Giving developing countries the best shot

Vaccines have contributed to some of the greatest public health successes of the past century, averting 2.5 million child deaths every year and millions more bouts of illness and disability. Yet even as the demand for existing, new and planned vaccines grows in developing countries, financing for immunization in poor countries has reached a crisis point, and major problems in the vaccines market mean that access to existing vaccines and development of new vaccines will be impeded and delayed.
This joint report of Oxfam International and Medecins Sans Frontieres provides critical insights on the existing challenges to ensure children across the developing world get timely, affordable and appropriate access to vaccines, while ensuring that the unmet needs of poor children are met by the public and private sector in the coming years.

Key conclusions

1. A dramatic funding shortfall is endangering global commitments to introduce new vaccines and plans to provide existing vaccines to developing countries. Competitive markets for existing vaccines, such as pentavalent, matched by increased donor contributions, are critical pre-requisites to meet existing demand in developing countries.
2. Any efforts to increase access and affordability in developing countries must also keep middle-income countries in mind. A more comprehensive approach could include new pooled procurement mechanisms (modelled on PAHO’s revolving fund), access to GAVI prices for some countries that might not qualify for subsidies, regional exports by government owned producers, and forms of tiered pricing acceptable to middle-income countries.
3. Shortening the time it takes for competitive products to reach the market is a key strategy to make vaccines more affordable for countries and donors.  Strategies that could help to reduce barriers to entry include: building the capacity of developing countries to produce vaccines, facilitating technology transfer, preventing or removing patent barriers, including open licensing policies on the part of universities and government research bodies and the use of TRIPS flexibilities, and ensuring procurement policies that support competition and, at a minimum, do not inadvertently reduce the dominance of a handful of established multinational suppliers.
4. The current, market-based R&D system has failed to develop vaccines for diseases such as TB and malaria that affect large numbers of people as well as vaccines for smaller markets such as dengue. In addition to new vaccines, there is also a need for improved, cheaper and more suitable versions of existing vaccines.
5. New mechanisms, including potentially prizes, are needed to support technology transfer and fund vaccine development.