The Global Alliance for Vaccines and Immunization's "Advance Market Commitment" policy: a new incentive for developing market vaccines?

Abstract

The existing health gap between developed and developing countries is considered by the international development community to be in a disequilibrium. Only 10 percent of the current global funding is spent on undertaking research on diseases that burden 90 percent of the world's population. The private sector has blamed this on low returns on investment, market failure and poor distribution of medicines which indicates a lack of interest in developing vaccines for developing countries. However since the late 1990s the international development community began to encourage more active cooperation between the private and public sector in the form of public-private partnerships. In 2000, a public-private partnership known as the Global Alliance of Vaccines and Immunization (GAVI Alliance) was launched in response to deteriorating immunization coverage in developing countries. Since the launch, the GAVI Alliance has been mobilizing funds from private and public donors and engaging United Nations agencies in partnership with pharmaceutical companies. In 2005 under the GAVI Alliance supervision, a new initiative known as the Advance Market Commitment (AMC) started an innovative financing (cash prize) model for incentivizing a new vaccine research and development. Although the AMC approach may seem innovative, scepticism remains as to whether it is having an incentivizing effect for the pharmaceutical research and development in developing countries. This study will examine the landscape of vaccine procurement, public-private partnerships, the creation of the GAVI Alliance and the rationale behind the AMC. In addition the paper will explore the capacity and potential of the GAVI Alliance and the AMC as a public-private partnership initiative to procure and incentivize the development of pneumococcal vaccines. This study examines external literature around the GAVI Alliance and the AMC and also internal documents published by the GAVI Alliance on the pneumococcal AMC. The study concludes that the pneumococcal AMC has brought together two particular pharmaceutical companies but questions the true motive behind it. An obvious shortcoming of a study like this relates to timelines because the pneumococcal AMC is a long term initiative (10-20 year program) and vaccines are just being procured after five years of preparation. Nevertheless, this study offers some insights into the nature of public-private partnership such as the GAVI Alliance pneumococcal AMC initiative, and how well they deal with the lack of affordable vaccines in needy developing countries.