Malaria Vaccine Taking a Novel Path to Market

Persuading drug companies to develop vaccines and antibiotics can take Bono-like persuasion skills. A malaria vaccine is desperately needed, but the parasite's complex life cycle presents formidable obstacles to bug-busting researchers. The Wall Street Journal has presented an interesting article [subscription required] describing how The Bill & Melinda Gates Foundation is taking a leading role in encouraging the development of a vaccine. Excerpts below from the 26 April story:

Next month, hundreds of African infants will get an experimental vaccine against malaria in a medical trial that could foster a multibillion-dollar collaboration of science, philanthropy and market savvy.

Under two new funding strategies championed by Microsoft Corp. founder Bill Gates and Britain's finance minister, Gordon Brown, rich nations and their private-sector partners for the first time would jointly guarantee the provision of vaccines against the worst scourges afflicting the developing world.

They are stepping in where market mechanisms have failed. While older vaccines for diseases like mumps and measles are more widely and cheaply available, vaccines for malaria, tuberculosis and AIDS, the developing world's top killers, are so risky and costly to bring to market that little progress has been made in these areas. The malaria vaccine about to be tested has been under development for two decades -- and at one point it was nearly abandoned. The annual death toll for AIDS, TB and malaria totals at least six million.

The new funding tools are aimed specifically at this market failure. In one approach, donor governments would guarantee that a company that produced a cutting-edge vaccine for poor countries would receive market-rate prices long enough to recoup development costs. This mechanism, proposed earlier this month, is called an advance-purchase contract.

The other strategy consists of rich countries, for the first time, floating government bonds geared specifically to supplying poor countries with available vaccines now and new vaccines later. Through a proposed International Finance Facility for Immunization, the billions of dollars expected to be raised would greatly expand the distribution of existing life-saving vaccines for diseases like polio and hepatitis, and ensure that newer vaccines reach those who need them.
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Malaria is one of the scourges targeted by the Bill and Melinda Gates Foundation set up by Mr. Gates and his wife, Melinda. The mosquito-borne disease, long kept in check in affluent nations with drugs and pesticides, kills nearly two million people in Africa every year, and claims additional victims elsewhere. Mr. Gates has steered his $28.8 billion foundation toward fixing such global-health inequities.

The focus of his current push is the malaria vaccine being tested next month. The vaccine program almost died in a corporate restructuring in 1999. But a Gates-funded group gave GlaxoSmithKline PLC's GSK Biologicals unit in Belgium a $10 million grant to fund the study for toddlers, and is negotiating for further grants to help fund the coming study in infants.
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Next month, GSK tests advance to the ultimate target group: 10-week-old infants. In Mozambique and Tanzania, 600 to 800 infants will get malaria vaccine with their routine shots. If Mosquirix protects them -- a delicate feat due to their immature immune systems -- tests will expand to more countries. If these succeed, GSK says Mosquirix could be available in five years.

Without the Gates money, "it is fair to say we would not be where we are today. It would be difficult...to sustain the cost," says Glaxo's [Chief Executive] Mr. [J.P.] Garnier. Commercializing the vaccine would top $1 billion. GSK's vaccine-unit chief, Mr. [Jean] Stephenne, says, "We need these incentives."

Update 04 May 2005: Galen's Log makes an interesting comment on the long-term, political aspects of the malaria-vaccine situation: "It [Africa] needs market access [not just medicine]. It needs to not be threatened when deciding how to deal with malaria. It needs help getting rid of rulers like Mugabe. It needs strategies for dealing with crippling corruption and tribalism."