Advanced Market Commitments

1
Advanced Market Commitments
Jean-Louis Sarbib Vice-President, Human
Development World Bank
2
Vaccines Pipeline
Potential vaccines
HIV/AIDS
Malaria
TB
HPV
Next generation
Pneumococcal
Typhoid
Available and underutilized
Rotavirus
General scientific/technical certainty
Cholera
Meningococcal A
Influenza
JE
HepB
YF
Polio
Measles
Tetanus
Traditional EPI
1960
1980
2000
1970
1990
2010
Year/anticipated year of registration
Size of circle indicates number of deaths
(400,000 deaths, 2002 data) Left side of circle
aligned with expected introduction date
3
Slow introduction Introduction of Hep B and Hib
vaccines into developing countries is occurring
10-15 years after initial availability
HepB -- all developing countries
The Vaccine Fund established
Hep B licensed in U.S.
HepB -- all developing countries, excl. India,
China, Indonesia
Million doses
Hib licensed in U.S.
Hib -- all developing countries
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
2003
2005
GAVI forecasts
4
AMC Concept

• Problem
• Small, risky and unpredictable markets lead to
  underinvestment in vaccines of importance to the
  developing world
• Proposed AMC Solution
• Response to challenging economics of vaccine
  development and production
• Market-based engaging vaccine and biotech
  industry
• Results-based payment will be made only for
  real results vaccines produced and demanded by
  countries

5
AMC Work to date

• Following request of G7 Finance Ministers in
  December, World Bank and GAVI organized work
  program and prepared background papers
• Consultations
• Independent Expert Committee recommended most
  suitable vaccines for AMC Pilot
• Advisory Group of stakeholders input and
  guidance from technical partners
• Focused consultation with developing countries,
  industry, and biotechs
• Paper provided to Ministers for discussion April
  further work requested

6
Current Status

• G8 Finance Ministers review AMC Pilot Proposal in
  June
• Rationale for AMC
• Recommended pilot options
• Optimal institutional, legal and financing
  structure
• G8 considering having AMC on agenda for St
  Petersburg Heads of State Summit in July
• Positive decision would start activities for end
  2006 launch

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Institutional roles

• GAVI
• Host the AMC Secretariat
• Build on current GAVI processes and systems
  country applications, demand forecasting .
• Support the Independent Assessment Committee
• World Bank
• Manage financial and fiduciary functions of the
  AMC
• Link with donors on structuring payments

8
Potential Risks to GAVI

• Risks to GAVI of hosting AMC
• Increased visibility
• Increased management time for programmatic
  elements (WB handle financial/fiduciary
  responsibilities)
• Increased need to focus on improving demand
  forecasts
• If early stage vaccine selected, increased
  attention to RD issues will be needed
• Risks to GAVI of not hosting the AMC
• Loss of momentum for the AMC since GAVI is the
  most practical host
• billions of additional funds for priority
  vaccine lost
• GAVI must use its own limited funds to support
  priority late stage vaccines (if G8 select
  rotavirus, pneumococcal or HPV).
• Access to the vaccine delayed resulting in
  unnecessary deaths of many children

9
Process forward

• If G8 leaders support the AMC pilot and request
  GAVI and the World Bank to support the effort
• A special session of the GAVI Boards/ ECs will
  be called by end-July for decision on GAVIs role
  based on
• in depth assessment of implications for
  secretariat (e.g. staffing, costs)
• Presentation of detailed risk analysis