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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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