The commitment made yesterday by rich countries to buy a suitable vaccine, meeting internationally recognized standards for efficacy and safety, could transform the economics of development of new vaccines. Pause briefly on how radical this policy is. There is a social need for extra R&D and investment in production facilities. But instead of paying researchers to do that research – which might or might not succeed, they are creating market incentives and allowing competition to do the rest. The donors create a reward for the private sector – the prospect of a lucrative market for vaccines – which enables firms to invest in developing and producing the needed vaccines. But if the research fails it will cost the donors nothing. The taxpayer will only have to cough up if the vaccines are actually developed and used. And if the vaccine is used, it will save more than 5m lives over the next 25 years – at $300 per life saved, a bargain in development terms. For firms, this is attractive because it creates a whole new market for their products, and enables them to serve poor country markets on a commercial basis, rather than as an act of corporate social responsibility. And for developing countries, they have the prospect of access to new vaccines, which in the past have taken 15-20 years to be mass produced cheaply enough for them to be widely used in developing countries. So this is an results-based, market-oriented, hard-headed partnership between donors, developing countries and the pharmaceutical industry which, if it works, will solve one of the most important health challenges on the planet.

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