Presentation on theme: "Advance Market Commitments for Vaccines Carlo Monticelli International Financial Relations Ministero dell’Economia e delle Finanze."— Presentation transcript:
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 VaccineEst. annual number of deathsAt-risk populations HIV/AIDS3 million High risk groups Continent of Africa Pneumococcus1.6 million Up to 50% of cases in children under 5; highest at risk are elderly and children <2 Tuberculosis1.6 million HIV infected or others with compromised immunity Malaria1.1 to 2.7 million 2 billion people in endemic regions; children under 5 Rotavirus440,000 to 500,000 Children under five; between 6 months and 2 years most vulnerable Human Papillomavirus 250,000 - 270,000 Women, primarily in developing countries
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
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 Capacity Investment Licensure Vaccine for wealthy countries Private investment to complete the pipeline Health R&D for wealthy countries $106 billion Public funds Private funds Vaccines for poor countries
Advance Market Commitments 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 A new tool in the fight against poverty
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
Advance Market Commitments AMC steps Framework Agreement Announced First Vaccine Approved Guarantee Agreement 1 Price guarantee Tail price/supply terms Vaccines delivered Second vaccine purchased Guarantee Agreement 2 Second Vaccine Approved Suppliers provide vaccine to eligible countries at agreed lower price AMC Commitment exhausted Details on AMC: Size, price, target product goal
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 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 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. The pilot project
The technical group meetings Advance Market Commitments 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
Rome, 9 February 2007 Advance Market Commitments Launch of the first pilot AMC for pneumococcal vaccines