Advance market commitment for pneumococcal vaccines: putting theory into practice
Advance market commitment for pneumococcal vaccines: putting theory into practice
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DOI：
10.2471/blt.11.087700
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发表时间：
2011-12-01
期刊：
影响因子：
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通讯作者：
McAdams, Susan
中科院分区：
文献类型：
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作者：
Cernuschi, Tania;Furrer, Eliane;McAdams, Susan
从公共卫生的角度来看，救生疫苗市场在产品数量、质量、可负担性、方案适用性和/或可持续性方面并不经常产生最理想的结果，供最低收入国家使用。对发展中国家可持续供资需求的风险和不确定性的认识往往导致对适当产品的开发和制造投资不足。2009年启动的肺炎球菌疫苗预先市场承诺试点举措旨在通过提供具有法律约束力的预先承诺，根据预定条款购买疫苗，消除其中一些市场风险。到目前为止，已有14个国家通过AMC引入了肺炎球菌疫苗，预计在2013年底前还有39个国家将引入。本文介绍了在选择目标疾病方面的早期经验教训以及试点AMC的核心设计选择。它强调了针对肺炎球菌疫苗的具体供应情况定制AMC设计所面临的挑战。它指出了在一个不断变化的不可预测的环境中建立长期、可信的承诺的困难和AMC的明显早期成功。它强调了AMC的固有挑战之一：它依赖于持续的捐助资金来确保长期购买产品。本文研究了替代设计选择，旨在提供一个起点，为讨论提供信息，并鼓励对AMC概念在其他领域的潜在应用进行辩论。
Markets for life-saving vaccines do not often generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability for use in the lowest income countries. The perceived risks and uncertainties about sustainably funded demand from developing countries often leads to underinvestment in development and manufacturing of appropriate products. The pilot initiative Advance Market Commitment (AMC) for pneumococcal vaccines, launched in 2009, aims to remove some of these market risks by providing a legally binding forward commitment to purchase vaccines according to predetermined terms. To date, 14 countries have already introduced pneumococcal vaccines through the AMC with a further 39 countries expected to introduce before the end of 2013.This paper describes early lessons learnt on the selection of a target disease and the core design choices for the pilot AMC. It highlights the challenges faced with tailoring the AMC design to the specific supply situation of pneumococcal vaccines. It points to the difficulty and the AMC's apparent early success in establishing a long-term, credible commitment in a constantly changing unpredictable environment. It highlights one of the inherent challenges of the AMC: its dependence on continuous donor funding to ensure long-term purchases of products. The paper examines alternative design choices and aims to provide a starting point to inform discussions and encourage debate about the potential application of the AMC concept to other fields.