World Bank HIV Vaccine Industry Study: Draft Summary

Ideas to stimulate development and introduction

The fact that companies were primarily focused on "push" (risk and cost) barriers
rather than "pull" (reward) barriers resulted in a series of very broad discussions on
mechanisms and incentives.
In summary, the ideas discussed were as follows:
In addition to market guarantee mechanisms for an HIV vaccine, companies
suggested indirect pull incentives, linked to existing products in OECD markets, such
as patent extensions or tax relief Some companies also suggested demonstrating the
commercial credibility of any proposed guarantee mechanism by supporting the rapid
introduction of an existing new vaccine.
"Push" ideas fell into three categories: supporting product research and development,
supporting efficacy trials, and supporting manufacturing capacity investment. In each
case, there were several variations on the theme.
Conclusions and recommendations
The single most important reason why there is not an HIV vaccine today is scientific,
compounded by the high costs and risk of definitive efficacy testing. This means that,
on their own, market guarantee mechanisms will do little to accelerate development.
Such mechanisms will however be critical in ensuring access and to some extent
relevance, once a product is in late stage development. Further, overcoming the
existing paradigm of vaccine supply to LDCs has a significant global health value
beyond HIV alone.
"Pull" recommendations
Therefore, given the likely time necessary to design and establish an appropriate
purchase or subsidy mechanism, we would recommend that the World Bank start
doing so now.
We also think that improving the commercial credibility of the existing LDC vaccine
market will significantly enhance relevance and access for all future vaccine products.
We therefore recommend that the World Bank develop and fund an accelerated
introduction programme for an existing new vaccine.
We also find attractive the idea of indirect pull incentives, and in particular G8 or
OECD patent extensions. In particular, we believe that such incentives might
stimulate greater interest from large pharmaceutical companies in the field, in turn
providing a stimulus to candidate and development efforts, especially in the biotech
sector. In addition a patent extension has the advantage that, whilst worth several
hundred million dollars to any major pharmaceutical company, its cost is hidden. The
cost to G8 healthcare systems could nonetheless be justified by the future healthcare
savings which would be generated by success.