Health equity requires transformational change: Financial incentives based on worn-out market thinking will not deliver

Abstract

The Covid-19 vaccine market concentration and hoarding that left many Global South countries unable to access vaccines in a timely manner have led to calls to expand and decentralize manufacturing capacity as a critical element towards more equitable access to vaccines globally Multiple initiatives are underway to build manufacturing infrastructure in low-and middle income countries (LMICs). However, without proper attention to who owns and controls the production and underlying technologies, there is a risk that well-meaning donor investments reinforce market dynamics that favour a handful of major international producers over truly local efforts This is particularly relevant for the African Vaccine Manufacturing Accelerator (AVMA), the new US$ 1Bn financing instrument approved by the Board of Gavi, the Vaccine Alliance, in December 2023