COVID-19 and Malaria Vaccine Advanced Market Commitments: Opportunities to Incentivize Investment in Africa’s Vaccine Manufacturing Industry

Abstract

Introduction Using push dynamics to drive the purchase of commodities with forecasted demand, the advanced market commitment (AMC) model has been applied to the development of vaccines catering to low-income countries in Africa and the globe. This model is currently the driving force behind both the delivery of COVID-19 vaccines to countries unable to afford open market prices and the roll out of the RTS,S/AS01 (Mosquirix) malaria vaccine in the WHO Africa region. Methods This literature review instills a comprehensive understanding of the costs associated with vaccine manufacturing development in the Africa region and draws particular focus to the prices paid by African national governments for the recently rolled out COVID-19 vaccines through the COMAX AMC as well as the estimated costs (based on birth cohort data and DPT vaccination coverage data) of the recently WHO recommended malaria vaccine program. Results Ethiopia, a GAVI supported country, is projected to pay between 4.2 and 9.9 million USD annually to vaccinate its target population with RTS,S/AS01b. GAVI ineligible countries such as South Africa and Egypt are projected to spend approximately 15.5 million and 43.3 million USD respectively. Of the GAVI ineligible and self financing countries, those with COVID-19 vaccine manufacturing capacity such as South Africa are able to access vaccine costs at 10 USD/dose compared to the 37 USD/dose spent by the 8 countries without manufacturing capacity. Results Investment in existing vaccine manufacturing companies in Eastern and Western Africa has projected growth with CAGR as high as 37% within 10 years. By purchasing and procuring vaccines from local regional manufacturing hubs, a number of donor un-supported self-financing countries in Africa have the potential to save up to 10 USD per vaccine dose.