Geneva June 12, 2009—A number of governments and the GAVI Alliance, a group of public and private stakeholders whose common goal is to spread childhood vaccination programs, have officially committed today to pay a set price for significant quantities of pneumococcal vaccines in a bid to speed up its roll-out in developing countries. The future of the scheme now depends on pharmaceutical companies choosing to participate. International medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warns that while the objective is laudable, the mechanism leaves significant challenges still unmet.
By contributing to the pneumococcal vaccine advance market commitment (pneumo-AMC) led by GAVI Alliance, donors aim to reduce the time lag between the release of a vaccine in wealthy countries and its roll-out in developing countries. Pneumococcal bacteria cause severe pneumonia and meningitis, killing between 700,000 and one million children each year. More than 90 percent of these deaths occur in developing countries.
“If the AMC works, it could get new vaccines to the poorest countries much faster,” says Dr. Tido von Schoen-Angerer, director of the MSF Campaign for Access to Essential Medicines. “The previous generation of pneumo-vaccine has been on the market since 2000 but is only reaching children in Africa this year, so there really was an urgent need for change.”
If companies do chose to collaborate in the scheme, the AMC would work by guaranteeing a set price of US$7 per dose in return for the manufacturers committing to producing sufficient quantities.
“But it is still impossible to say whether the pneumo-AMC will leave room for developing country suppliers, or whether the US$1.5 billion reward will all be swept up by the big players like GlaxoSmithKline and Wyeth,” says Laurent Gadot, a health economist with the MSF Campaign for Access to Essential Medicines. “And it’s only if developing country manufacturers enter the market that we can expect prices to come down to more affordable levels in the future.”
MSF is also concerned that although the AMC will boost access to the vaccine in the developing world, many developing countries are de facto excluded from the deal.
“The US$7 per dose price is limited to the poorest countries. Children in other developing countries like in Latin America will likely still go without the new vaccine,” says Dr. von Schoen-Angerer.
More research and development into vaccines is necessary to answer the needs of poor countries. But MSF does not think that an AMC, although it could create the conditions for the scaling up of production capacity, could trigger that innovation.
“There has been a lot of talk about AMCs as a tool to stimulate medical innovation. But this pneumo-AMC was not about innovation—only about creating incentives for increasing the production of a vaccine that was coming to the market anyway,” said Dr. von Schoen-Angerer. “AMCs cannot be touted as the answer to the lack of medical R&D into neglected diseases, and countries need to be very clear on this point before embarking on similar AMCs in the future.”
Contributors to the AMC are Italy, at US$635 million; the UK, at US$485 million; Canada, at US$200 million; Russia, at US$80 million; Norway, and the Gates Foundation at US$50 million each.