Person:

McNair, Sarah

Throughout history, wherever militaries have moved, camped and fought, in peacetime as well as war, disease has followed. Over the past several centuries, as expeditionary movements have become more widespread, the threat infectious disease has posed to military strength has become correspondingly broader. For this reason, the U.S military has long implemented measures to protect the health of its troops; over the past century or so, this has meant research programs intended to develop and test prophylaxis and therapies for the many infectious threats faced by troops. Despite relatively limited resources and funding, the military has achieved ample success, particularly in the realm of vaccine development, which is for obvious reasons the ideal approach to handling disease risk in a large, vulnerable population.

Because of the expeditionary history of the U.S. military, the diseases of interest to military doctors and researchers are often those of interest in the developing world; to this day, diseases prevalent in these areas remain either poorly understood, significantly under-funded, or lacking in effective treatments—often all three. Borne by mosquitoes and other vectors, non-potable water, and overcrowding, many of them are neglected by pharmaceutical companies—which lack a profit motive in poor countries—and by researchers in the areas most affected by them— who often lack the resources to investigate them. Since the 1940s, military researchers have worked closely with allied governments in a number of settings where these diseases are prevalent, from Egypt to Peru to Thailand and beyond. From collaborating on basic science research to conducting major clinical trials in local populations, these multi-national partnerships have been incredibly fruitful for U.S. military research; however, host nations have not always obtained the same benefit from collaborative research as the U.S. military. The mission of these combined research institutes and endeavors, which is unequivocally focused on research achievements for military ends, is one explanation for the disparity in outcomes; the U.S military process for technology production, which is in many ways fragmented and decentralized, is another. Distribution of vaccines within the free market has historically been an afterthought for military researchers, and sometimes barely a thought at all, much to the detriment of the military’s research partners and sometimes to the military itself.

This paper will investigate the history of U.S. military vaccine development, and the current process and projects. It will explore several case studies that provide a glimpse of those very processes and projects as they unfolded, focusing specifically on the outcome for our military and research partners. And it will present the basics of how the world of public health looks at vaccine accessibility in the developing world. Using this background, I will look to assess the U.S. military process of vaccine development and provide recommendations about how it might be improved to be more equitable to partners, changes that may even be strategically advantageous.