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A P R I L 2 0 0 6 W W W . C A L N U R S E S . O R G C A L I F O R N I A N U R S E 17 Francis agrees that vaccines are not profitable because of the very nature of the drugs themselves. "From the drug manufacturers' point of view, the ideal drug is one that doesn't cure, is defective, in a sense, but good enough to keep taking for years." Vaccines, he says, are gen- erally given only once or twice. The global shortfall is also about haves and have-nots, illustrated by the Global Forum for Health Research's "10/90 gap:" 10 percent of the world's resources are directed at diseases that are responsible for 90 percent of the world's disease burden. Put another way, North America, Europe and Japan constitute 23 percent of the world's population, but account for 80 percent of the world's drug market. Only 0.3 percent of the money spent on medical research goes to malaria, unarguably the biggest killer on the planet. Sixteen times that amount goes into researching and treating dia- betes, a dangerous disease, but hardly comparable to malaria, as reported in the Independent. Poor countries fear that in the advent of a flu pandemic, wealthy countries will hoard any vaccines that are developed. Markos Kypri- anou, health and consumer protection minister for the European Union, recently called for "rich and powerful countries" to share vac- cines and antiviral drugs with "poor and affected ones," according to the Financial Times. Poverty and unequal access to health care, however, is not just a Third World problem. The United States is the wealthiest country in the world, but it is 29th in life expectancy and 38th in infant mortality. A child born in the Upper East Side of New York City has a 1-in-600 chance of dying before the age of one. A child born 20 blocks further uptown in Harlem has a 1-in-50 chance. As Hurricane Katrina demon- strated, the Third World can exist in the heart of the First World. And lastly there are politics. "We live in a world where people have decided that government doesn't have a role," says Robbins, something he thinks needs chang- ing. One suggestion he has is for the United Nations to establish a vaccine cartel. He understands the impulse behind PPPs, but doesn't believe they are the solution in the long run. "We have to rescue these dedicated scientists from a trap not of their own making." ■ Carl Bloice is a freelance writer based in San Francisco. Conn Hallinan is a foreign policy analyst for Foreign Policy in Focus and a Lecturer in Journal- ism at UC Santa Cruz. This article was reprinted from Revolution magazine. SOURCE: Division of Parasitic Diseases, Center for Disease Control & Prevention, 2005 NO MALARIA COUNTRIES WITH MALARIA RISK NOTE: THIS MAP SHOWS COUNTRIES WITH ENDEMIC MALARIA. IN MOST OF THESE COUNTRIES, MALARIA RISK IS LIMITED TO CERTAIN AREAS. MALARIA GENERALLY OCCURS IN AREAS WHERE ENVIRONMENTAL CONDITIONS ALLOW PARASITE MULTIPLICATION IN THE VECTOR. THUS, MALARIA IS USUALLY RESTRICTED TO TROPICAL AND SUBTROPICAL AREAS (SEE MAP) AND ALTITUDES BELOW 1,500 M. HOWEVER, THIS DISTRIBUTION MIGHT BE AFFECTED BY CLIMATIC CHANGES, ESPECIALLY GLOBAL WARMING, AND POPULATION MOVEMENTS. (DIVISION OF PARASITIC DISEASES, CDC, 2005) Malaria Endemic Countries, 2003