Developing, Scaling, and Equitably Delivering a COVID-19 Vaccine

Successful development and introduction of an effective COVID-19 vaccine may be our only path towards fully reopening our economies without fear of future outbreaks and associated health and economic impacts. Even as science and research progress, governments, CEOs, and the public are all asking how to speed up development, finance late stage development, finance and manage the scale up of manufacturing, and prioritize doses in a supply-constrained environment, with the goal to interrupt global transmission. CGD is contributing to the conversation by offering innovative financing, organizational and policy ideas to solve these problems, drawing on its extensive experience diagnosing and addressing complex global health challenges.

Faced with the unique challenge of a solution to perhaps the modern world's first truly global health challenge, speed and efficacy are critical. CGD’s policy proposals focus on leveraging the "missing middle"—the private sector and middle-income countries, as well as developed economies. If we are not able to do so, we face the risk that this crucial task becomes an expensive exercise played along traditional donor and recipient lines, where national interests may trump the potential of the best science to advance.

Specifically, the global health policy team at CGD, with colleagues from the Office of Health Economics and PATH, have developed the “benefit-based advanced market commitment (BBAMC)” to speed vaccine development. The BBAMC explicitly targets middle-income countries, as well as high- and low-income countries, and builds an advanced commitment based on future expected health care expenditures (on COVID-19 vaccine), not just donor aid. By pooling demand across all income groups—and offering differential pricing to countries based on their ability to pay—it offers a path to incentivize private-sector investment while ensuring global affordability of the end product. It allows push funding to support early science and defray manufacturing fixed cost risks while creating a value-based market that will “pull” the best candidates forward through late stage development and manufacturing. You can find CGD's full body of work on COVID-19 here.

Click the image below to explore our presentation on our BBAMC proposal:

For more information, please contact Rachel Silverman and Kalipso Chalkidou.