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Read this, and then also, follow the link. A friend of mine is examining Bill Gates' (and others') "philanthropy" and what it actually entails, and what it costs us.
And then, read this response from Frank:
I don't think you should combine the vaccine controversy with the education stuff, because the vaccine issue is a lot more arguable. The plan of trying to get people to invest more in vaccine technology by making vaccines more profitable to distribute is not secret, nor is it unambiguously bad. It isn't like the educational leveraged philanthropy, where people extracting money from the process leads to worse outcomes for everyone who matters. The vaccines do exactly the same thing and work exactly the same whether the price is high or low or negative. Just as they work exactly the same whether the price is paid by the families being protected, the states those families are citizens of, or private foundations.
And then, read this response from Frank:
I don't think you should combine the vaccine controversy with the education stuff, because the vaccine issue is a lot more arguable. The plan of trying to get people to invest more in vaccine technology by making vaccines more profitable to distribute is not secret, nor is it unambiguously bad. It isn't like the educational leveraged philanthropy, where people extracting money from the process leads to worse outcomes for everyone who matters. The vaccines do exactly the same thing and work exactly the same whether the price is high or low or negative. Just as they work exactly the same whether the price is paid by the families being protected, the states those families are citizens of, or private foundations.
The argument is really just a supply and demand argument that comes in two parts. The cheaper vaccines are, the easier it is to convince people and nation states to pony up for them and the lower infant mortality is. On the flip side, the less money is paid for vaccines, the less corporations invest in vaccine research and the less diseases we have vaccines for in the future.
Now *obviously* the best way to thread that needle is to get private research money out of vaccines entirely, have government agencies go the full Moon Shot on it with massive, *public* expenditures that are motivated by votes rather than expectations of future dollars, and then provide vaccines to the world for cost or less. That was the Smallpox plan, and it worked. It worked really well. Eradicating smallpox has saved more lives than there are currently people in the United States. And the actual cost was not large. Of course, variola had many things about it that made it a good candidate for eradication (hundreds of years of research, a lack of animal reservoirs, an incredibly deadly course that made it easy to convince people to subject themselves to voluntary vaccination), but similar programs could and should be mounted in the future.
But if you're relying on the private sector to research vaccines, as we apparently are, then I don't really see any alternative to what Gates has proposed. There is a pile of money that acts as price subsidies so that the money pharma corporations *receive* for their vaccines is larger than the amount individuals and countries *pay* for them. This encourages people to get vaccinated and encourages corporations to continue investing in future vaccines. I am really not sure what else philanthropic donations could possibly hope to accomplish on the world vaccination front. Maybe pay for direct research and hope it pans out?