Efforts to make newer and more costly vaccines widely available to the poorest in Africa are being hampered by a long-standing system that makes vaccines affordable to middle-income Latin American countries, reports the Financial Times.
The Pan American Health Organization’s (PAHO) revolving fund, which began in 1979, negotiates substantial discounts with manufacturers on prices in richer countries, offering in exchange significant volumes, predictable demand and funding.
At issue is a clause demanding that the vaccines purchased for these middle-income countries are made available at the “lowest possible price” charged anywhere in the world, making it impossible to negotiate even lower prices to poorer countries.
Disagreement between PAHO and the Global Alliance on Vaccines and Immunisations (GAVI), has already delayed wider use of certain vaccines amongst the poorest of countries.
GAVI uses mechanisms such as advance market commitments and IFFIm’s (long-term, guaranteed aid funding from donor countries) to overcome historic limitations to development funding for immunisation.
GAVI also relies on the principle of tiered pricing to provide vaccines to the poorest of countries. Countries are grouped using a range of indicators of ability to pay, with poorer countries paying less per vaccine.
Companies have been increasingly willing to offer discounts on western prices to poorer countries, but they want richer countries to pay more in line with income levels to help support access to the poorest as well as research for future products.
Tension emerged last year over Wyeth’s vaccine against pneumonia and meningitis, which was offered to the revolving fund at $26 a dose, less than a third of its price in richer countries. However, the fund’s demand for the lowest possible price clashes with negotiations at $7 a dose for countries served by Gavi – with gross national income less than $1,000 a head.
Filed under: Africa, Central and South America, Commentary on news & events, Public health | Tagged: access to medicines, drug pricing, GAVI Alliance, Pan-American Health Organization | Leave a Comment »