Bill & Melinda Gates Foundation

Unique Partnership Breaks Vicious Cycle and Saves Millions of Lives

April 18, 2013

Twenty years ago, while working with the US Agency for International Development, I was charged with getting more Haemophilus Influenzae type B (Hib) vaccines to the poorest countries in the world. This vaccine had already saved so many kids in the United States and Europe that I was excited to help bring it to those who needed it most.

A Vicious Cycle:  When I was just getting started in this work, most poor countries had little understanding of the deadly impact of this disease. Add to this a limited supply and a price well over 10 times that of the most expensive vaccine being used in poor countries, and it was clear that this was not going to be easy.  

At the time, no vaccine supplier was willing to risk the cost of investing in improved technologies or increasing their operations without some assurances that there was demand for the vaccine and money to purchase the product. It was a vicious cycle.

A Unique Partnership is Born: A major breakthrough came with the launch of GAVI, a public private partnership, which included the 72 poorest countries in the world and their immunization partners. The way GAVI works is that they offer to co-finance vaccine purchases for countries in return for country commitments to deliver the vaccine and provide their portion of the purchase price.

The pentavalent vaccine – a combination of existing vaccines plus Hib and Hepatitis B – was preferred by developing countries because it protects children against infections from five different pathogens.  Responding to country needs, GAVI allocated money to purchase the vaccine for five years, effectively establishing a sustainable market for vaccine suppliers.

A Slowly-Growing Market: Success didn’t happen overnight, but slowly, we saw progress.  In 2010, a leading Indian vaccine manufacturer was approved to provide the vaccine in a 10-dose vial, reducing the original price of the vaccine by 50%.  Demand continued to increase, and in 2012 all of the 73 poorest countries in the world routinely started using the pentavalent vaccine in their national vaccination programs — or have plans to do so in the next 2 years. 

A New Chapter:  Today, I’m thrilled to say another Indian manufacturer, Biological E Limited (Bio E), working closely with the GAVI partners, has offered to lower the price of its lifesaving pentavalent vaccine to US$1.19 per dose — the lowest price to date.

The impact of Bio E’s lower price will be felt for years to come. As GAVI’s most widely used vaccine, this offer by Bio E has the potential to save GAVI up to $150 million over the next four years. More importantly, it is estimated that by 2020, GAVI’s support for this vaccine will have helped to avert more than seven million deaths.  

The pentavalent story illustrates the impact we can make when the global community pools resources to tackle the world’s most pressing global health issues. It does not happen overnight, but the impact is felt in the long-term. Now that we appreciate the power of working together, we need to do it better and faster.

 
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