Center for Global Development

In this chapter 1 examine and compare three proposals recently made to stimulate private involvement in developing pharmaceuticals for neglected diseases (1) Kremer and Glennerster (2004) and the Center for Global Development (2005) have described in detail a plan for Advanced Purchase Commitments for vaccines, which would commit a global body to pay a fixed subsidy per vaccine delivered for certain diseases, if the vaccine meets prespecified technical requirements and is priced below some level. This would help to solve both access and incentive problems, but is necessarily... 

The Advanced Purchase Commitments approach proposed by Kremer and Glennerster (2004) and the Center for Global Development (2005) has attracted considerable public attention as well as seed funding from the Gates Foundation in recent years. Advanced purchase commitments could be useful for certain types of pharmaceutical products, principally vaccines, to stimulate research by promising a subsidy of a fixed value per unit for a given number of units. The most attractive candidate product for such a commitment is a malaria vaccine, since the health (and economic) benefits from an effective malaria vaccine could be very large. 

Center for Global Development Advanced Market Commitment Working Group. 2005. Making Markets for Vaccines Ideas to Action. Available at vww.cgdev.org/ Pubhcations/vaccine/Jiles/MakingMarkets-complete.pdf. Last accessed April 28, 2005. 

Lanjouw, J. 2004. Outline of Foreign Filing License Approach. Washington, DC Center for Global Development Global Health Policy Research Network. Available at www.cgdev.org/ docs/FFLOutline.pdf. 

Center for Global Development. 2000. Making Markets for Vaccines Ideas into Action. Washington,... 

Lanjouw, J. O. and W. Jack. 2004. Trading Up How Much Should Poor Countries Pay to Support Pharmaceutical Innovation Center for Global Development Brief 4(3) 1-8. Available at http // www.cgdev.org/docs/CGDbrief%20pharmaceutical.pdf [Accessed February 5, 2006]. 

Motley, Samuel, and David Coady. 2003. From Social Assistance to Social Development. Washington, DC Center for Global Development and International Food Pohcy Research Institute. 

In 1993 the Institute of Medicine Gouncil proposed the establishment of a National Vaccine Authority because the private sector alone cannot sustain the costs and risks associated with the development of most Ghil-dren s Vaccine Initiative vaccines, and because the successful development of vaccines requires an integrated process, the committee recommends that an entity, tentatively called the National Vaccine Authority, be organized to advance the development, production, and procurement of new and improved vaccines of limited commercial potential but of global public health need (Mitchell, Philipose, and Sanford 1993). But in its recent report. Strengthening the Supply of Routinely Recommended Vaccines in the United States, the Center for Disease Control s National Vaccine Advisory Committee expressed little sentiment for the establishment of a National Vaccine Authority. 

Paul H. Gamache, Vice President, ESA Biosciences, Inc., Chelmsford, MA Jason S. Gobey, Associate Director, Pfizer Global Research and Development, Clinical Research Operations, New London, CT Michael C. Granger, USTAR Research Scientist, University of Utah, Center for Nanobiosensors, Salt Lake City, UT... 

Angus Nedderman, Director, Pfizer Global Research and Development, Department of Pharmacokinetics, Dynamics and Metabolism, Kent, UK Natalia A. Penner, Associate Principal Scientist, Schering-Plough Research Institute, Department of Drug Metabolism and Pharmacokinetics, Kenilworth, NJ Dil M. Ramanathan, Assistant Professor, Kean University, New Jersey Center for Science, Technology Mathematics Education, Union, NJ Ragu Ramanathan, Associate Director, Bristol-Myers Squibb Pharmaceutical Research Institute, Department of Biotransformation, Pharmaceutical Candidate Optimization, Princeton, NJ... 

M. P. Manahan, K. E. Newman, D. D. Macdonald, A. J. Peterson, Experimental Validation of the Basis for the Coupled Environment Fracture Model, in Rw. EPRI Workshop on Secondary-Side Initiated IGA/IGSCC, Minneapolis, MN, October 14-15, 1993. EPRI, Published while at the Center for Advanced Materials, The Pennsylvania State University, University Park, PA 16802 in cooperation with MPM Research and Consulting, 915 Pike St. PO Box 840, Lemont, PA in cooperation with Global Technical Consultants, Inc., Centre Hall, PA 16828 and in cooperation with Niagara Mohawk Power Corp. Research and Development, 300 Erie Blvd. W. Syracuse, NY 13202, 1993. 

Centers for Disease Control and Prevention (CDC), which estimated a prevalence in 2001 of 7.9% in adults. This is equivalent to 16.7 million people. Because at least 30% of all prevalent cases are undiagnosed, the total number may have been almost 22 million. Note that in 1987, the prevalence of diagnosed diabetes was 6.8 million. This large increase in diabetes has been observed globally. The prevalence of diabetes in adults worldwide was estimated to be 4.0% in 1995 and anticipated to rise to 5.4% by the year 2025. The prediction is that in 2025 there will be 300 million adults with diabetes, greater than 75% of whom will live in developing countries. These statistics have led to diabetes being described as one of the main threats to human health in the twenty-first century. The prevalence of diabetes mellitus increases with age, and approximately half of all cases occur in people older than 55 years. In the United States, -20% of the population older than 65 years have diabetes. There is racial predilection, and by the age of 65, 33%, 25%, and 17% of Hispanics, blacks, and whites, respectively, in the United States have diabetes mellitus. In 2002 diabetes mellitus was estimated to be responsible for 132 billion in healthcare expenditures in the United States. The direct costs were 92 billion, with 50% of that incurred by those older than 65 years. An estimated 186,000 deaths annually are attributable to diabetes. In fact, American women are twice as likely to die from diabetes mellitus as from breast cancer. Approximately one in five American healthcare dollars spent in 2002 was for people with diabetes mellitus. 

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