Background
Group A Streptococcus (GAS) leads to an estimated 600,000 deaths and 600 million cases of pharyngitis per year. There is much interest in GAS vaccine development. However, without an obvious market for such a vaccine in high-income countries, the mechanism to finance it is unclear.
Methods
We consider three models of vaccine finance: industry, government financing, and philanthropic funding. We conduct a literature review to determine how existing vaccines have been financed. We then collect data on vaccine R&D funding, prices, coverage rates, and disease burdens. We analyze the data to show how disease burdens associate with funding models and how funding models relate to coverage rates and prices.
Results
Diseases with burdens disproportionately in high-income countries attract more industry funding and have higher vaccine prices and lower coverage rates. Diseases with mixed burdens (significant burden in high-income and low-income countries, or mostly middle-income countries) attract more public financing. Diseases with exclusively low-income burdens have relied heavily on philanthropic funding.
We illustrate these results using the example of Pneumococcal, RSV, and HPV vaccines as those with substantial industry funding and high-income disease burdens. Meningococcal disease and Hepatitis B as examples of vaccines with mixed disease burdens and substantial public support for vaccine development. Finally, the development of the Malaria vaccine is a model of philanthropic funding.
Conclusion
Like Meningococcal disease and Hepatitis B, GAS has a mixed disease burden. It is a prime candidate for government support through a phase three trial and approval of a vaccine.