Are good intentions putting the vaccination ecosystem at risk?

ABSTRACT

Vaccination is made possible by an interconnected and interdependent ecosystem of vaccine producers, vaccination policy makers and implementers, and vaccine procurers and funders. The future of vaccination depends on the continued health of this ecosystem and its ability to produce, purchase, deliver, and innovate. However, the number of vaccine producers that also do significant research and development has decreased over the last several years. Many of these R&D-based producers have been forced to cease production of critical vaccines, despite global shortages, so that in several cases only one or two producers remain. We discuss the reasons for these changes and what might be done to maintain a healthy vaccination ecosystem.

KEYWORDS:

• economics
• funding
• health policy
• non-governmental organization
• vaccination program

Abbreviations

DTP	=	diphtheria-tetanus-pertussis
GAVI	=	Global Alliance for Vaccines and Immunization
R&D	=	research and development
UNICEF	=	United Nations Children's Emergency Fund

Disclosure of potential conflicts of interest

Michael Watson was employed by the vaccine developer and producer, Sanofi Pasteur, Lyon, France.

Acknowledgments

This review was presented in part at the 15th Annual World Vaccine Congress 2015, Washington, DC, and to United Nations High-Level Panel on Access to Medicines in March 2016. The authors thank Grenville Marsh (Sanofi Pasteur) and Phillip Leventhal (4Clinics, Paris, France) for editorial support.