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Advance Market Commitments for Vaccines. Carlo Monticelli International Financial Relations Ministero dell’Economia e delle Finanze. Advance Market Commitments. Vaccines and neglected diseases.
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Advance Market Commitments for Vaccines Carlo Monticelli International Financial Relations Ministero dell’Economia e delle Finanze
Advance Market Commitments Vaccines and neglected diseases • More than 7 million people a year die, mostly in poor countries, from infectious diseases like pneumococcus, malaria and HIV/AIDS. • Vaccines: the most effective and efficient solution to address this problem, but unfortunately, they are not available.
Advance Market Commitments Developing a new vaccine takes 7-20 years – assuming success at each stage– and costs hundreds of millions dollars. Expectations of future market determines today’s investment decisions and, therefore, tomorrows products.
Advance Market Commitments Slow introduction: Introduction of Hep B and Hib vaccines into developing countries is occurring 10-15 years after initial availability
Advance Market Commitments Markets sometimes fail • Global resources invested in finding new vaccines are far below the social optimum • Epidemics control and vaccination are text-book cases of market failure • huge externalities • opportunities for free-riding • difficulties in protecting intellectual property • risk and uncertainties
Advance Market Commitments Market failures and AMC • AMC establishes a market where one is currently missing • no winner-take-all • Environmental application • clean technologies
Vaccine for wealthy countries Health R&D for wealthy countries$106 billion Private investment to complete the pipeline Advance Market Commitments Attracting private investments to fund the vaccine pipeline for vaccines for poor countries is essential. Funding the pipeline Discovery &Research Early Development Late Development CapacityInvestment Licensure Vaccines for poor countries Private funds Public funds
Advance Market Commitments A new tool in the fight against poverty • AMC are an innovative tool • Market-based • Results-based • Potential to save millions of lives by accelerating the development and supply of vaccines • Widespread support for AMC
Advance Market Commitments How does the market-based incentive AMC work • Create a market (not a purchase guarantee) • Donors commit upfront • An Independent Assessment Committee determines if a vaccine meets the target specifications (effectiveness, public health impact) • Country demand: donors subsidize the purchase of the new vaccine and recipient countries provide co-payment. • Post-AMC predictable supply and pricing
AMC Commitment exhausted Second Vaccine Approved First Vaccine Approved Framework AgreementAnnounced • Suppliers provide vaccine to eligible countries at agreed lower price Guarantee Agreement 1 • Price guarantee • Tail price/supply terms • Vaccines delivered Guarantee Agreement 2 Details on AMC: Size, price, target product goal • Second vaccine purchased Advance Market Commitments AMC steps
Advance Market Commitments Why is AMC appealing? With an AMC donors commit to buy vaccines: • if and when they are available (donors’ money disbursed only “against delivery”) • if they are demanded by developing countries (compatible with recipient countries’ systems and priorities)
Advance Market Commitments From academia to political agenda • Idea of AMC for vaccines put forward some years ago in the academia • Italian Finance Minister, with the support of Gordon Brown, presented the AMC concept to his G8 colleagues, who expressed interest in the idea • 2 December 2005 - the Report on AMCs prepared by the Working group led by Italy is presented to G8 Ministers who welcome the Report and agree on the idea to launching a pilot project by 2006. • Six candidate diseases: HIV-AIDS, Malaria, Rotavirus, Tuberculosis, Pneumococcus and Human Papillomavirus.
Advance Market Commitments Thepilot project • Work for the preparation of the pilot project with the support of an Independent Expert Committee, chaired by Dr Ntaba. • Choice of Pneumococcus (more than 1.6 million deaths a year, nearly 1 million children under 5),for the first AMC. • Recommendation of malaria for the second AMC. • July 2006 - Proposal to launch the pilot project for a vaccine against pneumococcus by 2006.
Advance Market Commitments The technical group meetings • Representatives from 15 countries and a range of public health and development institutions Rome meeting • Review of the work undertaken on the legal, technical, institutional and financial aspects of an AMC pilot • Agreement to carry out additional technical work London meeting • The Working Group assessed the concrete proposal for a pneumococcus pilot developed by the World Bank and GAVI
Advance Market Commitments Rome, 9 February 2007 • Launch of the first pilot AMC for pneumococcal vaccines
Advance Market Commitments Rome, 8 March 2007 • First meeting of the donors group