The World Health Organization (WHO) has published a report titled “Catalysing solutions for equitable global access and sustainable financing for novel tuberculosis vaccines for adults and adolescents.” The document was prepared by the Working Group on Financing and Access of the TB Vaccine Accelerator Council.

The report analyses barriers and market dynamics surrounding promising TB vaccines for adolescents and adults and proposes concrete mechanisms for their financing and equitable allocation. The authors clearly show that in the coming decades demand for new TB vaccines will significantly outstrip supply. According to WHO estimates, between 2030 and 2040 global demand could exceed 3 billion vaccination courses, with countries bearing the highest TB burden accounting for most of this demand. A supply shortfall in the first years after vaccine approval is already anticipated, while procurement alone (excluding delivery and health system strengthening costs) is expected to require 5–8 billion US dollars.

Based on this analysis, WHO formulates six key solutions to ensure equitable access to future vaccines:

  • the use of global financing and market-shaping instruments (advance purchase commitments, volume guarantees) to incentivize manufacturers to expand capacity and reduce prices;

  • early preparation of country-level needs: demand forecasts, cost-effectiveness and budget impact assessments to support the introduction of vaccines into national programmes;

  • clear definition of roles and financial responsibilities: which resources can be mobilized domestically and which will need to come from external and donor funding;

  • creation of a standing platform to coordinate supply and demand, bringing together countries, donors and manufacturers to align timelines for production, financing and vaccine rollout;

  • improving transparency of non-proprietary information on products and supply to facilitate national planning;

  • promoting technology transfer and licensing to at least one manufacturer in each high-burden region in order to strengthen regional manufacturing capacity.

A separate section of the report is devoted to modelling the potential impact of introducing new vaccines. If a vaccine with 50% efficacy in preventing TB among adolescents and adults is approved and rapidly scaled up, up to 76 million cases of disease and 8.5 million deaths could be averted over 25 years, and up to 42 billion US dollars could be saved.

WHO stresses that the development of national strategies for financing and access must begin well before vaccines are licensed, so that countries with a high TB burden can secure rapid and equitable access as soon as the products reach the market.