Positive impact of Advance Market Commitment highlighted in report

Geneva, 26 February 2016 – Children in the world’s poorest countries are being protected against the leading cause of pneumonia more quickly than ever thanks in part to the influence of the pilot Advance Market Commitment (AMC) for pneumococcal vaccines, an independent evaluation report published today confirms.

The AMC Outcomes and Impact Evaluation examined the role of the AMC in the successful introduction of the pneumococcal vaccine into the routine immunisation programmes of more than 50 developing countries since 2010. Historically it has taken more than a decade for the first children in developing countries to access the same new, effective vaccines as children in richer countries. In this case, newly developed pneumococcal vaccines were provided to developing countries within a year.

The report concludes that “the introduction of pneumococcal conjugate vaccines through the AMC pilot has accelerated immunisation coverage against pneumococcal disease across 53 Gavi counties to date, with 49 million [children] fully immunised [against the disease]”. The report also confirms that manufacturers made decisions to expand capacity to serve Gavi countries’ requirements in response to the AMC and its supply agreements.

“More children than ever before are being protected against pneumococcal disease and that’s something to celebrate,” said Gavi CEO Dr Seth Berkley. “The AMC has enabled us to secure pneumococcal vaccines at a lower price and ensure that these vaccines reach children in the world’s poorest countries more quickly than ever before.”

Pneumococcal disease is the leading cause of pneumonia, which in turn is the largest infectious cause of death in children under the age of five. Despite significant progress in increasing access to pneumococcal vaccines, WHO estimates that pneumonia killed 922,000 children in 2015, mainly in developing countries.

“It is testament to the success of the pilot Advance Market Commitment that children in Senegal are being protected against pneumococcal disease today,” said Dr Awa Marie Coll Seck, Minister of Health and Social Affairs in Senegal. “The speed at which children in countries like Senegal have had access to this vaccine underlines the fact that equitable access to new vaccines is possible and is something we should strive for.”

The report highlights some of the AMC’s implementation challenges, most notably supply shortages between 2012 and 2014 which led to delays in some country introductions. Unprecedented demand for the vaccine contributed to the shortages and the Vaccine Alliance partners worked closely with countries to ensure those who introduced the vaccine were allocated adequate supply to continue their programmes uninterrupted. Supply is now fully meeting demand.

The report adds that the AMC did not succeed in accelerating the timelines of other manufacturers with pneumococcal vaccines under development. This is in large part due to the complexity of the production process for pneumococcal vaccines. Two further suppliers are working towards having licensed vaccines though the exact timing of entry into the market is uncertain.

However, the evaluation also notes that the AMC “affected donor behaviour, manufacturer behaviour, and the sustainability of immunisation programmes that will continue to benefit the global health community and the Gavi [countries’] population[s] well into the future”.

“The report provides a number of lessons learned that will be useful not only to Gavi but also to other organisations when looking at innovative financing mechanisms in the future,” added Dr Berkley. “When Gavi launched the AMC, it was a groundbreaking tool that had never been tried on this scale before. By sharing our experiences we are contributing to a body of evidence that will support decision making in years to come.”

The AMC Outcomes and Impact Evaluation is the third such report into the trailblazing innovative finance mechanism, which was launched in 2009. A Baseline Study was completed in 2010 and a Process and Design Evaluation was published in 2013.

The pilot AMC was developed in collaboration with the World Bank and UNICEF Supply Division. The governments of Italy, the United Kingdom, Canada, the Russian Federation and Norway, and the Bill & Melinda Gates Foundation have committed a total of US$ 1.5 billion to the initiative.