The global system for developing new vaccines against diseases that disproportionately kill and disable the world’s poorest people has become a victim of its own success. As the pace with which safe and effective vaccines against neglected tropical diseases are developed accelerates, the world is increasingly finding itself moving from a situation typified by low supply to one of dysfunctional demand. Safe and effective vaccines against chikungunya virus disease were approved in the last two years but remain largely undeployed despite a global epidemic. The governments where CHIKV levels its most significant toll have bigger and more expensive problems. At three hundred fifty dollars a dose, the vaccines are many times more than most victims of CHIKV make in a year and in some cases a decade. Thus, these vaccines that could save hundreds of lives, millions of dollars, and spare infants a fate of permanent blindness remains largely undistributed. Without changes, this appears to be the fate of emerging candidates against Lassa, Rift Valley Fever, and to some extent even characterizes the response to the mpox public health emergency. This Article analyzes this critical and growing problem in the global legal framework for vaccine access, including the inability of current global organizations to address it, and recommends measures to either fix the global vaccine infrastructure or establish an entirely new global procurement agency for vaccines against neglected tropical diseases.
Reforming the International Law and Organization of New Vaccines for the World’s Most Vulnerable People
7 May 2026