Abstract:
Vaccines are one of the most valuable and cost-effective public health interventions. While children in high-income countries were routinely vaccinated against a range of diseases, governments in many low- and middle-income countries (LMICs) faced significant challenges to making vaccines accessible to their countries’ children. One of these challenges was maintaining the “cold chain” – that is, keeping vaccines at the temperature required to maintain their efficacy (between 2-8 degrees Celsius) through the long distribution path from manufacturer to recipient. Together with colleagues, Harvard Kennedy School graduate Livio Valenti had founded the start-up company Vaxess to develop a silk-based technology that was very promising for the heat-stabilization of vaccines. Vaxess’ goal was to facilitate vaccines reaching the poorest children, such as those who lived in rural areas of developing countries where refrigeration was scarce. Developing a biomedical technology from its early stages into a final product was already a lengthy and risky endeavor; doing so for a product with limited market potential could be more complex still. In principle, creating heat-stable vaccines could offer many benefits from eliminating the need for a cold chain: decreased distribution costs, reduced vaccine spoilage, improved immunization coverage and increased compliance with vaccination schedules. However, what had initially seemed like a straightforward scientific challenge to address a widely-shared goal, quickly revealed itself to be much more complex as Valenti began to navigate the complex global health ecosystem: vaccine industry stakeholders included pharmaceutical companies, charitable foundations, UN agencies, global health initiatives and the governments of LMIC countries. What did Vaxess need to do to move toward its goal?
Learning Objective:
This case examines the complex global system that shapes the process of technological innovation for public health and the barriers that arise between the invention of a potentially useful technology and achieving beneficial impact with that technology, especially for poor populations. Case discussions should focus on how a relatively small, new organization can navigate this complex landscape to achieve social impact, and the organizational strategies and public policies that are needed to overcome these barriers.
