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Chapter at a glance
- The idea of making an advance
purchase commitment has been
discussed for several years, but
the details of how it could be
implemented have not been worked
out. Our Working Group was
established to determine whether
a commitment could be designed
that could be implemented and that
would be effective and good value
for money.
- We propose a framework for an
advance market commitment that
would bring new impetus to R&D
in vaccines for diseases occurring
mainly in developing countries. The
arrangements are intended to
create a market analogous to the
market for medicines in affluent
countries.
- Our proposal is for a market not a
prize. There is no winner-take-all.
By underwriting the purchase of
vaccines, donors create incentives
for firms to compete to bring
products to market quickly. Better
products can compete for market
share, as they can in affluent
markets.
- Advance market commitments
would accelerate the production
and availability of late stage
products (rotavirus and
pneumococcus vaccines) as well
as the R&D and availability of
early stage products (vaccines for
malaria, HIV, tuberculosis).
- We have set out a quantified
example for a malaria vaccine.
A market worth $3 billion would
create incentives for commercial
investment to accelerate R&D,
and the purchase of the vaccines
at $15 per dose for the first
200 million people would provide
remarkable value for money for
donors—less than $15 per life-year
saved.
- The commitment has been
designed to meet the needs of
all stakeholders. It would be of
significant benefit to donors,
industry and most of all the people
in developing countries.
- An advance market commitment
would fill an important gap in
our arrangements for R&D for
global health challenges. But our
enthusiasm for it does not diminish
the importance we attach to a
range of other measures that we
can and should take in the near
term to save lives immediately
and to enhance the prospect of
developing new medicines that are
essential for developing countries.
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