- Manheim D.
- Chamberlin M.
- Osonde O.A.
- Vardavas R.
- Moore M.
Investment Cases Reviewed
|No.||Reference||Year||Vaccine||Audience||Region||Page||Type of publication||Phase||Stated objectives and aims|
|1||The Africa Measles Partnership|
|2004||Measles||Donor (Gavi)||Global||80||Gray literature||Procurement and delivery||Not specified|
|2||PATH, World Health Organization, Centers for Disease Control and Prevention|
Accelerating the introduction of rotavirus vaccines into Gavi-eligible countries. PATH’s Rotavirus Vaccine Program (PATH, World Health Organization, Centers for Disease Control and Prevention).
|2006||Rotavirus||Donor (Gavi)||Global, Gavi-eligible countries||78||Gray literature||Procurement and delivery||“Recommend that Gavi establish a financing policy to subsidize the purchase of vaccines.” (p. 3)|
“Sets forth a comprehensive plan with the objectives of generating important evidence for informed decision-making and creating the necessary environment whereby rotavirus vaccines can join the other EPI vaccines in saving the lives of children in many of the world’s poorest countries.” (p. 4)
|3||Johns Hopkins University|
Gavi Alliance investment case: accelerating the introduction of pneumococcal vaccines into Gavi-eligible countries. Gavi’s PneumoADIP at JohnsHopkins University.
|2006||Pneumococcal||Donor (Gavi)||Global, Gavi-eligible countries||85||Gray literature||Procurement and delivery||“Outlines a 20-year strategic vision for introducing and sustaining pneumococcal vaccines.” (p. 5)|
|4||Gavi Vaccine Investment Strategy|
|2008||HPV, JE, rubella, typhoid||Donor (Gavi)||Global, Gavi-eligible countries||–||Gray literature||Procurement and delivery||“Determine optimal vaccine financing strategy; priority rank vaccine financing strategies given various value measures.” (p. 6)|
|5||World Health Organization and the United Nations Children’s Fund|
|2009||Meningitis A||Donor (Gavi)||Global, 25 Gavi-eligible countries||132||Gray literature||Procurement and delivery; disease control||Not specified|
|6||International Vaccine Institute|
An investment case for the accelerated introduction of oral cholera vaccines. Seoul: 2011. International Vaccine Institute.
|2011||Cholera||All stakeholders||Cholera endemic countries||200||Gray literature||Procurement and delivery; research and development||“Designed to meet this request [of the WHO Strategic Advisory Group of Experts].” (p. i)|
|7||International Vaccine Institute|
|2012||Cholera||All stakeholders||Bangladesh||134||Gray literature||Procurement and delivery||“Provide a useful, evidence-based guide to policymakers in Bangladesh in making decisions about the use of oral cholera vaccines, as well as to the global health community in considering technical and financial support for cholera vaccine introduction.” (p. 10)|
|8||Gavi Vaccine Investment Strategy|
|2013||Yellow fever, cholera, malaria||Donor (Gavi)||Global, Gavi-eligible countries||–||Gray literature||Procurement and delivery||“Enable upfront, evidence-based decisions about GAVI’s future vaccine investments in order to align planning by countries, industry and donors for the introduction of new, priority vaccines.” (p. 2)|
|9||PATH Malaria Vaccine Initiative|
Investment case for malaria vaccines. PATH Malaria Vaccine Initiative.
|2006||Malaria||Public and private sectors||Global||14||Gray literature||Procurement and delivery; research and development||“Begin improving data and answering questions about potential impact and costs.” (p. 2)|
|10||PATH and BIO Ventures for Global Health|
The case for investment in enterotoxigenic Escherichia coli vaccines. PATH and BIO Ventures for Global Health.
|2011||ETEC||All stakeholders||Global||52||Gray literature||Research and development||“Provide a rationale for the development of ETEC vaccines.” (p. 2)|
“Increase the awareness of biotechnology and pharmaceutical companies in Europe and the United States, as well as companies in emerging markets like China and India, about the opportunities and potential markets that exist for low-cost and effective ETEC vaccines.” (p. 2)
|11||Aeras and the Tuberculosis Vaccine Initiative|
|2013||TB||All stakeholders||Global||70||Gray literature||Research and development||“Demonstrate that a viable global market exists for new TB vaccines.” (p. 7)|
“Advocate for the portfolio management approach as the most efficient and effective mechanism for facilitating the development of new TB vaccines.” (p. 7)
|12||BIO Ventures for Global Health and Boston Consulting Group|
BIO Ventures for Global Health and Boston Consulting Group
Tuberculosis vaccine: the case for investment.
|2006||TB||Private sector||Global||30||Gray literature||Research and development||“Build the case for private-sector investment in tuberculosis (TB) vaccines or—if existing markets are inadequate to support such investment—reveal gaps where donor involvement may improve the market opportunity.” (p. 5)|
“Develop a deep understanding of the markets … illuminate the potential return on industry investment, the target product files needed to capture these market opportunities.” (p. 7)
|13||Hopkins et al|
|1982||Measles||All stakeholders||Global||3||Peer-reviewed article||Disease control||“Advocate establishing global measles eradication as a goal, to be achieved by accelerated implementation of the World Health Organization (WHO)’s Expanded Programme on Immunisation (EPI).” (p. 1396)|
|2002||Immunization||All stakeholders||Global||16||Gray literature||Disease control||Not specified|
|15||Thompson et al|
|2013||Measles and rubella||All stakeholders||Global||8||Peer-reviewed article||Disease control||Not specified|
|16||Nelson et al|
|2014||Cholera||All stakeholders||Bangladesh||4||Meeting report||Disease control||“To discuss the investment case for cholera vaccination as a complimentary control and prevention strategy.” (p. 1)|
Investing in vaccines for the developing world. PATH.
|2015||Immunization||All stakeholders||Global||4||Gray literature||Disease control||Not specified|
|18||Global Polio Eradication Initiative, McKinsey & Co|
|2016||Polio||Donor (BMGF)||Global||8||Gray literature||Disease control||“Establish core economic arguments for continuing to invest in eradication.” (p. 1)|
“Offer a forward-looking perspective on the benefits of eradication using updated cost inputs that underlie the Plan.” (p. 1)
|19||Nayagam et al|
|2016||Hepatitis B||All stakeholders||China||1||Abstract||Disease control||“We present the case for a comprehensive scale-up package of HBV interventions … evaluated its impact, cost and return on investment.” (p. 1)|
|20||Global Polio Eradication Initiative, McKinsey & Co|
Investment case. Global Polio Eradication Initiative.
|Polio||All stakeholders||Global, Nigeria, Afghanistan, Pakistan||28||Gray literature||Disease control||Not specified|
|21||Tsu and Ginsburg|
|2017||HPV||All stakeholders||Global||5||Peer-reviewed article||Disease control||“Draws on the insights of the expert contributions of the preceding papers to construct a compelling case for urgent investment in cervical cancer prevention.” (p. 70)|
|22||Tiwari and Richardus|
|2016||BCG (leprosy)||All stakeholders||Global||21||Peer-reviewed article||Disease control||“Review systematically the literature … and to assess this information on its applicability for defining a Leprosy Elimination Investment Case (LEIC) based on Eradication Investment Case guidelines.” (p. 2)|
|23||Thompson and Tebbens|
|2012||Immunization||All stakeholders||Global||8||Peer-reviewed article||Disease control||“Report on the final proposed content for investment cases and the insights from the stakeholder consultation process.” (p. 1)|
|24||Walker and Lupp|
Guide to preparing an eradication investment case.
|2012||Immunization||All stakeholders||Global||13||Gray literature||Disease control||Not specified|
Stated Objectives of Investment Cases
Categories of Outcomes Reported
Tuberculosis vaccine: the case for investment.
Gavi, The Vaccine Alliance.
|By phase||Procurement and delivery||Research and development|
Other donors (foundations and NGOs)
Local foundations and NGOs
|Type of funding||Grant|
Innovative financing mechanisms (climate financing)
Innovative financing mechanisms (advanced market commitment, blended capital, Bill and Melinda Gates Foundation’s program-related investments)
|Funders’ data needs||Demand and price forecast that predicts total procurement and delivery cost|
All potential funding sources
Projection of funding by funder and by cost types
Global and country-level funding gap
Incremental costs for the existing health system
Considerations for financial sustainability at the country level (comprehensive multiyear strategic plans and cost-effectiveness estimates)
|Demand and price forecast that predicts market revenue potential|
In-depth analysis of major drivers of revenue
Signals of donor commitment that could bring push or pull funding
Product development strategies and approaches that increase cost efficiency (ie, portfolio management approach)
Considerations for development hurdles (funding need for clinical trials and support for vaccine purchase in low- and middle-income countries)
Tuberculosis vaccine: the case for investment.
- Walker D.
- Lupp J.
- •Standardized definition and content based on 4 categories (burden of disease, cost of investment, impact of investment, and other considerations for implementation);
- •Consistent reporting of the key assumptions in health and economic impact models used for investment cases;
- •Transparency in stating aims, intended audience, and funding sources of investment cases;
- •Tracking of the final decisions on proposed investments;
- •Extensive review and comparative analysis of investment cases in the health sector;
- •Further harmonization could benefit from development of an umbrella investment case that provides:
- ○guidance on choosing among the existing guidelines and reference cases for each outcome;
- ○endorsement that investment cases be used for priority setting and that they incorporate efficiency measures such as those based on CEA or BCA; and
- ○guidelines for assessing opportunity costs and trade-offs of the proposed investment (ie, investment on other health or nonhealth sector interventions).
Source of Financial Support
- Appendices 1–6
- Health and development: why investing in health is critical for achieving economic development. International Monetary Fund.
- A healthier humanity: the WHO investment case. WHO/DGO/CRM/18.2. World Health Organization.http://www.who.int/about-us/planning-finance-and-accountability/financing-campaign/investing-global-investing-localDate accessed: October 1, 2018
- Strengthening primary health care through community health workers: investment case and financing recommendations. Johns Hopkins University, the Office of the UN Special Envoy for the health-MDGs, the World Bank, Partners in Health, Last Mile Health, the Clinton Foundation, ALMA, and the governments of Ethiopia and Liberia.
- Nurturing the health and wealth of nations: the investment case for breastfeeding. Global Breastfeeding Collective.http://www.who.int/nutrition/publications/infantfeeding/global-bf-collective-investmentcase.pdf?ua=1Date accessed: July 8, 2018
- The investment case for noncommunicable disease prevention and control in Mongolia. UN Interagency Task Force on NCDs.http://apps.who.int/iris/bitstream/handle/10665/259627/WHO-NMH-NMA-17.55-eng.pdf?sequence=1Date accessed: December 22, 2017
- Guidance note: investment cases. Global Financing Facility.https://www.globalfinancingfacility.org/guidance-note-investment-casesDate accessed: December 22, 2017
- Global vaccine action plan 2011-2020. World Health Organization.Accessed September 25, 2017)
- Improving decision support for infectious disease prevention and control: aligning models and other tools with policymakers’ needs.Accessed December 22, 2017)
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- Immunisation—a healthy return on investment. Gavi, The Vaccine Alliance.https://www.gavi.org/library/audio-visual/infographics/immunisation---a-healthy-return-on-investment/Date accessed: July 8, 2018
- Exploring issues in the conduct of web searching and other online sources for systematic reviews: how can we be systematic?.Syst Rev. 2016; 5: 191
- Gavi Alliance investment case: accelerating the introduction of pneumococcal vaccines into Gavi-eligible countries. Gavi’s PneumoADIP at JohnsHopkins University.http://www.nitag-resource.org/uploads/media/default/0001/01/8252ac0af32f9f93a979e8a017335e25e2d6bd08.pdf(Accessed November 15, 2017)
The Africa Measles Partnerships. Measles investment case submitted to the Executive Board Global Alliance for Vaccines and Immunization. Published April 20, 2004.
- Accelerating the introduction of rotavirus vaccines into Gavi-eligible countries. PATH’s Rotavirus Vaccine Program (PATH, World Health Organization, Centers for Disease Control and Prevention).http://www.nitag-resource.org/uploads/media/default/0001/01/ea8101072b609db7271b4a6fe0b1886e338a889e.pdf(Accessed November 15, 2017)
- History of vaccine investment strategy—Gavi vaccine investment strategy: executive summary. Gavi, The Vaccine Alliance.Accessed July 8, 2018)
- Eliminating serogroup A meningococcal meningitis epidemics as a public health problem in Africa: an investment case for the GAVI Alliance.2008
- An investment case for the accelerated introduction of oral cholera vaccines. Seoul: 2011. International Vaccine Institute.Accessed November 15, 2017)
- Country investment case study on cholera vaccination: Bangladesh. International Vaccine Institute.Accessed November 15, 2017)
- History of vaccine investment strategy—final report on the VIS (phase II)—November Board Paper. Gavi, The Vaccine Alliance.Accessed July 8, 2018)
- Investment case for malaria vaccines. PATH Malaria Vaccine Initiative.https://www.malariavaccine.org/sites/mvi dev.mrmdev.co.uk/files/content/resources/files/PublicFinancialRoIMalVax-GHCMay2006-v1_000.pdf(Accessed November 15, 2017)
- The case for investment in enterotoxigenic Escherichia coli vaccines. PATH and BIO Ventures for Global Health.https://www.path.org/resources/the-case-for-investment-in-enterotoxigenic-escherichia-coli-vaccines/(Accessed November 15, 2017)
- TB vaccine research & development: a business case for investment (draft discussion document). Aeras and Tuberculosis Vaccine Initiative.Accessed November 15, 2017)
- Tuberculosis vaccine: the case for investment.2006http://pacifichealthsummit.org/downloads/MDR-TB/Tuberculosis%20Vaccines%20The%20Case%20for%20Investment.PDF(Accessed November 15, 2017)
- The case for global measles eradication.Lancet. 1982; 1 (8286): 1396-1398
- The case for childhood immunization. Occasional Paper 5.2002. https://path.azureedge.net/media/documents/CVP_Occ_Paper5.pdf
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- Investing in vaccines for the developing world. PATH.Accessed November 15, 2017)
- Economic case for eradicating polio. Global Polio Eradication Initiative.Accessed November 15, 2017)
- Investment case for a comprehensive package of interventions against hepatitis B in China.J Hepatol. 2016; 64 (2): S469
- Investment case. Global Polio Eradication Initiative.Accessed November 15, 2017)
- The investment case for cervical cancer elimination.Int J Gynecol Obstet. 2017; 138 (Suppl 1): 69-73
- Investment case concepts in leprosy elimination: a systematic review.Lepr Rev. 2016; 87: 2-22
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Conflicts of interest: The authors do not have any conflicts of interest directly relevant to the content of this article.
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