Knowledge accumulation for vaccine innovation: Lessons from polio and HIV/AIDS
May 13 2009
Room 00-13, Ground Floor Chambers Building
ESRC Innogen Centre, The Open University, Walton Hall, Milton Keynes, MK7 6AA
Organised by: Innogen, Open University
Why are some vaccines developed quickly whilst others are not developed at all? A SARS vaccine was developed and tested within two years of the virus appearing in humans. In contrast, it has been nearly 30 years since HIV was discovered and, in 2007 alone, almost $1bn was invested in HIV vaccine R&D. Yet two thirds of leading HIV scientists do not think we will have a vaccine in the next ten years.
Explanations for this wide heterogeneity in vaccine innovation have focused on downstream issues. Economists have emphasised the concentrated demand for vaccine products, hostile legal environments, and the long and costly development times. Sociologists have highlighted anti-vaccination movements, delivery and access issues, and socio-political selection of vaccine products. But economic notions of market failure and sociological notions of neglected diseases are relatively silent on why HIV vaccine innovation is difficult.
An alternative analytical approach is to look further upstream in the innovation process to trace the unpredictable turns that characterise the evolution of knowledge, the historical circumstances in which certain research paths were taken, and others abandoned, and the local context in which technologies are developed. This paper provides an alternative explanation that builds on innovation theory, draws on vaccine history and is consistent with the HIV vaccine research record.
The paper argues that vaccine innovation requires technological knowledge; knowledge directed specifically towards technological ends. This knowledge cannot be obtained â€˜as-isâ€™ from scientific knowledge, but has to be specifically generated through its own dedicated and deliberate steps. The paper presents a process model, which focuses on the technical and institutional conditions that allow reliable technical knowledge to build up in a series of structured stages from the laboratory to the field. The paper contends that instrumentalities (instruments, skills and capabilities) are critical for allowing iteration between these stages; and the way instrumentalities are configured is structured by institutional set-ups. The resulting knowledge growth is cumulative and not fragmented.
By highlighting these components (intermediate conditions, instrumentalities, and institutions) in the cases of polio and HIV vaccine development efforts, the paper emerges with policy recommendations that complement, but are distinct from, those based on notions of market failure or poorly funded science. The case studies show that the accumulation of technological knowledge is a potentially fertile and largely unrecognised area for innovation policy.