From the Editor in Chief: A Shot In The Arm

The approvals of two groundbreaking vaccines in the last month is encouraging news. Vaccines have long been undervalued because they haven't been as profitable as other pharmaceuticals. So it's good to see them getting deserved attention that goes beyond fears of flu outbreaks.

Zostavax, for shingles, is unusual in that it is designed to prevent reemergence of an infection, rather than to prevent the initial infection. Gardasil, for cervical cancer and genital warts, is noteworthy because it is only the second vaccine designed to prevent cancer by avoiding viral infection (the other is for hepatitis B). One can start to envision the development of more such prophylactic cancer vaccines. Perhaps one day we'll not only cure cancer, but prevent it.

Laura Bush

It's also intriguing that both Zostavax and Gardasil are designed to prevent disease in adults, whereas traditionally, vaccines have been used mainly to protect infants.

And other progress continues: the week we went to press, we learned that researchers at St. Jude's in Memphis used reverse genetics to create new vaccine for avian flu, which offers new hope for a quick response in the event of an outbreak. And GlaxoSmithKline was reported to be planning its first vaccine manufacturing plant in Singapore, set to be operational in 2010.

Yet these scientific achievements highlight the lingering hurdles in broadening access to healthcare. Gardasil's greatest need is not in the developed world, where Pap tests prevent many cases of cervical cancer, but in the developing world, where most women cannot get such screening. Yet the high price of the vaccine ($360 for all three shots), will limit access for those who need it most, including the uninsured in this country.

Also troubling was the outcome of the June meeting of the G8, where the world's richest countries were unable to come to an agreement to fund research into vaccines for diseases afflicting the world's poor.

So the news about vaccines is encouraging, and a reminder of how far we have to go. For the first world, these developments offer hope, but people in poor countries still need a shot in the arm.