Best sense of what’s going on (my info’s second-hand) is it would cost ~$600M to buy and distribute all of Serum Institute’s supply (>120M doses $3.90 dose +~$1/dose distribution cost) and GAVI doesn’t have any new money to do so. So they’re possibly resistant to moving quickly, which may be slowing down the WHO prequalification process, which is a gating item for the vaccine being put in vials and purchased by GAVI (via UNICEF). Natural solution for funding is for Gates to lead an effort to do so, but they are heavy supporters of the RTS,S malaria vaccine, so it’s awkward for them to put major support into the new R21 vaccine which can be produced in large quantity. Also the person most associated with R21 is Adrian Hill, who is not well-liked in the malaria field. There will also be major logistical hurdles to getting it distributed in the countries, and there are a number of bureaucracies internally in each of the countries that will all need to cooperate.
Best sense of what’s going on (my info’s second-hand) is it would cost ~$600M to buy and distribute all of Serum Institute’s supply (>120M doses $3.90 dose +~$1/dose distribution cost) and GAVI doesn’t have any new money to do so. So they’re possibly resistant to moving quickly, which may be slowing down the WHO prequalification process, which is a gating item for the vaccine being put in vials and purchased by GAVI (via UNICEF). Natural solution for funding is for Gates to lead an effort to do so, but they are heavy supporters of the RTS,S malaria vaccine, so it’s awkward for them to put major support into the new R21 vaccine which can be produced in large quantity. Also the person most associated with R21 is Adrian Hill, who is not well-liked in the malaria field. There will also be major logistical hurdles to getting it distributed in the countries, and there are a number of bureaucracies internally in each of the countries that will all need to cooperate.
Here’s an op-ed my colleague Zach, https://foreignpolicy.com/2023/12/08/new-malaria-vaccine-africa-world-health-organization-child-mortality/
Here’s one from Peter Singer https://www.project-syndicate.org/commentary/new-low-cost-malaria-vaccine-could-save-millions-by-peter-singer-2023-12
Here’s an FAQ with more info—https://docs.google.com/document/d/1mgeU-efHzs83lQNR3ma3qvFd1xqvZJQSp-ut1VEPAUY/edit