Does neuroprotection improve stroke outcome?

conjugate vaccine to the South American market. This competition may be all that is required to bring the price there within reach. Policymakers should, however, be made aware of the high value of vaccination. Even if a new vaccine is considerably more costly, its costeffectiveness in a particular country may be almost unparalleled as a medical intervention. Sadly, even inexpensive routine childhood vaccines (eg, against diphtheria, tetanus, and pertussis) are affordable in some poorer African countries only because of the special arrangement whereby UNICEF, in collaboration with WHO, purchases high volumes at substantially reduced cost from non-US vaccine manufacturers that adopt a two-tiered pricing policy. Thus richer countries are effectively subsidising those less able to pay. Lately, US manufacturers have reportedly been taking steps to have some of their vaccines certified by WHO. Perhaps President Clinton’s recent catch-cry in Africa, “trade not aid”, can be reversed in respect of life-saving vaccines.