An analysis of how the GAVI alliance and low- and middle-income countries can share costs of new vaccines

Health Affairs

Volumn 30, Issue 6, 2011, Pages 1122-1133

  Saxenian, Helen ^a   Cornejo, Santiago ^b   Thorien, Kira ^a   Hecht, Robert ^a   Schwalbe, Nina ^b  

^a RESULTS FOR DEVELOPMENT INSTITUTE   (United States)

^b GAVI Alliance   (Switzerland)

Author keywords

[No Author keywords available]

Indexed keywords

HAEMOPHILUS INFLUENZAE TYPE B VACCINE; HEPATITIS B VACCINE; JAPANESE ENCEPHALITIS VACCINE; MEASLES VACCINE; PNEUMOCOCCUS VACCINE; ROTAVIRUS VACCINE; RUBELLA VACCINE; TYPHOID VACCINE; VACCINE; YELLOW FEVER VACCINE;

ARTICLE; DRUG COST; DRUG INDUSTRY; GOVERNMENT; HEALTH CARE COST; HEALTH CARE FINANCING; HEALTH CARE POLICY; HUMAN; IMMUNIZATION; SENSITIVITY ANALYSIS;

CAPITAL FINANCING; COOPERATIVE BEHAVIOR; COST ALLOCATION; DEVELOPING COUNTRIES; VACCINES;

EID: 79959534086     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0332     Document Type: Article

References (24)

1. In the past, vaccine prices tended to fall to low levels as manufacturers recouped research and development costs and as economies of scale and technological change reduced production costs. Because of the complexity of manufacturing certain new and underused vaccines, price drops may be mor e limited, decreasing the prospect of affordability for poor countries.
2. GAVI Alliance. Revision and alignment of country support policies in phase 2 [Internet]. Geneva: GAVI; 2005 Dec 6 [cited 2011 Jan 23]. (Doc A.8). Available from: http://www.gavialliance.org/resources/17brd_8_CountrySupport PoliciesPhase2_6Dec2005.pdf.
3. GAVI Alliance. GAVI Alliance Board Meeting, 16-17 June 2010, Doc 07-Co-financing Policy Revision [Internet]. Geneva: GAVI [cited 2011 May 22]. Available from: http://www.gavialliance.org/resources/07___Co_financing_Policy_ Revision.pdf.
4. For example, see UNICEF. Co-financing new vaccines and sustainability. Meeting report of the Africa Regional Workshop; 25-28 May 2009; Dakar, Senegal. New York (NY): UNICEF; 2009.
5. Heller P. Back to basics-fiscal space: what it is and how to get it. Finance and Development [serial on the Internet]. 2005;42(2) [cited 2011 Mar 15]. Available from: http://www.imf.org/external/pubs/ft/fandd/2005/06/basics.htm.
6. We did not look at the scope for improving efficiency in immunization programs (or in the health sector) in this analysis. However, there are possible ways to improve efficiency: for example, by reducing wastage or better selection of vaccine presentation in procurement.
7. Williams G, Hay R. Fiscal space and sustainability from the perspective of the health sector [Internet]. Paper commissioned for: High-Level Forum on the Health Millennium Development Goals; Paris; 2005 Nov 14-15 [cited 2011 Mar 15]. Available from: http://www.hlfhealthmdgs.org/Documents/iscalSpacePerspective.pdf.
8. Tandon A, Cashin C. Assessing public expenditure on health from a fiscal space perspective [Internet]. Washington (DC): World Bank Group;2010 Feb [cited 2011 May 16]. (HNP Discussion Paper). Available from: http://siteresources.world bank.org/HEALTHNUTRITION ANDPOPULATION/Resources/281627-1095698140167/Assesing PublicExpenditureFiscalSpace.pdf.
9. Vos R, Sanchez M, Inoue K. Constraints to achieving the MDGs through domestic resource mobilization [Internet]. New York (NY): United Nations Department of Economic and Social Affairs; 2007 May [cited 2011 May 16]. (DESA Working Paper No. 36). Available from: http://www.un.org/esa/desa/apers/2007/wp36_2007.pdf.
10. World Bank. World development indicators online [Internet]. Washington (DC): World Bank; 2011 [last updated 2010 Dec; cited 2011 May 25]. Available for download from: http://data.worldbank.org/data-catalog/world-developmentindicators.
11. UNICEF. Vaccine price data [Internet]. Geneva: UNICEF; 2011; [cited 2011 May 26]. Available from: http://www.unicef.org/supply/index_57476.html.
12. UNICEF. Product menu for vaccines supplied by UNICEF for the GAVI Alliance [Internet]. New York (NY): UNICEF; 2011 Apr [cited 2011 May 4]. Available from: http://www.unicef.org/supply/files/Product_ Menu_April_2011.pdf.
13. World Health Organization. National health accounts [Internet]. Geneva: WHO; 2011 [cited 2011 May 25]. Available from: http://www.who.int/nha/en/.
14. Ravishankar N, Gubbins BA, Cooley R, Leach-Kemon K, Michaud C, Jamison D, et al. Financing of global health: tracking development assistance for health from 1990 to 2007. Lancet. 2009;373(9681):2113-24.
15. Lu C, Schneider M, Gubbins P, Leach-Kemon K, Jamison D, Murray C. Public financing of health in developing countries: a cross-national systematic analysis. Lancet. 2010; 375(9723):1375-87.
16. Van der Gaag J, Hester V, Hecht R, Gustafsson E, Menser N, McGreevey W. Fiscal space and political space for financing the global AIDS response to 2031 [Internet]. Washington (DC): Results for Development Institute; 2009 Sep 10 [cited 2011 Mar 15]. (aids2031 Working Paper). Available from: http://www.results fordevelopment.org/publications/fiscal-space-and-political-spacefinancing-global-aids-response-2031.
17. Similarly, Tandon and Cashin (see Note 10) estimate the elasticity of government spending to gross domestic product at about 1.16 percent across low-income countries, meaning that a 1 percent rise in income results in a 1.16 percent increase in government health spending.
18. To access the Appendix, click on the Appendix link in the box to the right of the article online.
19. Advance Market Commitments for Vaccines. The pneumococcal AMC: ready to save lives [Internet]. Geneva: GAVI Alliance; 2007 [cited 2011 May 3]. Available from: http://www.vaccineamc.org/pneu_ amc.html.
20. Pan American Health Organization. Immunization in the Americas, 2010 summary [Internet]. Washington (DC): PAHO; 2010 [cited 2011 Mar 15]. Available from: http://new.paho.org/hq/index.php?option=com_content&task=view&id= 3573&Itemid=2573&lang=en8.
21. For more information on the advantages and disadvantages of different approaches, see GAVI Alliance. Final minutes, GAVI Alliance Programme and Policy Committee, 2010 Oct 21-22 [Internet]. Geneva: GAVI; 2010 [cited 2011 Mar 15]. Available from: http://www.gavialliance.org/resources/PC_Minutes___21_22_October_ 2010.pdf.
22. GAVI Alliance. Revised vaccine cofinancing policy [Internet]. Geneva: GAVI; 2010 [cited 2011 Mar 15]. Available from: http://www.gavialliance.org/vision/programme_policies/cofinancing_policy/index.php.
23. World Bank, GAVI Alliance. Immunization finance toolkit, brief 7. Washington (DC): World Bank; 2010 Dec.
24. The GAVI Alliance recognizes that some countries may rely on development assistance to meet their cofinancing requirement.