Institute of Health & Wellbeing, College of Social Sciences, University of Glasgow, Glasgow G12 8QQ, UK.
Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK.
Vaccine. 2019 Oct 3;37 Suppl 1(Suppl 1):A3-A5. doi: 10.1016/j.vaccine.2019.01.065. Epub 2019 Mar 27.
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.
尽管狂犬病可以通过疫苗完全预防，但每年仍有数十万人因此死亡。关键的全球卫生行动者发起了一项由国家主导的计划，目标是到 2030 年在全球范围内实现犬介导的狂犬病导致的人类零死亡。这一伙伴关系最近得到了加强，疫苗联盟（Gavi）决定投资于人用狂犬病疫苗用于接触后预防（PEP）。虽然国家是消除狂犬病的关键，但不能低估 Gavi 作用的重要性。与任何其他行为者不同，Gavi 可以直接解决狂犬病 PEP 供应不足这一难以解决的市场失灵问题。在本评论中，我们采用能力方法来确定导致这一市场失灵以及因此导致不必要的死亡和痛苦的 PEP 获取障碍。我们展示了 Gavi 可以在减少 PEP 供应受到市场力量影响方面发挥的作用，这是一个社会正义问题，因此纠正了导致人类狂犬病死亡的不公平现象。
