Advance Market Commitments ‘promising solutions’ to global health challenges

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Evaluation of AMC design and processes offers insight into key decisions behind innovative funding mechanism

Nicaragua pneumococcal launch Dec 2010

Caleb Alexander Martinez, aged 10-weeks, is vaccinated against pneumococcal disease in Nicaragua in 2010 – the first country to rollout pneumococcal vaccine with GAVI support thanks to the pneumococcal AMC.
GAVI/2010/German Miranda.

Geneva, 7 March 2013An evaluation of the design of the pilot Advance Market Commitment (AMC) for pneumococcal vaccines published today shines a light on the groundbreaking funding mechanism which has already helped vaccinate 13 million children against the world’s biggest childhood killer.

Four factors

The AMC process and design evaluation’s major findings highlight four key factors that enabled the GAVI Alliance to turn the AMC concept into a successful and innovative funding mechanism to ensure pneumococcal vaccines reach children quicker than ever before:

  • The pilot AMC designers had a clear blueprint for their work, provided by the “Making Markets for Vaccines” report.
  • Committed champions, including donors and the technical experts who developed the idea, maintained project momentum throughout the process.
  • The initiative garnered high-level political endorsement, particularly from ministries of finance.
  • Designers leveraged events, such as G8 summits, and organisations like the GAVI Alliance, the World Bank, UNICEF, and the World Health Organization to drive the process forward.

“Pneumococcal vaccines are protecting the lives of children in many of the world’s poorest countries right now,” said Dr Seth Berkley, CEO of the GAVI Alliance. “Through the pilot AMC, GAVI has been able to help immunise more than 13 million children in developing countries with a sophisticated conjugate vaccine that in the past would have taken a decade to reach them.”

Promising solution

Noting that the pilot AMC is ‘on track’ and progressing towards its objective of reducing morbidity and mortality from pneumococcal disease in developing countries, the evaluation report cites the pilot AMC as a “promising solution to the challenge of accelerating access to life-saving medicines.”

The pilot AMC is also credited with prompting unprecedented demand for and supply of a new vaccine which, in the past, would have taken 10 years or more to reach children in the world’s poorest countries. The report underlined the importance of the decision to ensure the two manufacturers with WHO-approved products were part of the AMC from the beginning to ensure consistency of supply and capacity.

Through the pilot AMC, GAVI has been able to help immunise more than 13 million children in developing countries with a sophisticated conjugate vaccine that in the past would have taken a decade to reach them. 

Dr Seth Berkley, CEO of the GAVI Alliance

The report states: “The launch of this AMC, and the momentum it created, appears to have contributed to the creation of a longer-term market for PCV (pneumococcal conjugate vaccine), as participating suppliers have expanded capacity and additional manufacturers have expressed interest in joining the initiative.”

Pricing agreement

Alongside an unprecedented increase in production capacity as a result of the pilot AMC, GAVI also secured a pricing agreement with manufacturers and a tail price of US$ 3.50 per dose.

Since the first GAVI-funded introduction of pneumococcal vaccines in Nicaragua in December 2010, 24 countries have been able to introduce the vaccine against pneumococcal disease, a leading cause of pneumonia which is the largest killer of children worldwide.

26 countries approved to introduce pneumococcal vaccines

A further 26 countries have been approved to introduce pneumococcal vaccines. By 2020 GAVI expects the vaccines to have helped avert around 1.5 million future child deaths.

The report recommends strengthening performance measurements and ensuring that the 2014 impact evaluation is well designed. It also recommends further work to explore potential for reductions in tail price.

Seth Berkley added:
“The experience gained during the design and implementation of the pilot AMC provides important lessons learned and the GAVI Alliance as a learning organisation remains committed to evaluating our interventions and sharing these experiences both good and bad with the international development community.”

Second report

The AMC process and design evaluation is the second report into the innovative finance mechanism, which was launched in 2009. A Baseline Study was completed in 2010 and an Impact Evaluation will be commissioned by the GAVI Alliance in 2014.

The pilot pneumococcal AMC aims to stimulate the supply of appropriate and affordable pneumococcal vaccines for developing countries.

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 $1.5 billion to the initiative.

GAVI is funded by governments [Australia, Canada, Denmark, France, Germany, Ireland, Italy, Japan, Luxembourg, Netherlands, Norway, Republic of Korea, Russia, South Africa, Spain, Sweden, United Kingdom, United States], the European Commission, the Bill & Melinda Gates Foundation, as well as private and corporate partners [Absolute Return for Kids, Anglo American plc., The Children’s Investment Fund Foundation, Comic Relief, Dutch Postcode Lottery, His Highness Sheikh Bin Zayed Al Nahyan, JP Morgan, “la Caixa” Foundation, LDS Charities and Vodafone].

Click to view the full donor list.

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