Chapter 1: We need to invest more in vaccines

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Chapter at a glance

• Vaccines represent the best hope for large, rapid and affordable improvements in health in the developing world.
• Vaccines developed for affluent countries have already contributed greatly to improving the health of people in poor countries. A remarkable 75% of children receive a basic set of childhood immunizations. But because of shortcomings in financing and delivery, including delays in introduction of life-saving vaccines, more than 3 million people die each year of vaccine-preventable diseases.
• Increasingly, the main diseases in poor countries are not a high priority in affluent countries. As a result, developing countries can no longer depend on rich markets to meet the costs of the development of new vaccines that would benefit poor countries.
• The total market size for vaccines in developing countries is tiny? about $500 million a year. This is insufficient to provide an incentive for pharmaceutical companies to invest in developing new vaccines for these diseases.
• In addition to being small, the vaccine market is characterized by collective procurement. Success in stretching health budgets by keeping prices as low as possible has important short-term benefits. But the aim of minimizing shortterm costs to ensure access must be balanced with the goal of providing returns sufficient to stimulate development of new products.
• Largely as a result of the low value and high risks of the developing country market, less than 10% of global spending on health research and development is devoted to the major health problems of 90% of the population.
• Without a valuable market to stimulate the development of new vaccines for diseases that occur mainly in developing countries, alternative arrangements are needed to ensure that vaccines are developed, produced on a large scale and made available affordably and reliably to developing countries.

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Making Markets for Vaccines