Extending vaccines to the worlds poorest
–Joe Cerrell is director of Global Health Policy and Advocacy at the Bill & Melinda Gates foundation. He oversees the foundation’s global health communications, public policy, and international finance. The views expressed are his own. —
I recently took my three-year-old twin daughters to their annual doctor visit, where they received their latest round of routine vaccinations. Thanks to the miracle of vaccines, I know my daughters will be protected for life against measles, tetanus, and other diseases that were once serious threats. But incredibly, millions of children in poor countries still die from diseases that could easily be prevented with the effective, affordable vaccines that Americans take for granted.
Fortunately, that is starting to change. This week, a landmark report from the World Health Organization, UNICEF, and the World Bank concludes that a renewed global push on childhood immunization has raised the number of children vaccinated to an all-time high. The authors find that vaccines now save 2.5 million lives worldwide every year.
(Read related Reuters story: Global immunizations hit record but miss millions.)
As we continue expanding access to basic vaccines that have existed for decades, we also need to ensure that new vaccines quickly reach children in need. Typically, when new vaccines are invented, they don’t become available in poor countries until years, or even decades, after being introduced in the U.S. What’s more, effective vaccines don’t yet exist for some of the developing world’s biggest killers, like malaria and HIV.
This situation is a classic case of markets failing the world’s poorest people. Because poor countries have limited ability to pay, vaccine makers have little incentive to make the enormous investments required to develop and manufacture new vaccines for the developing world. So vaccines remain unavailable where they could save the most lives.
Now, innovative thinking on global markets promises to bring long-overdue change.
One of the most exciting new approaches takes aim at pneumococcal disease, a leading killer of children worldwide. While relatively unknown to Americans, pneumococcal disease causes the deaths of more than a million young children worldwide each year, 90 percent of them in developing countries.
If you’re an American parent like me, your kids are probably protected against pneumococcal disease by a vaccine called Prevnar, made by Wyeth. But this and other pneumococcal vaccines were designed for use in wealthy nations. They don’t protect against the types of the disease that are common in the developing world.
That is about to change thanks to a groundbreaking partnership launched with financial support from the governments of Italy, the UK, Canada, Norway, and Russia, along with the Bill & Melinda Gates Foundation. Known as the Advance Market Commitment, or AMC, the effort could save the lives of seven million children over the next 20 years.
The AMC applies a concept that is simple but had never been tried before. In essence, the six donors have made a promise: If vaccine makers develop and produce affordable pneumococcal vaccines designed specifically for poor countries, then the donors will buy them. By committing $1.5 billion, in advance, they’re helping to create a predictable market where none existed before. With the necessary incentives in place, vaccine makers can make the investments needed to develop the new vaccines and manufacture them on a large scale.
To qualify for the AMC, participating companies must make long-term, binding commitments to provide the new vaccines at affordable prices. Thanks to donor funding and the manufacturers’ pricing commitments, developing countries will be able to purchase the vaccines at guaranteed prices of no more than $3.50 per dose. The first of the new vaccines could become available as soon as 2010. Developing countries are already signing up to purchase them.
If the AMC for pneumococcal vaccines proves successful, a similar model could be used to quicken the development of other urgently needed drugs and vaccines, such as new vaccines against tuberculosis, the cause of some 1.8 million deaths worldwide each year.
The AMC is one of several new initiatives that are creatively using market principles to save lives in the developing world. For example, through a partnership launched earlier this year, donors are negotiating with manufacturers to dramatically reduce prices on the most effective drugs against malaria. By making these prices comparable with those of older, much less effective drugs, they hope to greatly increase the number of patients who are successfully treated. In another effort, the World Bank and donor governments have quickly raised billions of dollars for childhood immunization by issuing bonds in the global capital markets. The funding unlocked by these bonds could help to immunize 500 million children worldwide.
Vaccines are arguably humanity’s greatest scientific achievement, and have already saved countless lives over the last 50 years. Today, the AMC and other new approaches offer more ways to extend the benefits of vaccines to everyone in need. With millions of lives still at stake, it’s time to use them.