SEATTLE, Washington — Pneumonia remains the deadliest killer of children under 5 years of age, with 100 children dying of the disease every hour. The leading cause of severe pneumonia, pneumococcus bacterium, is entirely preventable by receiving the pneumococcal conjugate vaccine (PCV). Its previous $3.50 price point thwarted many children in poverty-stricken countries from accessing this life-saving vaccine. However, a new supply agreement between the United Nations Children’s Fund (UNICEF) and the Serum Institute of India has dramatically dropped the pneumonia vaccine price by 43%, making the PCV vaccine cost $2 per dose. The drop in price expands the protection against one of the world’s deadliest diseases for millions of children in developing countries.
Pneumonia’s Role in the Cycle of Poverty
Given the close link between poverty and pneumonia, it is no surprise that pneumonia disproportionately inflicts those living in the world’s most impoverished households and countries. In fact, 99% of children who die from pneumonia live in developing countries. Children living in poverty suffer from many insidious health effects, including malnutrition, poor access to medical treatment, air pollution and immune-compromising infections. All of these additional factors significantly increase one’s risk of catching and dying from pneumonia. Moreover, according to a report from UNICEF, more than half of the children who die of pneumonia before their fifth birthday also suffer from undernutrition.
Beyond combatting the inflicting loop between pneumonia and other poverty-associated health factors, vaccines also play an essential role in interrupting the cycle of poverty. Researchers estimate that administering the pneumococcal vaccine in 41 low-and middle-income countries will forestall two million deaths and 1.25 million medical impoverishment cases. However, treating pneumonia is often too costly, leading to dire situations. For instance, in the Gambia, families pay up to 10 times their daily household budget to afford pneumonia treatment. By curbing these future medical care costs, vaccines limit the expensive health expenditures that can quickly push families below the poverty line and keep them there.
Expanding Access to the PCV Vaccine
Since the PCV vaccine prevents not only diseases but also further impoverishment for those who contract them, ensuring everybody has timely and affordable access to the pneumonia vaccine is critical. For three years in a row, Gavi, the Vaccine Alliance, has successfully negotiated reductions to the PCV vaccine price. The most recent of these negotiations on June 2, 2020, was a supply agreement between Gavi’s procurement agency, UNICEF, and the Serum Institute of India. As a result of these negotiations, the PCV vaccine price dropped to $2 per dose, and the organization procured 10 years of 20 million annual doses for Gavi’s 58 supported countries.
This supply agreement is the eighth one in Gavi’s Advanced Market Commitment—a financing mechanism aimed to reduce pneumococcal disease-induced child mortality in developing countries. The AMC targets a common problem in supplying pneumococcal vaccines: manufacturers in industrialized countries are typically the first to develop and receive the distribution of vaccines. As a result of these practices, developing countries where diseases have the most significant impact on populations don’t receive vaccines until 10 to 15 years later.
Furthermore, the AMC incentivizes researchers to prioritize developing vaccines tailored explicitly to the epidemiology of developing countries. The 2020 supply agreement with the Serum Institute of India took this goal further by being the first to be fulfilled by a manufacturer in a developing country.
Looking Ahead
“Thanks to this visionary model we have a healthy PCV market that is producing enough vaccines to supply both rich and poor countries and, as a result, hundreds of millions of children are now protected against one of the world’s deadliest diseases,” said Aurelia Nguyen, Gavi’s managing director for vaccines and sustainability, in UNICEF’s press release. As the immunization manufacturing market’s capacity continues to expand into developing countries, the reversal of prohibitive vaccine pricing will only continue, saving many people in the process.
—Christine Mui
Photo: Flickr