New Scientist - USA (2020-04-25)

50 | Read more at healthawareness.co.uk MEDIAPLANET

G

eneric medicines – budget

versions of brand-name

drugs – are often quite

literally a lifesaver because

they are affordable. Vaccines are

just as critical, protecting against

infectious diseases such measles

and polio, yet we don’t have cheap

generics for vaccines.

This is because the biological

nature of vaccines means the pro-

cesses of manufacture, licensing

and regulation are vastly different

to medicines, leading to high fixed

costs in development.

Since a vaccine can be the

difference between life and death

for billions of people, pushing for

change in the factors that keep

vaccine prices high is crucial.

Developing a vaccine never

gets cheaper

So why can we have generic drugs

but not vaccines? Manufacturers

of generic drugs and medicines

need to follow the same chemical

recipe as the brand-name version,

but they don’t necessarily need to

test the generics on people to see

whether they respond to them the

same way.

A vaccine, however, is consid-

ered to be a new biological entity,

and must be tested on people,

which is costly and time-consum-

ing. With vaccines, manufacturers

may have to repeat trials for any

innovation they want to make,

adding to costs.

Along each step of production,

hundreds of quality control steps

are needed, raising costs and

increasing timelines for produc-

tion. All of this can send the cost

of vaccine production soaring.

Making vaccines more

affordable for all

Since 2000, Gavi, the Vaccine

Alliance, has been working to make

vaccines accessible and affordable

through innovative financing

mechanisms such as committing

to the purchase of a vaccine still in

development, thereby reassuring the

manufacturers that a market exists.

However, newer vaccines can

be more complex – for example,

pneumococcal conjugate vaccines,

which protect against diseases like

pneumonia – and this can make

them more costly.

While funding programmes can

lower the costs for poorer countries

by subsidising the vaccines, ideally

the cost to produce the vaccines

would be lower in the first place.

How to drive down vaccine costs

Uncertainties about vaccine

demand can mean manufacturers

increase prices to ensure they get a

return on their investment sooner

rather than later. Introducing

greater certainty of demand can

therefore lower costs.

Investing in ways of improving

biological standards and assays

to speed up investigation or

proof-of-concept could lower

costs too, as could new platform

technologies to accelerate R&D and

better regulatory science for faster

approvals. These shifts along the

value chain of vaccine production

would ultimately help lead to

cheaper vaccines for those who

need them most.

Fundamental differences in developing

vaccines and medicines mean that second

generation vaccines are never going be as

cheap as generic drugs, but there are still

ways to reduce their cost.

Aurélia Nguyen

Managing Director,

Vaccines and

Sustainability, Gavi,

The Vaccine Alliance

Keeping vaccines as

affordable as generic

medicines: a matter

of life and death

Read more at

healthawareness.co.uk

D

espite the high death

toll, bacterial pneumonia

• which is particularly
  serious for kids – only
  receives about 2% of global funding
  for neglected disease research and
  development.^1 Access to diagnostic
  tools and treatments like X-rays,
  antibiotics, or oxygen also remains
  a challenge, particularly in
  low-income countries where most
  pneumonia deaths occur. The best
  option for children in these areas
  is to prevent them from getting sick
  in the first place by giving them the
  vaccines they need.

Pneumococcal conjugate vaccines

have had major success in high-

income countries

One particularly important tool

in the fight against pneumonia are

pneumococcal conjugate vaccines

(PCV), which have reduced rates

of severe pneumonia by more than

half in the high-income countries

that have used them for nearly two

decades. But, while this important

tool exists, many communities

in low- and middle-income

countries still don’t have access

to the vaccines, leaving millions

of children without protection

against this deadly disease.

Thankfully, a new vaccine will

soon be on the market that will

help reduce this disparity and make

PCVs available to more children.

The availability of this vaccine will

help alleviate one of the biggest

barriers to sustainable access to

PCVs that countries face – price.

A new pneumococcal vaccine

from the Serum Institute of India

was recently approved for use by

the World Health Organization

and is expected to be 30% cheaper

for low-income countries than

existing vaccines.

Lower-priced vaccines

With the support of organisations

like Gavi, the Vaccine Alliance,

poor countries will be better placed

than ever before to introduce

these vaccines into their routine

immunisation programmes. Gavi

helps increase access to vaccines

in low-income countries and has

already supported 59 low-income

countries to introduce PCVs, reach-

ing more than 183 million children.

With the availability of a more

affordable vaccine, countries will

have more options to choose from.

The lower price means they can

free up valuable resources for other

health or development priorities.

There are encouraging signs of

progress. Indonesia announced in

January that it would make PCV

part of its routine immunisation

programme and committed to

vaccinating four million children

each year. Rolling PCVs out in a

country like Indonesia, with a large

population and a high burden of

pneumonia, is a major step forward.

Pneumonia prevention must

be a priority

Reducing deaths from pneumonia

in the long-term will require putting

pneumonia at the top of the global

agenda and keeping it there.

High-burden countries must

make protecting children from

pneumonia through well-function-

ing primary healthcare systems

a top priority.

Donor governments must

continue to generously fund

organisations like Gavi to ensure

countries have the support they

need to introduce PCVs and sustain

their use in every community.

To create a world free of prevent-

able disease, we must ensure every

child can access these life-saving

vaccines – no matter where they live.

REFERENCES:

1. Policy Cures Research. G-FINDER 2019:
   Neglected Disease Research and Devel-
   opment: Uneven Progress, Jan 2020.
   https://s3-ap-southeast-2.amazonaws.
   com/policy-cures-website-assets/app/
   uploads/2020/01/30100951/G-Finder-
   2019-report.pdf

Every year, 800,000 children die of pneumonia, a

well-known but often-neglected disease. Though

effective treatment and preventive vaccines

exist, pneumonia remains the leading infectious

cause of death for children.

Pneumonia: the

preventable health

crisis the world

has neglected

Keith Klugman

Director, Pneumonia,

Bill & Melinda Gates

Foundation

Thankfully, a new vaccine

will soon be on the market

that will help reduce this

disparity and make PCVs

available to more children.

©MANIT CHAIDEE