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[e-drug] The G8, Profits, the Poor and a pneumococcal vaccine

E-DRUG: The G8, Profits, the Poor and a pneumococcal vaccine

Dear E-druggers,

You have probably seen, or will soon, the press release from The Lancet about 
an intersection of pharmaceuticals, business, and reducing global poverty. The 
article in the July 28 issue claims that three-quarters of the $1.5 billion in 
donations to the G8 to buy Synflorix, a new pneumococcal vaccine for the poor, 
will go to extra profits, because the G8 is committed to paying about four 
times the nonprofit, average price. 

As a result, only one-quarter as many poor children will be immunized as the 
donations could make possible. The R&D costs of Synflorix are fully paid, based 
on large expected sales in affluent countries. 

The article recommends that G8 leaders use the Advance Maximum Benefit 
Commitment (AMBC) approach so that several hundred million more poor can 
receive the vaccine than using the AMC contract. 

Will the G8 leaders alienate a humanitarian movement of donations that has 
taken years to build up by commercializing it for profits? Or will they show 
that donations are well used to do the greatest good for the greatest number of 
people? Have G8 leaders been misled by an elite of AMC advocates? 

What you probably don’t know is that GSK (the vaccine’s manufacturer) 
apparently told the Dutch Ministry of Foreign Affairs it is willing to share 
its technology with qualified, third-world manufacturers. The Ministry reported 
the news to Parliament last month in response to a question concerning a policy 
recommendation I developed at NIAS this year. 

Sharing technology would enable open, global bidding that would maximize the 
number of doses that could be bought and help lift the burden of disease in 
nations having an average income of less than $1,000. Attached are the original 
(see Ques 13) and a translation, followed by some comments. 




        EMBARGO: 0001H (UK time) Friday 27 June, 2007


Only a quarter of the $1.5 billion donated by G8 leaders to eradicate disease 
among poor children will be spent on the costs of vaccines, while 
three-quarters will go to profits. G8 should instead negotiate the lowest, 
sustainable, non-profit price in order to maximize the number of lives saved 
and children who can benefit. These are the conclusions of a Comment published 
in this week’s edition of The Lancet. 

Professor Donald Light, Netherlands Institute for Advanced Study and the 
University of Medicine and Dentistry of New Jersey, USA, says that the kind of 
contract which the G8 is using was designed to match the revenues and profits 
which multinational pharmaceutical firms earn from medicines sold in affluent 
markets. But in this case, the G8 plans to purchase a pneumococcal vaccine that 
is already discovered and developed for affluent markets so it is really a 
large, extra contract that should be non-profit to help lift the burden of 
disease in poor countries. He says: “This alternative strategy could be called 
the Advance Maximum Benefit Commitment (AMBC).” 
The current G8 contract is set to pay $5.00 - $7.50 a dose, about four times 
what Prof Light estimates to be the average cost, including capital and 
overheads costs for enlarging production facilities. Thus 300 million or fewer 
children can benefit from the donations, while if the G8 used the AMBC 
strategy, 1.2 billion or more children could benefit. Prof Light questions 
whether poor countries and donors will stand by and watch G8 paying four times 
the average sustainable cost of these vaccines.

Still better would be for G8 leaders to negotiate for licenses and technology 
transfer so that third-world based companies could compete for long term 
contracts. The donated money would then provide a double benefit: boost the 
economies of low income countries as well as lift the burden of disease. He 
concludes: “The low cost structure in developing countries might get the price 
down to $1 a dose, so that 300 million more children could be saved.”

Professor Donald Light, Netherlands Institute for Advanced Study and the 
University of Medicine and Dentistry of New Jersey, USA contact by e-mail only 
E) dlight@princeton.edu 
Tony Kirby
Press Officer
The Lancet
32 Jamestown Road
Tel: +44 (0) 20 7424 4949
E-mail: pressoffice@lancet.com   
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