Advance Market Commitment for Pneumococcal Vaccines: Putting Theory into practice/Engagement Prealable Relatif Au Marche Pour Les Vaccins Contre le Pneumocoque: Mettre la Theorie En pratique/Compromiso De Mercado Avanzado Para Vacunas Neumococicas: Poniendo En Practica la Teoria
Notice bibliographique
Résumé
Introduction The prevention of disease through vaccination with efficacious and safe vaccines is one of the most cost-effective public health interventions. (1) However, often the markets for vaccines do not generate the most desired outcomes from a public health perspective in terms of product quantity, quality, affordability, programmatic suitability and/or sustainability, particularly when it comes to serving the poorest populations. Economic factors may hinder or delay the clinical development of candidate products as well as prevent manufacturing of licensed vaccines at sufficient scale to respond to these needs. Manufacturers face competing interests when making investment decisions and they perceive demand from developing countries as very uncertain. While the need for and the willingness to adopt new vaccines exist, resources to sustainably fund such products are often missing. Manufacturers thus find this market segment very risky and less attractive. An Advance Market Commitment (AMC) for vaccines aims to make the market for vaccines in developing countries more attractive through a legally binding commitment to purchase vaccines according to predetermined terms. As some of the risks are removed, the vaccine industry is encouraged to increase investments to stimulate the development and manufacture of target products. Different models have been designed to create market-oriented incentives to support the development and introduction of appropriate health technologies for developing countries. Many have remained academic exercises, but the AMC moved from theory to practice with a pilot AMC for pneumococcal vaccines launched in 2009. While it is still early to assess the efficiency and effectiveness of this pilot, this paper discusses lessons learnt on moving from the theoretical concept to implementation. It provides a starting point to inform discussions and encourage debate about the potential applications of the AMC concept to other interventions. The pilot AMC An AMC for vaccines gained public attention with a report by the Center for Global Development in April 2005. (2) The report proposed to create incentives for commercial investments in research, development and manufacturing of vaccines for developing countries through a legally binding pledge by donors to pay a certain price for a new vaccine if it is developed and desired. (2) A pilot AMC for pneumococcal vaccines was announced in February 2007 and formally launched in June 2009 with a joint pledge of 1.5 billion United States dollars (US$) by the Governments of Canada, Italy, Norway, the Russian Federation and the United Kingdom of Great Britain and Northern Ireland, and the Bill & Melinda Gates Foundation. (3) The key design features and the functioning of the AMC for pneumococcal vaccines are described in Box 1. The GAVI Alliance, a public-private partnership created to increase access to immunization in poor countries, and The World Bank co-led the design of the pilot and they implement it together with the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO). By placing the AMC on its balance sheet, The World Bank effectively guaranteed US$1.5 billion in AMC funding for the purchase of pneumococcal vaccines. (5) Meanwhile, the GAVI Alliance serves as the secretariat for the AMC and has committed to support eligible countries to purchase the product. Some of the expected benefits of the AMC are outlined here. Box 1. Design and functioning of the Advance Market Commitment for pneumococcal vaccines The pilot Advance Market Commitment (AMC) offers a legally binding commitment to support the market of targeted pneumococcal vaccines with US$1.5 billion of funds for which vaccine manufacturers can bid. Interested manufacturers compete over successive tenders to supply a share of the annual forecasted demand of vaccines (which is expected to increase over time and reach around 200 million doses per year at peak). …
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,034 | 0,045 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,003 | 0,002 |
| Études des sciences et des technologies | 0,003 | 0,025 |
| Communication savante | 0,011 | 0,012 |
| Science ouverte | 0,005 | 0,007 |
| Intégrité de la recherche | 0,008 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,011 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».