This is a feel good story reported by Xconomy. It concerns the nonprofit PATH's success in developing a meningitis A vaccine (MenAfriVac) for less than 50 cents per dose to serve the needs of sub-Saharan Africa. As I type, populations in Burkina Faso, Mali and Niger will start receiving their shots. This is a story made possible with the leadership of PATH in partnership with WHO and backed by $70 M worth of financial assistance from the Bill and Melinda Gates Foundation.
PATH brought its technology expertise and WHO its knowledge and relationships in the African meningitis belt. Early on PATH made the critical decision to go after only the most common meningitis A strain (85% of disease) rather than try to develop a quadravalent vaccine. The design goal to deliver a vaccine at less than 50 cents per dose was also made to make sure the populations that needed it could afford to use it. The immediate goal is to now vaccinate more than 12 M people under the age of 30, who normally have less immunity to the meningitis bug.
No big vaccine makers joined the project. PATH partnered with Serum Institute of India (which makes 50% of UNICEF's vaccines) to make the carrier protein (tetanus toxin) and Synco Bio (Netherlands) to make the antigen. The USDA provided the license to the conjugation process. The vaccine was authorized for sale to the UN in July. Now it is a matter of getting it to the population in need.
Interestingly the Financial Times (coming to you via Medical News Today) recently did an analysis of big pharma (vaccine) 'top down' development model versus the 'bottom up' model that was employed by PATH and its collaborators.
The top down model is known as Advanced Market Commitment (AMC) - whereby governments are asked to pledge money to a pool to guarantee a profit and induce pharma companies to work on the disease/treatment that is needed. The first example, a pneumococcal vaccine, resulted in a pool of $1.5 B. It is set to launch next week.
PATH's approach was engineered from the beginning to meet the needs of the poor - by focusing on affordability, recruiting a network of low-cost contractors, securing funding from Gates Foundation and focusing on one targeted strain important to the African population. Reminder, it cost about $70 M to achieve.
The big question - is the PATH model reproducible to other diseases or was it an aberration? Can this modest investment work in instances where the science is less well known or the vaccine more complicated (multi-valent)? This remains to be seen but I don't think the program should be dismissed without trial and study. It may be the better model for many diseases. We could be headed down the right PATH.
Posted by Bruce Lehr December 8th 2010.