The Sabin Sustainable Immunization Financing (SIF) Program was on the agenda at a symposium hosted by the Penn Center for Vaccine Ethics and Policy. The event, “Global Vaccines 202X: Access, Equity, Ethics,” drew over 100 participants to The Franklin Institute Science Museum in Philadelphia, USA, on May 2-4, 2011.

The symposium addressed key ethical issues for the decade-plus ahead. What are the pharmaceutical industry and global partners doing to develop and make new vaccines available to all those who need them? Who are the stakeholders and how do they decide which vaccines a national immunization program offers? How will we ensure that children everywhere will always be immunized? Participants considered these and other issues, generating some useful insights that complement ongoing policy work for the Decade of Vaccines.

In my presentation, I focused on the ethics of dependency. At present, resource-poor countries must depend on richer countries for the needed technology and financing to fully immunize their children. The present equilibrium is saving lives but it is unstable and fraught with ethical dilemmas. In the absence of developed markets, true vaccine prices are unknown. Decisions to introduce new vaccines are often clientelistic, bypassing national institutions. Nor are recipient countries adequately investing in their immunization programs. At a higher equilibrium, every government will provide immunization as a public good. Vaccine costs will be considerably higher but they will be equitably shared. The ethical approach is to invest in the public institutions that will make this equilibrium shift happen.