Beyond patents: the GAVI Alliance, AMCs and improving immunization coverage through public sector vaccine production in the global south.

摘要

To date, Donald Light has been the most principled participant in the development of the Advance Market Commitment (AMC) approach to improving vaccine coverage for children.1'2 His latest critique of the GAVI Alliance's (mis) use of the AMC to purchase and discount-sell pneumococcal conjugate vaccines (PCVs) is on target in a number of ways:(1) The vaccine is of questionable relative benefit, since it assumes that the prevalence of serotypes is the same worldwide, an assumption that is not necessarily valid;3(2) The AMC was extended to an existing vaccine developed for a high-income market rather than its stated purpose of developing new vaccines for low-income settings;(3) The PCV AMC is financing exorbitant pharmaceutical company profits;(4) The efficacy and cost-effectiveness of PCVs, as opposed to other vaccines and child health interventions-or integrated sociopolitical primary health care approaches-are dubious.