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Vaccines are one of the most cost-effective technologies to save lives ever developed, but significant supply- and demand-side obstacles constrain their use. Pharmaceutical companies, for example, often lack incentives to create vaccines for diseases that primarily affect the developing world. Countries may also struggle to procure vaccines at affordable and predictable prices as they transition away from donor support or remain ineligible for it. Rising rates of vaccine hesitancy and low demand more generally further limit the reach of variably strong vaccine delivery systems.

CGD has produced numerous policy proposals to improve the availability of vaccines. Our research led to international backing for the Advance Market Commitment (AMC) mechanism, where donors promise to buy a vaccine if it’s developed. Over 80 million children have subsequently been vaccinated against deadly pneumococcal disease. We have also provided recommendations to the Board of Gavi that would refocus Gavi’s policies and programs on improving outcomes, incentives, and value-for-money. In 2019, we will launch a blueprint for a novel financing model that builds on the AMC to bridge the gap between the need for new tuberculosis medicines and perceived return on investment. A CGD working group report considers how the global health community can ensure the medium- to long-term efficiency, quality, affordability, and sustainability of global health procurement.

In the race to develop a vaccine for COVID-19, CGD experts are focused on leveraging the "missing middle"—the private sector and middle-income countries, as well as developed economies. Read about their proposal for a benefits-based advanced market commitment (BBAMC), written alongside colleagues from the Office of Health Economics and PATH. You can find all COVID-19 work here.