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12 C A L I F O R N I A N U R S E W W W . C A L N U R S E S . O R G A P R I L 2 0 0 6 D r. don francis' office is a museum of his fami- ly's long war with disease. His grandfather's and parents' medical degrees are next to a California State Legislative Resolu- tion thanking him for his "outstanding" service in the battle against AIDS. A small trophy from the Hemophilia/HIV Peer Association cel- ebrates him as a "Warrior for Justice," and a plaque on the wall thanks him for helping to eradicate smallpox in India. He has just returned from trying to beat back polio in the Indian state of Bihar, and he is preparing to leave for Africa. But if his office is crowded with laurels, the rest of his operations at Global Solutions for Infectious Disease (GSID), a nonprofit drug research and development firm in Brisbane, Calif., is a study in minimalism. The wall-to-wall carpet is rarely broken by furniture, and the place feels blank and cavernous. Asked why it looks so bare, development manager Ian Francis, a nephew, looks up from his laptop: "No money," he shrugs. Indeed, until recently, Francis and his partner paid the rent out of their own pockets, forgoing any salary. And while GSID has an AIDS vaccine ready to go into its final testing phase, it doesn't have the money to move it into the field. It is a bind Francis finds deeply aggravating. "Vac- cines have had the biggest impact on health of any prod- uct ever made," says Francis. "With biotechnology, we now have a revolution in our ability to make vaccines, but we are only beginning to take advantage of it because we don't value what they do." GSID's combination of veterans in the battle against humanity's great killers—malaria, AIDS, dysentery— and the organization's poverty and search for funding sums up the problem and the potential of medicine's new kid on the block, public-private partnerships (PPPs). Public-private partnerships are just that: They meld pharmaceutical companies, non-governmental organi- zations, charitable foundations, universities, and national and international institutions like the Center for Disease Control and the World Health Organization (WHO) into coalitions that form a nonprofit organiza- Must public health activists go begging for low-profit vaccines in a high-profit drug marketplace? A Work in Progress By Carl Bloice and Conn Hallinan