Developing Countries

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Status Brief


Developmental Milestones/Developments to Date:

Current Assessment/State of the Field:




Gerberding, Julie L., “SARS: How effective is the state and local response?“, Hearing before the Permanent Subcommittee on Investigations, May 2003, pgs 10-12.

  1. “As of May 2003 globally there was 7,700 cases of SARS and 643 deaths.
  2. “The epidemic in the United States was controlled by methods of isolation and quarantine.”
  3. “Furthermore active monitoring done by health officials on people exposed to SARS have been occurring in hospitals or at their homes.”
  4. “Communication has been critical at the local and state levels”
  5. “We have learned from SARS that the United States can respond quickly to define the virus, develop tests, and sequence it.”
  6. “The question is are we quick enough to contain it if we end up having a highly infectious person who sets off a cascade of transmission.”
  7. “Containment of SARS has been successful even in developing countries.”
  8. “The perceived weakest link is that SARS could spread so entire public health system needs to be strengthened.

Biosecurity, SARS, Quarantine


Editors, “International Health Regulations“, WHO, 2005, 2nd Edition.

  1. to provide support to developing countries and countries with economies in transition if they so request in the building, strengthening and maintenance of the public health capacities required under the International Health Regulations (2005)
  2. to collaborate with States Parties to the extent possible in the mobilization of financial resources to provide support to developing countries in building, strengthening and maintaining the capacities required under the International Health Regulations (2005)
  3. The Director-General shall select the members of the Review Committee on the basis of the principles of equitable geographical representation, gender balance, a balance of experts from developed and developing countries, representation of a diversity of scientific opinion, approaches and practical experience in various parts of the world, and an appropriate interdisciplinary balance.

Public Health, WHO, Developing Countries


Gorman, Brian, J., “Biosecurity and Secrecy Policy: Problems, Theory, and a Call for Executive Action,I/S, A Journal of Law and Policy 2, no. 1 (2006): 53-102.

  1. “For the first time since the formalization of information policy at the federal level, there is an opportunity to fashion a well reasoned solution to the growing dual use dilemma in life science research. This paper examines the biosecurity threat in the context of federal secrecy policy and dynamics of the information society. In the absence of a rich literature on secrecy theory, an attempt to examine the theoretical issues underlying aspects of federal secrecy policy is undertaken with particular emphasis on classic problems in secrecy policy.”
  2. “The duty to consider developing countries when assuming public health risks related to the public release of dual use biological research is introduced.”
  3. “It is also suggested that the Executive amend Export Administration Regulations in order to create a notice mechanism to enable national security vetting of U.S. research on select agents, toxins and microorganisms integrally related to pandemics and bioweapons.”

Information Policy, Open Science, Developing Countries


Forden, Geoffrey, “How the World’s Most Underdeveloped Nations Get the World’s Most Dangerous Weapons,” Technology and Culture, 2007, pp. 92-103.

  1. “Iraqi biological weapons administrative infrastructure relied on its own mytoxin experts, who encouraged first research and then production.”
  2. “According to the Iraq Survey Group’s ”Comprehensive Report”, the Iraqis began research on the powerful nerve agent VX in 1985 with a literature search for published work on its synthesis and production.”
  3. “In 1975, the Sunday Times of London revealed that the British patent office had, a number of years earlier, approved and published the formula and method of synthesis for a whole family of organophosphate chemicals, including VX.”
  4. “A machinist can just as easily learn to operate a flow-forming machine by making a tuba horn as a rocket nuzzle; a technician can learn to control a fermenter to brew a vaccine as well as a pathogen; producing a nerve agent is not so different from producing a pesticide. As such beneficial knowledge spreads–and no one would deny a developing country the right to produce vaccines or refine its own agricultural chemicals–it will become that much easier for proliferators to find the necessary population of skilled workers already within the country.” *”We still need our supply-side-oriented nonproliferation regimes to try to prevent crucial technologies from being shipped to countries that might abuse them.”

Tacit Knowledge, A.Q. Khan, Dual Use, Bioterrorism, WMD, Synthetic Biology, Open Science, Developing Countries


Oshitani, Hitoshi, Kamigaki, Taro, Suzuki, Akira, “Major Issues and Challenges of Influenza Pandemic Preparedness in Developing Countries.Emerg Infect Dis. 2008 June; 14(6): 875–880.

  1. ”Deaths attributable to an influenza pandemic could be substantially higher in developing countries than in industrialized countries. Pharmaceutical interventions such as vaccines and antiviral agents are less likely to be available in developing countries.”
  2. ” The most critical limiting factor for stockpiling of neuraminidase inhibitors in developing countries is their high cost. One treatment course of oseltamivir (i.e., 10 tablets) costs US $15, even at a discount rate (16), which is far too expensive for developing countries. Some industrialized countries have set a target to stockpile oseltamivir to treat 25% of the general population. To purchase adequate oseltamivir for 25% of the total population, only 0.11% of the total annual health expenditure is required in high-income countries. In low-income countries, however, the expense would be 12.9% of the annual expenditure (Table 1). Therefore, it is not feasible for low-income countries to allocate scarce resources to stockpile sufficient quantities of oseltamivir for an unpredictable influenza pandemic.”

Vaccination, Flu, Pandemic, Developing Countries


Poltzer, Patrice, “Tuberculosis: A New Pandemic?“, CNN, November 17, 2008.

  1. “TB mutating into dangerous new strains for which there is no known cure”
  2. XDR-TB = a drug-resistant TB, incurable, could lead to a pandemic, airborne disease,
  3. 40,000 new cases of XDR-TB each year – WHO
  4. disease primarily affects developing nations
  5. TB is curable but if drugs not administered or used, disease can mutate into strands like XDR
  6. strong link between TB and poverty

Developing Countries, Public Health, Vaccination, Pandemic, Tuberculosis


Verweij, Marcel, “Health Inequities In Times Of A Pandemic“, PUBLIC HEALTH ETHICS, Volume 2, Issue 3, pgs 207-209, 2009.

  1. people in low-income countries may have no access to vaccination despite being more vulnerable to the significant negative effects of H1N1
  2. “Australia, Canada, and the Netherlands expect to have sufficient vaccines to immunise the whole population”

Ethics, Flu, Pandemic, Vaccination, Public Health, Developing Countries


Adams, Vincanne, Le, Phuoc V., Erwin, Kathleen, “Public health works: Blood donation in urban China,” Social Science & Medicine 68 (2009) 410–418,

  1. “Recent shifts in the global health infrastructure warrant consideration of the value and effectiveness of national public health campaigns. These shifts include the globalization of pharmaceutical research, the rise of NGO-funded health interventions, and the rise of biosecurity models of international health. We argue that although these trends have arisen as worthwhile responses to actual health needs, it is important to remember the key role that public health campaigns can play in the promotion of national health, especially in developing nations…. , we argue that there is an important role for strong national public health programs. We also identify the key factors that enabled China’s response to this bourgeoning epidemic to be, in the end, largely successful.”

Developing Countries, China


Ryerson-Cruz, Geraldine, “As Flu Pandemic Declared, Leaders Must Focus On Poor Countries To Avert Bleaker Picture“, WORLDVISION.ORG, June 11, 2009.

  1. Africa and Central America
  2. “With limited access to health services, extreme poverty, high malnutrition rates, and the slower-burning pandemics of HIV and AIDS, tuberculosis, and malaria already stretching society’s coping mechanisms, the poor are more at risk than the general population,” said Stefan Germann, World Vision International’s Geneva-based director for global health partnerships.

Flu, Pandemic, Public Health, Developing Countries


Yamada, Tadataka, “Poverty, Wealth, and Access to Pandemic Influenza Vaccines“, THE NEW ENGLAND JOURNAL OF MEDICINE. September 17, 2009. Volume 361, Number 12, pgs. 1129-1131.,

  1. do developing countries have the manufacturing capacity, cost, and delivery systems and resources available to get vaccines?
  2. only a few countries in the world have plants for manufacturing influenza vaccine and 3 companies account for most of the world’s manufacturing capacity: GlaxoKlineSmith, Sanofi-Aventis, and Novartis.
  3. problem- “much if not most of the manufacturing capacity is already spoken for through purchasing contracts held by many of the world’s wealthy countries.”
  4. steps to ensure global community has vaccinations: identify strategies and mechanisms to make vaccines more accessible

Flu, Pandemic, Vaccination, Public Health, Ethics, Developing Countries


Editors, “Swine Flu Pandemic Will Reveal 21st Century’s Poverty Pandemic“, GLOBAL HEALTH POLICY AT NYU-WAGNER, Sept 27, 2009.

  1. historically influenza not an “equal opportunity” disease
  2. “people with coexisting conditions are more susceptible to poor health outcomes” and “most developng countries have high incidence of malnourished children and adults with many coexisting medical conditions.”
  3. socioeconomic factors- “poor resources for clean water and sanitation, no health care system or inadequate resources to seek medical attention”

Flu, Pandemic, Vaccination, Public Health, Ethics, Developing Countries


McNeil, Donald, G., “Nation Is Facing Vaccine Shortage For Seasonal Flu: An Increase in Demand,” NYT, A1, Nov. 5, 2009.

  1. “The current problems began years ago, experts said, when vaccine companies started abandoning the American market. Vaccines, which involve living viruses, are much harder to make than most drugs. Profits are lower and unused flu vaccine expires after a few months. Also, vaccines are primarily intended for children, and Americans frequently sue when a child is injured.”
  2. “Little was done to lure companies back until bioterrorism fears emerged after the anthrax attacks of 2001 and H5N1 avian flu virus, which kills about 60 percent of humans infected with it, emerged in 2003, Dr. Fauci said.”
  3. “The drawback of relying on foreign plants was made clear recently when the Australian government pressured CSL to keep its vaccine at home instead of fulfilling its contract for 36 million doses of swine flu vaccine for the United States.”
  4. “Although the government itself ordered and paid for all this year’s swine flu vaccine, about 90 percent of each year’s seasonal vaccine is made for the private sector.”
  5. “They [vaccine makers] are under pressure to make more to donate or sell to the World health Organization. Even optimistic predictions say the world’s poorest countries will get only 10 percent of the vaccine they need by winter’s end.”

Vaccination, Flu, Australia, WHO, Developing Countries


Brown, Matthew Hay, “Hopkins and Catholic Group to Shield World Against Malaria,Baltimore Sun, p. 1, Nov. 6, 2009.

  1. “two Baltimore institutions tapped for a five-year; $100 million project to help combat the mosquito borne disease. the school will work with Catholic Relief Services.”
  2. “[Malaria] kills up to 3 million people a year, the great majority of them in Africa, and most of them children under 5 years old. The disease can cause brain damage or cognitive and learning deficiencies in children, according to the Global Program on malaria, and can account for up to 40 percent of a country’s health expenitutres.”
  3. “Particularly labor-intensive are plans to design individualized programs on a country-by-country basis, for greatest efficiency and impact.”

Malaria, Developing Countries, Africa, Public Health


McNeill, Donald, “Ally for the Poor in an Unlikely Corner,” NYT, February 9, 2010.

  1. “Last year, in a speech to Harvard medical students, Mr. Witty promised to keep the prices of all Glaxo drugs in poor countries to no more than 25 percent of what was charged in rich ones, and to donate one-fifth of all profits made in poor countries toward building their health systems.”
  2. “Last year, in a speech to Harvard medical students, Mr. Witty promised to keep the prices of all Glaxo drugs in poor countries to no more than 25 percent of what was charged in rich ones, and to donate one-fifth of all profits made in poor countries toward building their health systems.”
  3. “‘If they were seriously interested in patent pools.’ Mr. Berman said, echoing a criticism voiced by Oxfam as well, ‘they’d try out the Unitaid one.’ (Unitaid, a European agency using an airline ticket tax to buy drugs for poor countries, has offered to oversee a pool of patents on AIDS drugs so new combination pills can be made cheaply.)”

Pharma, Developing Countries


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