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CSU 59/2011: ARE ADVANCE MARKET COMMITMENTS WORKING?

Sunday, 20th of February 2011 Print

GAVI Chair Calls For Greater Reductions In Vaccine Prices For Developing Countries

From the Kaiser Daily Global Health Report

Tuesday, February 15, 2011

On Monday, the same day the GAVI Alliance helped oversee the roll out of a routine pneumococcal vaccine in Kenya, GAVI chairman Dagfinn Hoybraten highlighted the need for greater reductions in vaccine prices in developing countries during an interview with Reuters, the news service reports. The piece examines the funding mechanism in place to finance the pneumococcal vaccines, known as Advance Market Commitment (AMC), as well as the budget shortfall facing the group (Kelland, 2/14).

The AMC "has already earmarked $1.5bn from international donors, persuading two large producers [GlaxoSmithKline and Pfizer] to guarantee delivery of 300m doses of their pneumococcal vaccines, which were developed for rich countries, at a deep discount to western prices," the Financial Times writes. "Under the terms of the AMC, first discussed in 2006, GlaxoSmithKline and Pfizer commit to providing their competing vaccines Synflorix and Prevenar for an initial price of $7 per dose, falling later to a maximum of $3.50," the news service adds.

Though "[a]dvocates say the AMC is permitting rapid distribution of vaccines to those most in need, potentially saving 700,000 lives by 2015 by reducing pneumonia, one of the leading childhood killers," others are more critical of the price point, according to the Financial Times (Jack, 2/14). For instance, Medecins Sans Frontieres (MSF) has "criticized the AMC for providing just two major companies with a huge new market and paying them subsidies in return for securing lower prices," Reuters writes (2/14).

According to the Financial Times, "GSK said it was producing the vaccine at just above cost price, and that the AMC support had allowed it to build a $400m factory in Singapore to guarantee supplies and provide Synflorix at unprecedented speed to poor countries. It said they were not obliged to buy its vaccine, and nothing prevented rivals providing it more cheaply if they believed it possible." Donald Light of the University of Medicine & Dentistry of New Jersey; Kim Mulholland of the London School of Hygiene and Tropical Medicine; and Orin Levine, head of GAVI's PneumoAdip program are also quoted in the piece (2/14).

Though Hoybraten acknowledged criticisms over the AMC deal and noted GAVI continues to look for new ways to get a better vaccine deal in the future in his interview with Reuters, he "said GAVI would stick to its commitments under [the current] AMC deal," the news service writes (2/14).

The GAVI Alliance "needs an additional US$3.7 billion over the next five years to continue its support for immunisation in the world's poorest countries and introduce new and underused vaccines including the pneumococcal vaccine and the rotavirus vaccine which tackles diarrhoea – the second biggest killer of children under five," a press release by the group states (2/14).

Hoybraten, calling attention to the cost-effectiveness of vaccine programs, said he hopes GAVI's "pledging conference," scheduled for June, will motivate countries and other donors to help fill the organization's funding gap, Reuters continues. "Vaccines are really the best buy in global health at the moment ... and if you care at all about the lost lives, it's hard to see a better opportunity to do something about it," Hoybraten said.

Meanwhile, IRIN, also reporting on the pneumococcal vaccine program in Kenya, notes some of the challenges countries face when launching immunization campaigns. "The further we get from big cities, the more challenging the rollout is; the vaccine requires refrigeration and we have seen issues with the cold chain, for example, in areas where electricity is a problem," GAVI Alliance interim CEO Helen Evans said. "Access to families in remote areas can also be difficult," Evans added (2/14).

"The rapid roll-out of new-generation pneumococcal vaccine shows how innovation and technology can be harnessed, at affordable prices, to save lives in the developing world. The payback, as measured by reduced childhood mortality, will be enormous," WHO Director-General Margaret Chan said, according to a WHO press release. "Accelerating routine use of pneumococcal conjugate vaccines in developing countries can make a real difference in reducing child deaths and put priority countries closer to reaching Millennium Development Goal four, to reduce the under-five mortality rate by two-thirds between 1990 and 2015," the release states (2/14).

Nature News Explores Proposal For Public-Private Partnership To Speed Drug Development

"The early stages of drug development could be freed from the shackles of intellectual property under a proposal to be tabled at a meeting of leading pharmaceutical players [in Toronto] this week," Nature News writes in an article that outlines pieces of the proposal, as envisioned by Chas Bountra, head of the head of the Structural Genomics Consortium at the University of Oxford in the U.K.

Bounrta "envisions a global initiative worth about $200 million a year – half from private money and half from public and charitable sources – that would focus solely on new therapeutic targets," the publication writes. "The initiative would rush these through to phase II clinical trials – the stage at which drugs are given to larger groups of people, but before the huge phase III trials that represent a drug's final hurdle before reaching the market. … If drug candidates proved successful, they would then be made available for the initiative's commercial sponsors to buy and bring to market," according to the article.

The story describes how the initiative would aim to reduce duplication of drug development efforts and notes the growing trend of public-private partnerships to promote drug discovery. Bountra and Judy Slinn, a business historian at Oxford Brookes University in the U.K., are quoted in the piece (Cressey, 2/14).

The Kaiser Daily Global Health Policy Report is published by the Kaiser Family Foundation. © 2011 Henry J. Kaiser Family Foundation. All rights reserved.

 



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