Funding New Vaccines To Save Millions Of Lives
WASHINGTON, D.C., 3 Apri, 2009: The World Bank has approved a financial platform for a pilot vaccine program that will benefit millions of children in the developing world.
The Advance Market Commitment (AMC) pilot will help accelerate the creation of a viable market for pneumococcal (lunge) vaccines by providing up-front financing for incremental (stadigt stigende) costs of vaccine production to meet demand from developing countries.
– This program will give children in developing countries timely access to safe, effective vaccines, at affordable prices. We are very pleased to join donors and partners on this innovative and life-saving effort, said World Bank President Robert B. Zoellick.
An AMC is a commitment to finance the future purchase, up to a pre-determined price, of a vaccine needed in developing countries.
Pneumococcal infections are the largest killers of children worldwide. Immunization is estimated to prevent more than two million deaths globally each year from infectious diseases. Yet, there has been chronic underinvestment in suitable new vaccines.
It is estimated that AMC funds will help immunize nearly 700 million infants, directly preventing about 2,8 million deaths through 2020. In addition, it is estimated that the accelerated introduction of pneumococcal vaccines will prevent another 4,9 million deaths.
The 1,5 billion US dollar donor subsidy for the AMC pilot, which will be placed on the balance sheet of the World Bank Groups International Bank for Reconstruction and Development (IBRD), will be funded by six donors:
Italy (635 million dollar); the United Kingdom (485 million); Canada (200 million); Russia (80 million); Norway (50 million); and the Bill & Melinda Gates Foundation (50 million). The IBRD will provide standard financial management and administrative services regarding donor contributions, AMC commitments, and disbursements.
The World Bank has been closely engaged over several years in the development of the pilot AMC providing support to donors and leadership on health, finance and legal aspects of its design and implementation.
– Establishing the AMC subsidy on IBRDs balance sheet responds to a specific request from donors, who believe that IBRDs direct financial support will maximize the financial efficiency, simplicity and credibility of the AMC, said Philippe Le Houérou, World Bank Vice-President for Concessional Finance and Global Partnerships.
– With todays approval the pilot should be ready to be launched in two to three months, added he.
The GAVI Alliance and the World Bank will be the lead implementing partners for the AMC pilot, with technical support from the World Health Organization and with UNICEF as procurement agent for low-income countries.
– The pilot AMC will demonstrate both the feasibility and the impact of the AMC mechanism and help determine if AMCs can help accelerate other health priorities, such as vaccines against malaria, said Joy Phumaphi, World Bank Vice-President for Human Development.
AMC Process and Flow of Funds
– Donors make grant payments to IBRD, each donor paying in accordance with its specific schedule or agreed demand-based payment arrangement.
– IBRD holds donor payments on its balance sheet, as designated assets with a corresponding liability to pass through the payments for the benefit of GAVI under the AMC terms and conditions. Notional investment income is allocated to the AMC program balances.
– Countries apply to GAVI for AMC funding for pneumococcal vaccines. Countries must meet GAVI criteria designed to ensure a multi-year immunization plan is in place, synchronized with an overall health sector plan and supported by the finance ministry and national coordination body. Proposals are assessed on a first-come, first-served basis by an Independent Review Committee and approved by the GAVI Board.
– Once a vaccine is approved by the AMC Independent Assessment Committee as meeting the required target product profile (including technical requirements and prequalification by the WHO), its manufacturer enters into one or more Supply Agreements with UNICEF consistent with the AMC terms and conditions.
– UNICEF procures AMC-eligible vaccines. All AMC vaccines are initially purchased at 7 dollar per dose, comprising the applicable tail price (set by each manufacturer subject to the tail price cap) plus the per-dose subsidy amount. When the full subsidy amount allocated to a manufacturer under a contract has been paid, purchases take place at the tail price.
– The total subsidy entitlement paid to each manufacturer is the AMC subsidy, 1,5 billion, times the manufacturers share of committed supply (the number of doses it commits to supply annually divided by the annual target supply level of 200 million doses).
– When the total subsidy entitlement under a given Supply Agreement has been fully paid, GAVI and recipient countries continue to pay for, and the manufacturer continues to supply, vaccines at the agreed price (at or below the tail price cap) until the manufacturer has supplied ten years worth of vaccine at the committed level. Vaccines supplied out of headroom (existing excess capacity) prior to dedicated capacity coming onstream count toward the ten year total commitment.
– After the full AMC subsidy of 1,5 billion has been paid out to manufacturers (when AMC supply commitments from all manufacturers add up to the 200 million annual dose level needed by 2020) GAVI will remain responsible for ongoing tail price payments. Any amounts remaining in the AMC program, such as surplus investment income, would be directed toward other development uses by donors.
– Monitoring and evaluation will be conducted under the AMC Monitoring and Evaluation Framework Study.
Kilde: www.worldbank.org
