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Shaping markets to benefit global health – A 15-year history and lessons learned from the pentavalent vaccine market

机译：塑造市场以造福全球健康–五价疫苗市场已有15年的历史和经验教训

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Market shaping for health products used in lower-income countries strives to benefit public health. As a funder of vaccines, Gavi, The Vaccine Alliance (Gavi) has goals for its market shaping efforts, achieved through a strategy developed and implemented by the Gavi Secretariat, UNICEF, the World Health Organization (WHO) and the Bill & Melinda Gates Foundation (BMGF). A case-study of Gavi’s fifteen-year engagement with a vaccine against diphtheria, tetanus, pertussis, hepatitis B and haemophilus influenzae type b (pentavalent) provides evidence of the benefits and potential risks of trying to influence markets. During 2001–18, Gavi disbursed US$3.5 billion to support use of 50 million pentavalent doses annually before 2005, increasing to ∼300 million doses annually by 2016. During this time, eight manufacturers invested in vaccine development and manufacturing and the first two manufacturers have subsequently ceased production. Following its strategy, Gavi implemented coordinated market interventions including technical assistance to manufacturers, improving market information transparency, risk-sharing agreements and innovative procurement aiming to stimulate and capitalize on a competitive market. In 2018 supply allows ∼80 million children per year to be immunised, a sixteen-fold increase from 2005, with vaccine-related costs per child for donors and countries of one-quarter the 2005 level. Lessons learned include the importance of frameworks and strategies; the need to adjust interventions with changing conditions; the important role of manufacturers; and the potentially powerful effects of interconnected markets. This case study is limited by its focus on a single health product in a specific market, however the lessons can inform other market shaping efforts when taken in context. While countries and children have improved vaccine access, risks of financial sustainability and continued manufacturer investment in Gavi vaccine markets are being monitored. Gavi should continue implementing a market shaping strategy, adjust with market conditions and expect and measure unintended consequences.
机译：低收入国家使用的保健产品的市场塑造努力使公众健康受益。作为疫苗的资助者，疫苗联盟（Gavi）的目标是通过Gavi秘书处，联合国儿童基金会，世界卫生组织（WHO）和比尔和梅琳达·盖茨基金会制定和实施的战略来实现其市场塑造工作的目标。 （BMGF）。 Gavi从事针对白喉，破伤风，百日咳，乙型肝炎和B型流感嗜血杆菌（五价）疫苗的十五年个案研究提供了证据，证明了试图影响市场的好处和潜在风险。在2001–18年期间，Gavi支付了35亿美元，以支持2005年之前每年使用五千万剂量的五价剂量，到2016年每年增加到约三亿剂量。在此期间，有八家生产商投资于疫苗的研发和生产，而前两家生产商随后停产。 Gavi遵循其战略，实施了协调的市场干预措施，包括向制造商提供技术援助，提高市场信息透明度，风险分担协议和旨在刺激和利用竞争性市场的创新性采购。 2018年的供应量使每年约有8000万儿童获得免疫，比2005年增加了16倍，捐助者和国家每名儿童的疫苗相关费用为2005年水平的四分之一。所汲取的教训包括框架和战略的重要性；有必要根据情况的变化调整干预措施；制造商的重要作用；以及相互关联的市场的潜在强大影响。该案例研究由于只专注于特定市场中的单个保健产品而受到局限，但是，根据实际情况，这些经验教训可以为其他市场塑造工作提供参考。尽管国家和儿童已经获得了更多的疫苗，但仍在监控财务可持续性的风险以及制造商对Gavi疫苗市场的持续投资。 Gavi应继续实施市场塑造策略，根据市场情况进行调整，并预期和衡量意外后果。

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