The introduction of new vaccines into developing countries II. Vaccine financing

The development of new vaccines for important childhood diseases presents a n unparalleled opportunity for disease control but also a significant probl em for developing countries: how to pay for them. To help address this prob lem, the William H. Gates Foundation has established a Global Fund for Chil dren's Vaccine. In this paper, we discuss the allocation of this and other similar funds, which we call Global Funds. We propose that allocation of th e Global Funds to individual countries be guided in part by a Vaccine Procu rement Baseline (VPB). The VPB would set a minimum of 0.01% of gross nation al product (GNP) as an amount each developing country would devote to its o wn vaccine procurement. When this amount is not sufficient to procure the v accines needed by a developing country, the Global Funds would meet the sho rtfall. The amount required of donors to maintain the Global Funds would be about $403 million per year for both existing EPI vaccines as well as for a hypothetical group of five new vaccines costing $0.50 per dose and requir ing three doses per child. Including program costs, poor developing countri es currently spend about 0.13% of GNP on EPI immunizations. In contrast, th e United States, as one example donor country, spends about 0.035% of GNP f or childhood immunization including several new vaccines. This paper analyz es the Global Funds requirements for hepatitis B and Haemophilus influenzae type b (Hib) vaccines. After a ramp-up period, needler countries would eve ntually require about $62 million for hepatitis B and $282 million for Hib at current prices. Various additional criteria could be used to qualify cou ntries for participation in the Global Funds. (C) 2000 Elsevier Science Ltd . All rights reserved.