A social justice perspective on access to human rabies vaccines

Diorbhail Wentworth,Katie Hampson,Samuel M Thumbi,Athman Mwatondo,Gati Wambura,Nai Rui Chng

doi:10.1016/j.vaccine.2019.01.065

Abstract

Rabies kills tens of thousands of people every year despite being entirely vaccine preventable. Key global health actors have launched a country-driven plan to achieve zero human deaths from dog-mediated rabies by 2030 worldwide. This partnership has recently been strengthened by Gavi, the Vaccine Alliance’s decision to invest in human rabies vaccines for post-exposure prophylaxis (PEP). While nation states are key to rabies elimination, the importance of Gavi's role cannot be understated. Unlike any other actor, Gavi can directly address an otherwise intractable market failure in the inadequate supply of rabies PEP. In this commentary, we employ the Capabilities Approach to identify the barriers to PEP access that lead to this market failure and, as a result, unnecessary deaths and suffering. We show the role that Gavi can play in reducing exposure of PEP supply to market forces as a matter of social justice, and hence redress the inequity underlying human rabies deaths.

Highlights

Canine rabies kills tens of thousands of people every year despite being a disease that is entirely vaccine preventable, and one for which effective vaccines have existed for over a century [1]
We employ the Capabilities Approach to identify barriers to post-exposure prophylaxis (PEP) access that lead to this market failure and show the role that Gavi can play in reducing exposure of PEP supply to market forces
People in lowand middle-income countries (LMICs) have their capability to good health that is free from rabies constrained because of market and state failure to ensure PEP access

Summary

Introduction

Canine rabies kills tens of thousands of people every year despite being a disease that is entirely vaccine preventable, and one for which effective vaccines have existed for over a century [1]. Unlike any other global or state actor, Gavi can directly address an otherwise intractable market failure in the supply of PEP. We employ the Capabilities Approach to identify barriers to PEP access that lead to this market failure and show the role that Gavi can play in reducing exposure of PEP supply to market forces.

Results

Conclusion