Working Towards a Sustainable, Healthy Market for Vaccines: a Comprehensive Framework to Support Policy Dialogue and Decision-Making

By placing a strain on health care systems and the global economy, the COVID-19 pandemic clearly shows the need to more comprehensively understand both supply- and demand-side aspects of a “healthy” vaccines market that can meet public health demand over time and across dynamic events. The goal of a healthy vaccines market, as defined for this study, is to support sustainable innovation and equitable access to address public health needs. Current frameworks that describe the global vaccines market, however, focus primarily on demand-side activities in low- and lower-middle income countries. Further, they do not fully reflect the interconnectedness of national and regional vaccine markets that comprise the global vaccines ecosystem. They do not account for spill-over effects of market-shaping activities (e.g. demand forecasting and procurement) across markets and across time. This motivated the development of a more comprehensive Healthy Vaccines Market Framework (HVMF), based on literature review and expert interviews, and applied this to the COVID-19 pandemic as a case study analysis. The HVMF shows how the characteristics of a healthy vaccine market hinge on supply- and demand-side activities and policies that cut across multiple markets. It helps illustrate how challenges in the global vaccines market may be rooted in multiple factors across a market and how market-shaping interventions aimed at addressing a single challenge in a single market can strengthen or undermine the overall health of the global vaccines market in the short- and long-term. Another critical component of the HVMF is that it draws attention to the diverse set of stakeholders actively engaged in market-shaping activities at the national, regional, and global levels. Given such a complex set of dynamics, it is critical that all actors shaping the global vaccines market understand the broader implications and interconnectedness of individual supply- and demand-side activities and how they shape the global marketplace collectively. In working towards a sustainable, healthy market for vaccines, the HVMF can serve as a comprehensive framework to support policy dialogue and decision-making.