Give Me Vaccine or Give Me Death

After four years of grueling negotiations, the GAVI Alliance announced a ten-year agreement with pharmaceutical titans Pfizer and GlaxoSmithKline, who will supply 30 million doses of the pneumonia vaccine at a greatly reduced cost: $7 per dose compared to $54 to $108, the current asking price in developed countries.

This is an historic agreement for two reasons. First, children in developing countries will have access to new vaccines at the same time children in developed countries do. (Merck’s Gardasil® Access Program also mirrors this trend; the lag between pharmaceutical rollout in the West and the developing world was considerably shorter than usual.)

Second, this agreement was made possible by an Advance Market Commitment (AMC), which creates the demand—and thus, essentially, a market—for services or goods that disproportionately benefit the poor.

How the Pneumococcal AMC Works (source: the GAVI Alliance)

Owen Barder lauds AMCs as an innovative bottom-up method for improving accountability in addition to citizen-driven social accountability movements such as Twaweza.

On the other hand, Dr. Orin Levine condemns the inefficiencies of GAVI and the pharmaceutical companies; four years have passed since the original WHO announcement. Negotiations were prolonged due to legal hurdles and disagreements concerning procurement contracts, product labeling and pricing policies.

Levine urges global health practitioners to resolve the policy inconsistencies that delayed people from being vaccinated against a disease that kills 1.6 million people per year.

In four years time, that’s 6.4 million lives lost.


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