned fall into four sets of messages concerning: what makes intersectoral collaboration genuine, the notion of the product 'life cycle,' the implications of divergent sectoral mandates and notions of risk, and the roles of advocacy and public education.

These lessons, taken together, signal needs for: (1) more information, (2) more predictability, and (3) more sharing of costs and risks, if the requirements for products for emerging infectious diseases are to be satisfied. Looked at systematically across the product cycle, these sort into more specific categories where incentives might be developed to bolster the competitiveness of such public health products in industrial portfolios.

The report lays out these categories, highlighting actions expected to be especially critical for advancing the infectious disease enterprise as a whole.