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WASHINGTON -- A spat between the U.S. and France is blocking progress on a
novel, business-friendly plan to persuade drug companies to develop vaccines for
deadly diseases in the developing world.
Despite lobbying by the U.S., Italy and the United Kingdom, chances have
faded that President Bush and other leaders of the Group of Eight major powers
will endorse the proposal when they meet next weekend in St. Petersburg, Russia,
for their annual summit.
The proposal "is now in substantial danger of flopping even though there is
an extraordinary level of support among some key stakeholders," said one senior
official with direct knowledge of the G-8 vaccine discussions.
A summit-planning meeting last month ended with senior French and U.S.
officials in a heated exchange over the plan, in which the G-8 would guarantee a
market for pharmaceuticals companies that develop successful vaccines. France
refused to endorse the vaccine plan unless the U.S. backed a French proposal for
a new international airline-ticket tax to pay for aid to poor countries, and the
Bush administration refused to do so, according to the senior official.
Further complicating matters, Germany and Japan are reluctant to contribute
much money for the vaccine plan, called an advance market commitment.
The situation marks a sharp reversal for the initiative. The proposal
appeared to be on the fast track in February when G-8 finance ministers,
including then-Treasury Secretary John Snow, endorsed the idea. At that time,
the ministers expected to agree by April on a pilot project to tackle at least
one deadly infectious disease.
That meeting led to creation of a panel of experts, who recommended that the
first advance market commitment be used to promote development of a vaccine for
pneumococcal disease. According to the World Health Organization, the bacterial
infection killed 1.6 million people in 2002, 716,000 of them under the age of 5.
The panel suggested that the approach could help generate a vaccine for malaria,
which kills one million people a year, but predicted that it would take longer
than a pneumococcus vaccine.
G-8 officials say that drug companies, although initially skeptical, have
rallied behind the idea. "They're ready to give this a go," said the official
familiar with the G-8 discussions.
The plan aims to address a problem in global drug markets: The countries that
most need new treatments for diseases such as AIDS and tuberculosis are those
that can least afford to pay for them. An Italian Finance Ministry paper
concluded last year that poor financial prospects have made drug companies
reluctant to develop vaccines aimed at diseases found mostly in developing
nations.
Under the advance market commitment plan, the G-8 would guarantee a subsidy
-- valued at $800 million to $6 billion depending on the disease -- for any
company or companies that produce vaccines that meet agreed-upon
safety-and-efficacy standards. Once the donors spend that initial subsidy, the
pharmaceuticals companies would discount the vaccine sharply for
developing-world customers.
"All of the technical work that can be done on an abstract level has been
done," said Orin Levine, an epidemiologist who works on pneumococcus vaccines at
Johns Hopkins University in Baltimore. "It's time to just commit, to take that
step and move into the first stage, which is negotiating the first-ever advance
market commitment for a vaccine."
Wyeth, the Madison, N.J., pharmaceuticals company, makes a pneumococcus
vaccine, but it doesn't prevent infection by bacterial strains common to the
developing world, according to the Treasury Department, which has been helping
push the vaccine initiative. The company "has always been supportive of the
G-8's efforts around advanced market commitments for vaccine development," Wyeth
spokesman Christopher Garland said in a written comment.
Hopes that the G-8 leaders would push the plan in St. Petersburg have gone
astray at the negotiating table. The proposal is one of three major drug-finance
plans floating around the G-8. While the plans could complement each other, they
compete for the limited financial resources -- and political bragging rights.
U.K. Chancellor of the Exchequer Gordon Brown has championed what he calls
the International Finance Facility, in which the G-8 would issue bonds to raise
money to purchase drugs for poor nations. France, Italy and several other
nations have signed on, and the first series of bonds is expected to raise $4
billion in the next few months, according to a French government official. The
Bush administration has said the British plan doesn't fit with the U.S. system
of yearly budget appropriations.
France has lobbied hard for an airline-ticket tax to fund drug purchases. A
week ago, Paris took the lead by imposing a tax of £¿, or about $1.25, on
domestically purchased tickets for economy-class flights within Europe, as well
as a £¿0 levy on business- and first-class tickets. For flights outside Europe,
the tax rises as high as £¿0. The revenue will go for drugs to treat AIDS and
other illnesses in poor countries, according to a French official, who says 13
other countries have agreed to the tax plan.
At the summit-preparatory meeting last month, France argued that the G-8
should endorse its approach, provoking opposition from the U.S. and reluctance
from Japan on antitax grounds. The U.K. gave only tempered support for its
European Union partner. A U.K. Treasury spokesman said London would only go so
far as to divert some of its current ticket-tax revenue to the French effort; it
won't impose a new tax.
Failing to win support for the ticket tax, the French negotiator blocked the
advance-market-vaccine proposal from the G-8 leaders' statement being drafted
for the coming summit, according to the senior official.
The French government official played down the disagreement. "We're not
expecting to see the U.S. joining the air-ticket tax group on a short horizon --
maybe at a later stage," the official said. The ticket-tax plan does "not
require you to have everybody around the same table."
At the same time, Japan and Germany shied away from the vaccine plan because
of concern about the cost. "A number of other governments in the G-8 don't want
to pony up more money for something right now," said a senior U.S. Treasury
official.
Some G-8 officials expressed hope that wealthy nations would find a way to
launch an advance market commitment pilot by year's end. Other supporters of the
plan are worried it is being slowly derailed.
"I just think it's a tremendous opportunity, and it would be an absolute
shame to let the window pass without an announcement in St. Petersburg," said
Mr. Levine.