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The Journal of Health, Population and Nutrition
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ISSN: 1606-0997 EISSN: 1606-0997
Vol. 22, No. 3, 2004, pp. 223-231
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Bioline Code: hn04029
Full paper language: English
Document type: Research Article
Document available free of charge
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The Journal of Health, Population and Nutrition, Vol. 22, No. 3, 2004, pp. 223-231
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Translational Research to Assist Policy Decisions about Introducing New Vaccines in Developing Countries
Clemens, John D. & Jodar, Luis
Abstract
Few new-generation vaccines have found their way into public-health programmes for the poor in
developing countries, and for those that have, delays of years or even decades after their licensure and
introduction in industrialized countries have been the rule. Financial constraints and political obstacles
have played major roles in delaying the introduction of the vaccines. Also contributing to this situation
has been a dearth of needed research. While past analyses have identified inadequate support for conducting
Phase 1 studies as an obstacle, other types of translational research are also needed. Vaccines
may perform less well in impoverished populations in the developing world than in more affluent populations.
Consequently, Phase 2 and Phase 3 trials of new vaccines in developing countries are a second
essential type of translational research needed for the introduction of vaccines in developing countries.
Moreover, even for vaccines that have performed well in pre-licensure human trials in developing
countries, doubts often remain about whether the local disease burden justifies introduction of vaccine,
whether the vaccine will be cost-effective, and whether introduction of vaccine will be programmatically
feasible, acceptable, and financially sustainable. Because these residual doubts constitute obstacles
to the introduction of vaccine, a third type of translational research is needed to provide this evidence
required for policy. In this paper, these three types of translational research are illustrated with
projects being undertaken in the Diseases of the Most Impoverished Programme. The Programme is
conducting translational research to accelerate the rational introduction of new vaccines against
cholera, shigellosis, and typhoid fever in developing countries affected by these diseases.
Keywords
Vaccines; Vaccine development; Bacterial vaccines; Communicable diseases; Research; Developing countries
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