I applaud Bill and Melinda Gates and their astounding donation to the Program for Appropriate Technology in Health (PATH). Having worked with PATH on contraceptive availability in Brazil and hepatitis B vaccine studies in Thailand while I was with the U.S. Agency for International Development (USAID), I am a big fan of both their remarkable vision and their continued commitment to bring innovative technologies to the developing world.

While a very large percentage of the Gates endowment will (and should) go to shore up existing immunization programs that are badly in need of funding, I would urge PATH to also take this extraordinary opportunity to address a related problem: the need to develop vaccines for diseases that are epidemic in the Third World but are not prevalent in the United States and therefore not economically viable investments for U.S. pharmaceutical companies. While the World Health Organization (WHO) and USAID have...

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