Milestones :: Perspectives :: Featured Articles

Milestones :: Perspectives :: Featured Articles

Access to Vaccines Index: 2017
How vaccine companies are responding to calls for greater immunisation coverage
Access to Medicine Foundation
2017 :: 102 pages
The 2017 Access to Vaccines Index provides an initial baseline of industry activity to improve access to vaccines. It examines where and how companies are already taking action to improve immunization coverage, and brings good practices to the attention of other companies and stakeholders working in the vaccines space. These organisations will be able to use the Index to inform priorities and strategies, and to clarify where new incentives are needed to spur greater positive change. The methodology for the Index has been developed with reference to experts working in the field and industry. The research was reviewed prior to publication by a group of Expert Advisors: including from Clinton Health Access Initiative (CHAI) and Gavi the Vaccine Alliance.
The Access to Vaccines Index has been developed by the Access to Medicine Foundation, an independent non-profit organisation based in the Netherlands. The Access to Vaccines Index is funded by the Dutch National Postcode Lottery.

Foreword [Excerpt]
Vaccines are a cornerstone of modern health systems. A few shots can protect a child for life
against diseases such as diphtheria and cholera. While many of us take vaccines for granted, every year, 1.5 million children under five die from vaccine-preventable diseases. Most unvaccinated children live in low- and middle-income countries, where health systems are often under pressure.

Many parties share responsibility for ensuring everyone can benefit from vaccines. Governments
and many others are dedicated to boosting immunisation coverage or reshaping vaccine markets, to ensure safe and effective vaccines can be made available and affordable everywhere.

The role for companies
Vaccine manufacturers, the innovators and producers of vaccines, stand early in the vaccine value chain. The decisions they make to improve access to vaccines can help safeguard the health, wellbeing and economic potential of many millions of people. Take the decisions to develop pneumococcal, malaria, dengue and HIV vaccines. In all three cases, the technical hurdles have been immense. The benefits, when such projects prove successful, are profound. The Access to Vaccines Index has now mapped, for the first time, what vaccine companies
are doing to improve access to vaccines, and what prompts them to take action.

The drivers behind company action
The Index finds that companies are responding to global calls to increase immunisation coverage, and to mechanisms put in place to ensure vaccine markets are viable long-term. We found a high level of diversity in how companies approach access. Yet overall, their actions and strategies are largely driven by the reliability and sustainability of vaccine markets, and by political will. At least in part, this is because vaccines development and production are lengthy, complex and expensive…

…Vaccine companies need to be at the table as governments and others work to build resilient health systems. Several companies are already in the right conversations and poised to do something about investing in remaining vaccine R&D gaps, addressing affordability, and ensuring supply meets increasing global supply of vaccines. The map will help define next steps and chart progress. For those looking to deepen company engagement in vaccines access, the Index shows that the formula of commitment-making, market-shaping and incentivizing collaborative action really works, especially as the world faces challenges to global health security.
Jayasree K. Iyer
Executive Director
Access to Medicine Foundation

Media Release
New Access to Vaccines Index reveals first landscape of vaccine company actions to improve immunisation coverage
Amsterdam, the Netherlands, 6 March, 2017 – The 2017 Access to Vaccines Index reveals the first landscape of industry activity to improve immunisation coverage. It finds a high level of diversity in how vaccine companies are improving access to vaccines for people living in poorer countries. This diversity is generally linked to the size of their portfolios and pipelines.
Vaccines are one of the most powerful and cost-effective health interventions available. Yet WHO states that an estimated 19.4 million infants worldwide are still missing out on basic vaccines.
The independent Index, published Monday, analysed companies’ R&D pipelines, identifying nearly 90 vaccine projects for high-priority diseases. This includes dozens of first-ever vaccines, for diseases such as Ebola and a range of deadly bacterial infections. If successful, such vaccines could prove critical for tackling anti-microbial resistance (AMR). The Index also finds that companies are taking steps to prevent vaccine shortages and that, when setting prices, most take affordability into account to a degree. All companies consider a country’s eligibility for support from Gavi, a public-private partnership that funds vaccine purchases for lower-income countries.
Portfolios and pipelines follow the markets
In their vaccine portfolios and pipelines, the eight companies in scope concentrate on diseases with larger global markets: for example, the diseases with the most vaccines on the market are meningococcal disease, polio, seasonal influenza and hepatitis (A and B); the top five diseases targeted by R&D projects are pneumococcal disease, seasonal influenza, meningococcal disease, respiratory syncytial virus and human papillomavirus, which causes cervical cancer…

[See Lancet editorial below in Journal Watch]


Featured Article[s]

Economic Papers
Études et Documents, n7, No 201707, Working Papers from CERDI
Post-neonatal Mortality Impacts Following Grants from the Gavi Vaccine Alliance: An Econometric Analysis from 2000 to 2014
Robert John Kolesar Martine Audibert
We completed a retrospective multivariate panel and longitudinal trend study to evaluate the effect of Gavi Vaccine Alliance grants on vaccine-preventable disease (VPD) post-neonatal mortality. Feasible Generalized Least Squares (fGLS) regression analysis was used to examine the association between VPD post-neonatal mortality rates and Gavi funding. We also applied segmented regression analysis to assess the structural trend in VPD post-neonatal mortality rates, the impact of Gavi funding, and trend changes following Gavi support. We separately tested a composite VPD mortality rate and five vaccine-preventable mortality rates: pertussis, meningitis, measles, diarrhea, and pneumonia (lower-respiratory infection) as dependent variables. All 77 countries eligible for Gavi assistance from 2000 to 2014 were included in the study. To isolate the effect of Gavi funding in our primary model, we controlled for known and likely predictors of child mortality. Among other factors, Gavi investment and corruption control/system efficiency are important elements to reduce vaccine-preventable mortality rates. For every $1 per capita invested by the Gavi Vaccine Alliance, there are highly statistically significant effects- decreasing the vaccine-preventable disease post-neonatal mortality rate by 2.535 per 1,000 live births. We also found Gavi investments to be significantly associated with reductions in four vaccine preventable disease-specific rates: pertussis, meningitis, diarrhea, and pneumonia. Furthermore, we found Gavi support to be significantly associated with both immediate impacts and trend changes on vaccine-preventable mortality rates. We conclude that Gavi investments in developing country immunization programs have measurably contributed to reductions in post-neonatal VPD mortality rates. Furthermore, we found evidence of a longer term catalytic effect of Gavi funding with accelerated reductions in the trend for post-neonatal meningitis, diarrhea, and pneumonia mortality rates.