Academic journal article Bulletin of the World Health Organization

Impact of BRICS' Investment in Vaccine Development on the Global Vaccine market/Impact De I'investissement Du Groupe BRICS Dans le Developpement De Vaccins Sur le Marche Mondial Des vaccins/El Impacto De la Inversion De Los BRICS En El Desarrollo, De Vacunas Sobre El Mercado Mundial De Vacunas

Academic journal article Bulletin of the World Health Organization

Impact of BRICS' Investment in Vaccine Development on the Global Vaccine market/Impact De I'investissement Du Groupe BRICS Dans le Developpement De Vaccins Sur le Marche Mondial Des vaccins/El Impacto De la Inversion De Los BRICS En El Desarrollo, De Vacunas Sobre El Mercado Mundial De Vacunas

Article excerpt

Introduction

Through their vaccine manufacturers, Brazil, the Russian Federation, India, China and South Africa have a substantial and increasing role in the global vaccine market. Together, these countries known as BRICS are increasing the production capacity for vaccines with a high global demand and vaccines that are required specifically in the developing world. BRICS are also generally replacing multinational corporations as sources of traditional vaccines--i.e. the five vaccines originally included in the World Health Organizations (WHO) Expanded Programme on Immunization (1)--and enhancing competition and lowering prices in the United Nations' and national vaccine markets.

In this paper, we analyse the growth of vaccine production, vaccine regulation and development in BRICS over the past 20 years. We evaluate the impact of that growth on the global vaccine market, by comparing vaccine production in each of the five countries in 1993 and 2013, analysing the relevant technology sources and collaborations, following the evolution of national regulatory authorities, and determining temporal trends in the numbers of vaccines prequalified by the WHO that were produced. We also identify some of the current limitations of BRICS' vaccine-related strategies and explore ways in which the international community might help reduce those limitations.

BRICS' role in the global vaccine market

The vaccines needed for the Expanded Programme on Immunization (1) and the subsequent national immunization programmes were initially sourced from both national and international manufacturers. Recombinant hepatitis B and Haemophilus influenzae type b vaccines became available in the 1980s but their production was felt too complex for many vaccine manufacturers. Three major developments subsequently influenced the global vaccine market. One was the introduction, in 2001, of highly profitable products such as the conjugate pneumococcal vaccine, which produced profits measured in billions of United States dollars (US$). (2) The second major development was the growth of funding initiatives to introduce new vaccines nearly simultaneously throughout the developing world. (3) The third major development was the emphasis placed on quality control and assurance standards for all vaccines used worldwide. This emphasis was mainly the result of the establishment of WHO's programme of vaccine prequalification in 1987 (4) and that programme's collaboration with large vaccine procurement agencies such as the Supply Division of the United Nations Children's Fund (UNICEF) and the Revolving Fund of the Pan American Health Organization (PAHO). Vaccine production has become a research-based global business with high industrial standards for quality and the potential for substantial profits. In the early days of the Expanded Programme on Immunization, the prices of the traditional vaccines used in the developing world were low because multinational corporations could produce the vaccines using existing capacity that the corporations did not need to supply their more usual, higher-priced markets. As new more-profitable vaccines became available, however, most of the multinational corporations stopped producing the older vaccines. Fortunately, the growth of vaccine manufacturing in some of the BRICS countries has helped to keep the prices of traditional vaccines relatively low.

Vaccine manufacturers and markets in emerging economies

Some manufacturers in low- and middle-income countries have been included in WHO's vaccine prequalification programme since the programme was established. Examples include the Pasteur Institute of Senegal and some manufacturers in the formerly communist states of central and eastern Europe--represented by the Canada-based buying group, Conpharma. By 2007, nearly 50% of the manufacturers of prequalified vaccines were based in emerging economies. (5) Around that time, such economies also became key importers of new vaccines. …

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