Origins of the Children's Vaccine Initiative: The intellectual foundations

The Children's Vaccine Initiative (CVI) was created as an attempt to revolutionize the way vaccines are developed for the developing world. It was formed, in part, out of optimism that the scientific advances of the biotechnology revolution could be harnessed to create new and improved vaccines, and in part out of fear that the health needs of the developing world would be ignored by the increasingly profit-oriented vaccine industry that gave low priority to countries lacking a hard currency market. The CVI was founded in 1990/1991 but its intellectual roots came out of ten years of discussion and agitation about the opportunities and dangers that faced the international health community. The article looks at the indispensable role played by pivotal individuals (William Foege of the Task Force for Child Survival, Kenneth Warren and Scott Halstead of the Rockefeller Foundation, James Grant and James Sherry of UNICEF and D. A. Henderson of Johns Hopkins University) without whom the CVI would not have come into existence. While these individuals worked within the confines created by the large social/economic/political changes that shaped the 1980s, their personal goals, often targeted at fairly limited objectives, were crucial in determining the final, rather unlikely, outcome. The role of both individual choice and serendipity in determining major policy decisions are often under-estimated in the social science literature.