Gates Package — page 1024

business, industry, and markets, with if you factor in the cost of all the failures you'll have along the way: One widely cited but debated study on drugs (not vaccines) put the total figure at $2.6 billion.8 During an outbreak, vaccine companies also have to contend with high expectations from the public. People want to have a new vaccine that's safe and effective, they want it fast, and they want it to be cheap. Some have argued that vaccines should be free. I'm not defending every decision that a pharmaceutical company has ever made about pricing a product, and I'm not asking anyone to feel sorry for the industry. But if we're going to tap into their expertise in developing testing, and manufacturing drugs and vaccines--and there's no way to prevent or even stop pandemics unless we do--then we need to understand the challenges they face, the process they go through when they're deciding what products to work on, and the incentives that push those decisions in one direction or another. You may have noticed that I keep using words like business, industry, and markets, with the implication that much of the work on vaccines is done by private companies. That's intentional. Although nonprofits and governments have essential roles to play--funding basic research and deploying vaccines widely among them--the private sector is almost always responsible for the final stages of developing vaccines and manufacturing them at scale. This has important implications for our efforts to keep future outbreaks from going global. Remember that our goal is to have no more pandemics, so although we definitely need to be able to produce enough vaccines for everyone on the planet in case a disease goes global before we can contain it, we would rather keep a disease from turning into a pandemic in the first place. So we'll need vaccines for regional outbreaks, in which potential patients will number in the hundreds of thousands, rather than the millions or billions. This will change the pharmaceutical companies' incentives dramatically. Why spend all the effort and funding