Vaccines have become a common tool to prevent infections, with many deadly diseases kept under control by a programme of childhood immunisation. In developed countries, such health programmes normally include vaccination against the bacteria Streptococcus pneumonia. Severe pneumococcal diseases – primarily pneumonia and meningitis – are the leading vaccine-preventable causes of death in children under five. Globally, nearly a million young children die each year from pneumococcal infection, the vast majority in developing countries. This is because poor countries have historically been unable to afford the necessary vaccines in large enough quantities to meet demand.
In June 2009, the governments of Italy, the UK, Canada, Russia and Norway, along with the Bill & Melinda Gates Foundation, launched a pilot initiative to help address the problem of affordable vaccines for developing countries. Known as Advance Market Commitment (AMC), the scheme provides a framework to promote the development and manufacture of new vaccines for developing nations. With an AMC, country governments and donors commit funds to guarantee a certain price for vaccines once they are developed and the ordering of enough quantities from the drugs companies to ensure mass manufacturing is viable.
The first AMC to be sponsored and launched is a vaccine against pneumococcal disease. The existing vaccine used in Europe and the United States is unsuitable for developing countries, where different strains of the pneumococcal bacteria are present. The production of a broader pneumococcal vaccine, which protects against 6 additional strains (on top of the existing 13), received 1.5 billion dollars of commitment from the AMC and also 1.3 billion dollars for the period 2010-2015 from the Global Alliance for Vaccines and Immunisation (GAVI). GAVI is a public-private partnership of organisations which includes the World Health Organisation, UNICEF, the World Bank, governments, research and technical agencies in the vaccine industry and charities such as the Bill & Melinda Gates Foundation.
Now Nicaragua has become the first developing country to receive this new broader-based pneumococcal vaccine. With AMC funding, the vaccine has been produced to cost only 3.50 dollars per dose, compared with 108 dollars for the ordinary 13-strain vaccine. However, Nicaragua will pay just 30 cents per dose, each child needing four doses. The rest of the cost will be covered by the AMC. Currently in Nicaragua, one fifth of annual deaths in children below the age of five are caused by pneumococcal disease and around 30,000 children die across Latin America as a whole. A spokesperson for the AMC said that a series of roll-outs for the vaccine are now planned, with Guyana and Honduras as the next countries to be targeted. With extra funding, it is hoped that more than 40 countries can be included in the Pneumococcal AMC vaccination programme by 2015, an achievement which could save 900,000 lives.