Senior Fellow and Director for Europe Owen Barder is quoted in an article on Advanced Market Commitments (AMCs).
Kampala, Uganda: After nearly 25 years in development, the world’s most promising malaria vaccine disappointed. The results of Phase III clinical trials released in November showed the experimental malaria vaccine candidate, known as RTS,S, protected about one-third of infants between six and 12 weeks – failing the criteria set by the World Health Organization (WHO) to be deemed viable.
Nevertheless, with few other potential vaccines on the horizon, this set back could finally spur the public health donors to do something they have been failing to do for more than two decades: get more innovative in funding research and development.
That is what Advanced Market Commitments (AMCs), in contrast to traditional donor-subsidised efforts, were created to do. The idea behind AMCs is relatively straightforward: donors and developing countries put out a call for a vaccine. Ahead of any research, development or manufacturing, governments commit to buying a certain amount – with the cost heavily subsidised by donors – if the vaccine meets certain predetermined standards. That guarantees the pharmaceutical company a set market and a good price for any drugs it develops. Once a fixed number of sales is reached and the pharmaceutical company has turned its profit, it is then obligated to continue selling long-term at an affordable price, or license the technology to someone who would.
What an AMC has not yet shown, however, is whether it can stimulate pharmaceutical companies to start early-stage development of vaccines. In the case of pneumococcal, a vaccine already existed, and the AMC simply compelled companies to scale up manufacturing. But a malaria AMC, for instance, would require companies to develop and test from scratch an extraordinarily complicated vaccine – as the RTS,S results underscored. “The biggest challenge with an early-stage vaccine is creating a market big enough that it offers companies a sufficient return on a risky investment,” says Owen Barder, a senior fellow at the Center for Global Development and one of the originators of the AMC concept.