Page 469 - Binder2

A Global Standard for Immune Compatibility

Tolerogenic platforms can become the backbone of a new
biologic commons—shared technologies that nations can
adapt, manufacture, and distribute based on their own needs
and population profiles.

But for that to happen:

• Global regulators and procurement agencies
(like WHO, Gavi, and PAHO) must begin
evaluating biologics by durability and delivery
independence.
• Philanthropic capital must prioritize shelf-stable,
low-cost, tolerogenic therapies as a global public
good.
• Clinical trials in diverse geographies must track
ADA rates and SLOR across different HLA
haplotypes, nutrition baselines, and microbiomes.

Because if immune rejection is preventable—and we do
nothing to prevent it—we are not just failing scientifically.

We are failing ethically.

Durability as a Tool of Justice

In the world’s most fragile healthcare systems, the biologic
that works once and fades is not just ineffective—it’s cruel.
It gives hope, then withdraws it. It invites reliance, then
punishes it.

467