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A shot in the arm: The world’s market for vaccines is being turned upside down

Global-health experts are often a glum lot, but a few billion dollars should be enough to perk anybody up. Over the past decade the Global Alliance for Vaccines and Immunization (GAVI), founded with the help of the Bill and Melinda Gates Foundation, has become the world’s main advocate of immunization. Last year Mr Gates announced a new “decade of vaccines”. But it seemed unclear whether the vast sums needed to pay for it would really be available; GAVI said it needed $3.7 billion between now and 2015 for new vaccines, mainly to prevent pneumonia and diarrhoea, the biggest killers of young children. On June 13th, at a conference in London, the group got its wish, and more, with donors pledging $4.3 billion to help immunise 250m children.

If they come through with the money, the world may be indeed on the verge of a vaccine boom. Drug firms have been researching vaccines for everything from addiction to cancer. As important, the past decade has seen changes in how vaccines are developed, financed and delivered—solving, at least partially, the conundrum of the vaccine market: poor regions have ample demand for vaccines but little ability to pay for them. As a result, immunisation rates in the poor world have soared.

One reason for this success is increased competition among manufacturers, largely thanks to vaccine-makers in emerging markets. The Serum Institute of India, for instance, says that its vaccines now immunise half the world’s children. Another is GAVI itself. Before its creation, UNICEF offered short-term tenders for vaccines. By contrast, GAVI has insisted on higher volumes and long-term contracts to attract manufacturers and drive down prices. The alliance has had particular success with the hepatitis B vaccine. From 2000 to 2010 GAVI’s support led to the immunisation of 267m children, according to the World Health Organization (WHO).

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