Results for Development Institute (R4D), received a grant from the Bill & Melinda Gates Foundation to conduct a study to enhance global knowledge and understanding of the challenges that Lower Middle Income Countries (LMICs) face as they consider the adoption of new vaccines.

Some questions the study addresses are: What are the barriers/challenges that limit the rate of new vaccine adoption by LMICs? What are the potential options to address these rate limiting constraints? And what are the likely costs, benefits and implications of various options for supporting countries to address identified rate limiting constraints?

Based upon its analyses the study will develop prioritized strategies and suggest practical measures at the global, regional, and national level to support LMICs in their decisions to adopt new vaccines.

Substantial benefits could be attained by enhancing new vaccine introduction in LMICs, including: contributing to achieving the Millennium Development Goals; improvements in global health by preventing priority diseases; paving the way for other more risk averse countries to introduce new vaccines (providing information on licensing, vaccine presentation issues, adverse events following immunization, impact of vaccine use on disease burden); and providing a potentially large and attractive market for manufacturers. 

LMICs' rates of vaccine adoption will influence vaccine supply, pricing, and demand forecasting, and thus could encourage a broader market strategy for manufacturers, rather than one that focuses mainly on high-end markets.

This study is gathering data on vaccine introduction from a variety of sources, including visits to conduct in-depth assessment of LMIC countries, and interviews with key opinion leaders in all aspects of vaccine introduction, supply, and financing.These interviews will inform recommendations, on how to overcome the barriers to introducing the new and underutilized vaccines in LMICs. The study will also model the impact of these policies on vaccine demand, price and supply.

The R4D team conducting the work is led by Study Director Marty Makinen, and includes consultant Piers Whitehead and R4D staff members Robert Hecht, Grace Chee, and Farzana Muhib, among others.The study team benefits from input provided by an Advisory Group co-chaired by Steve Landry (Bill & Melinda Gates Foundation) and Miloud Kaddar (World Health Organization) with representatives from WHO regional offices, GAVI, UNICEF, vaccine manufacturers and other experts.The advisory group provides critical feedback on all aspects of the study, including the development and implementation of the work plan, and recommendations resulting from the project. The study began in October 2009 and is expected to be completed in about nine months.