Working paper: Access conditions for public investment in the private pharmaceutical sector – What options for MAV+?

Introduction

Access to health products remains a critical issue today, with billions of people worldwide lacking adequate and consistent access to quality health products. Recent data indicates that about four and a half billion people are not fully covered by essential health services (WHO & IBRD, 2023). This multifaceted challenge includes the lack of access to medical countermeasures during outbreaks, medicines shortages caused by structural issues and vulnerabilities in the supply chain, rising prices of new pharmaceuticals, and lack of market incentives for older medicines (WHO, 2017). This lack of access can result in poor health outcomes, with diseases or conditions remaining undiagnosed, untreated, or sub-optimally treated. 

To address this issue, UN Member States have set a target to achieve universal health coverage by 2030, aiming to provide financial risk protection, access to quality essential health-care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all (Sustainable Development Goal 3.8). In addition, many governments are supporting the development of a local pharmaceutical industry with the multiple objectives of improving access to health products, increasing health sovereignty and supporting economic development. 

One such strategy is the African Union’s strategy to establish regional manufacturing hubs and increase local production capacity of vaccines, medicines and diagnostics as part of their plan to produce 60% of their vaccines locally by 2040 (African Union & Africa CDC, 2022). To support this strategy, European actors established the Team Europe Initiative on Manufacturing and Access to Vaccines, Medicines and Health Technologies (TEI MAV+), which includes the European Commission, Belgium, France, Germany, Netherlands, Luxembourg, Spain, Sweden, and the European Investment Bank as members. The initiative adopts a 360-degree approach, addressing health product supply, demand, and the enabling environment. Close to €2 billion has been committed, with more than half directed at health product manufacturers, either directly or through mechanisms such as Gavi’s African Vaccine Manufacturing Accelerator (AVMA).

In parallel, the Team Europe MAV+ is working on improving access to health products in line with the Human Rights Council recommendation to promote collaborative efforts between States, the private sector, civil society, and other stakeholders to improve access to medicines, vaccines, and other health products. (Human Rights Council, 2024). Ensuring better access to health products is also a priority of multiple MAV+ members including Belgium, France, and Spain. 

In this context, this note proposes to explore what factors, practices and conditions lead to more equitable access resulting from local manufacturing initiatives.