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Market Shaping and Market Access in the Global Vaccines Market: Approaches for the Future

This paper looks at market access and market shaping in the interest of public health in a post-COVID world. It starts out with a detailed case study of Gavi’s market shaping (presented in a snapshot over 20 years), highlighting the key successes in: (i) introducing new vaccines in Gavi-eligible countries successively, (ii) expanding the number of suppliers, and (iii) bringing down prices for immunization in LMICs. Looking closely at how these successes were facilitated, the paper identifies a number of ‘behind-the-scenes’ factors that helped Gavi achieve these successes in different vaccine categories. In its second part, the paper moves on to the lessons learned through these experiences, highlighting ways in which these learnings can be used to address the opportunities and challenges for market access and market shaping in the future. Finding that some of these challenges arise directly from the dynamics of the vaccine sector itself, while some others are the outcome of contrasting policy interventions, the paper advocates a more integrated approach to local production, pricing, procurement, and competition given the inter-related workings of many of these incentives. Acknowledging that such market shaping will also require closer monitoring of progress (in terms of greater access) across specific vaccine categories, the paper calls for working closely with more actors in the field including regional agencies and national governments in Africa. Findings suggest that a discussion of how to enable such a wider, more structural approach to market shaping with Gavi’s active involvement and coordination with other partners, might be necessary.