An innovative financial mechanism designed to boost the development and distribution of vaccines in the developing world is set to launch next year, after publication of an expert report this month on how it will work.
Under the advance market commitment scheme, donor countries promise to buy specified vaccines from the companies that develop them for use in poor countries, which guarantees firms a market for their products.
The first advance market commitment set to be formally approved in June by donors that are contributing $1.5bn (£750m; €960m) is designed to stimulate the production and supply of vaccines for pneumococcal disease, which is estimated to kill 1.6 million people a year.
Pneumococcal vaccines already exist in richer countries, but their price and the different nature of the disease in other parts of the world mean that they are not used elsewhere.
The new mechanism is designed to push experimental products for which the commercial market is limited through the costly development process.
The donors—Italy, the United Kingdom, Canada, Russia, Norway, and the Bill and Melinda Gates Foundation—will provide money that guarantees an adequate return for commercial producers of vaccines. Their financial support will be supplemented by increasing support from the poorer countries that use the vaccine in the decade of the mechanism’s duration.
In exchange for a guaranteed market that offers a considerable volume of sales, vaccine developers will have to invest not only to bring their products through regulatory approval to market but also in sufficient manufacturing capacity to ensure that they can supply large quantities.
The final price is yet to be determined, but early estimates indicated that the vaccine would initially be purchased at $5-$7 a dose, declining in time to a maximum of $2-$3.
The revised mechanism tackles previous concerns, including a provision to ensure that the first developer of a vaccine does not earn all the money. Rival vaccine developers that offer a more effective or cheaper version can also subsequently compete for contracts, and developing countries will be able to switch supplier after a time lag.
GlaxoSmithKline and Wyeth are the most likely beneficiaries, although others, including some developers from India, are also at work on vaccines.
If the mechanism, set to start in the first half of 2009, is successful in supplying pneumococcal vaccine, the existing donors and new ones, including the United States, Spain, and Ireland, have expressed interest in new schemes. Likely candidates include vaccines for malaria and tuberculosis.
All three such diseases have vaccines in advanced stages of development. A future challenge is how effective advance market commitment schemes will be in stimulating much earlier stage research into vaccines for other diseases for which the scientific challenges are still greater.
Advanced Market Commitment For Pneumococcal Vaccines: Expert Group Report is at www.vaccineamc.org.