AIDS Vaccines for All: Assuring Global Access "A vaccine that sits on the shelf is useless." Albert Sabin, developer of the oral polio vaccine IAVI believes that simultaneous access to AIDS vaccines in both North and South must be addressed before a vaccine is developed, so that there is no delay in providing it to those who need it most. If we act now, we will have policies and systems in place to quickly provide access to a vaccine once it is developed. If we wait until such a product is available before making concrete plans for its distribution, those in need will wait years, perhaps decades, before obtaining access. The greatest scientific triumph of our era might well turn into a humanitarian disaster. For all modern day vaccines, the path to market has been immediate availability in industrialized countries at high prices (to make back the R & D costs); only a decade or so later do relatively cheap versions of the product trickle into developing countries. This paradigm should be unacceptable for any vaccine, but especially for a vaccine against AIDS, which continues to ravage the developing world. AIDS Vaccines for the World: Preparing Now to Assure Access In July 2000 at the World AIDS Conference in Durban, South Africa IAVI released AIDS Vaccines for the World: Preparing Now to Assure Access. This blueprint calls for a global action plan for AIDS vaccine distribution that would assure timely use of preventive vaccines in all at-risk populations, regardless of where they are found. The blueprint terms the prevailing approach to the delivery of new vaccines "a colossal public health failure," and says that ensuring swift, equitable access to HIV/AIDS vaccines is a global moral and public health imperative - but one that will require radical changes in the global approach to vaccine production, licensure, pricing, purchasing, and distribution. AIDS Vaccines for the World outlines a five-step global action plan to ensure timely use of a preventive vaccine in all at-risk populations, regardless of where they are found. 1. Effective pricing and global financing mechanisms must be developed to ensure that vaccines are promptly available for use where they are needed. 2. Mechanisms must be developed to make reliable estimates of demand for specific vaccines and to ensure creation of production capacity to permit accelerated worldwide access. 3. Appropriate delivery systems, policies, and procedures must be developed for adolescents, sexually active adults, and other at-risk populations. 4. National regulations and international guidelines governing vaccine approval and use must be harmonized. 5. To demonstrate global commitment to effective worldwide deployment of important vaccines, immediate efforts should be undertaken to achieve maximum use in developing countries of one or more currently underutilized pediatric vaccines.