by Charlotte Kilpatrick | Oct 24, 2024 | Global Health |
In October 2024 the International Finance Facility for Immunisation (IFFIm) priced a US$1 billion, 3-year fixed-rate bond to fund “critical vaccine research and immunisation programmes”. This is IFFIm’s largest single benchmark transaction in the primary market since its inaugural benchmark in 2006, with proceeds supporting Gavi and CEPI. The bond will mature on 29th October 2027 and carries a semi-annual coupon of 4.125% and a semi-annual re-offer yield of 4.222%.
“The success of this bond highlights the ongoing strength of IFFIm’s model, which leverages sovereign support and strong financial structuring to offer investment opportunities that make a positive impact on children’s health.”
The order book was IFFIm’s largest to date, exceeding US$4 billion. The bond drew interest from a diverse group of investors with geographic spread.
Support for vaccine programmes
IFFIm is an “important flexible tool” for organisations like Gavi; since 2006 it has provided Gavi with US$5.8 billion in financing, one sixth of its overall budget. It has been “critical” in enabling Gavi’s recent emergency responses as well as routine immunisation and health system resilience efforts. Dr Sania Nishtar, CEO of Gavi, reflected that IFFIm has been a “groundbreaking and indispensable tool”.
“Today’s bond issue provides us with vital flexibility in our mission to protect millions of children from preventable diseases and to protect our world from the threat of future pandemics.”
As Gavi nears the end of the 2021-2025 strategic period and prepares for the next phase, IFFIm states that the bond issue will play a “pivotal role” in supporting life-saving programmes.
IFFIm has also provided approximately US$272 million in past financing to CEPI in support of the research and development of new vaccines. Dr Richard Hatchett, CEO of CEPI, acknowledged the “serious threat to global health security” presented by epidemics and pandemics. He commented that these can be “mitigated through investment in vaccine R&D and manufacturing”.
“The IFFIm financing mechanism enables CEPI to access the critical funding it needs to accelerate the development of vaccines against emerging infectious disease threats, for the benefit of all.”
Offering opportunities
IFFIm Board Chair Ken Lay believes that the latest issue “highlights IFFIm’s unparalleled strengths”; it is “backed by sovereign donors, driven by a vital global mission, and structured to maximise impact”.
“IFFIm’s bonds continue to offer investors compelling opportunities to earn competitive returns with good secondary market liquidity and assured use of proceeds.”
Jorge Familiar, Vice President and Treasurer, World Bank commented that capital markets are a “powerful tool for connecting private investment with global public goods”.
“As IFFIm’s Treasury Manager, the World Bank is pleased to support IFFIm in accessing capital markets to provide a long-term and flexible funding source to Gavi to accelerate access to vaccines and vaccine development.”
Head of SSA and EMEA IG Syndicate, BofA Securities Adrien de Naurois congratulated the IFFIm team on a successful return to the USD market.
“Today’s transaction, the first USD benchmark in two years, is a clear demonstration of IFFIm’s loyal and diverse investor base, attracted by the importance of its mission to deliver immunisation programmes to those most vulnerable via the ongoing work of Gavi.”
For the latest vaccine news, don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Oct 14, 2024 | Global Health |
In October 2024 the European Investment Bank (EIB Global) announced €2 million financing for early-stage vaccine development in Rwanda by Akagera Medicines Africa Limited. The support is intended to accelerate research, development, and manufacturing of new vaccines against infectious diseases like tuberculosis, HIV, Lassa fever, and Ebola. It will also be used to “strengthen technical skills and expertise” to support “home-grown discovery, manufacturing, and development of vaccine delivery systems” in Rwanda.
Global Gateway
This financing is part of the EU Global Gateway initiative, a strategy to “boost smart, clean, and secure links in digital, energy, and transport sectors and to strengthen health, education, and research systems”. Team Europe is mobilising up to €300 million between 2021 and 2027 to “allow EU’s partners to develop their societies and economies” whilst creating opportunities for EU Member States to “invest and remain competitive”. EIB Global supports “high impact investment” to enhance healthcare and pharmaceutical manufacturing, encourage greater “health resilience”, and support equitable access to healthcare.
Continent-based solutions
EIB Global states that Africa bears the highest disease burden globally, demanding “more home-grown or continent-based solutions”.
“Vaccination is a critical activity to ensure and guide investments in universal health and has a crucial role to play in achieving 14 of the 17 United Nations Sustainable Development Goals.”
Akagera Medicines was founded in 2018 and registered a 100%-owned subsidiary in Kigali in 2022. Its mission is “targeting tuberculosis and other infectious diseases with liposomal nanotherapeutics”. Commenting on the financing announcement at the World Health Summit in Berlin, Chief Executive Officer Michael Fairbanks recognised the “significant support” of the European Investment Bank.
“We are now a clinical company and moving faster to build human capacity and specialised infrastructure in Africa to support vaccine development.”
CEO of the Rwanda Social Security Board (RSSB) Regis Rugemanshuro stated that the financial support is an “important contribution to the realisation of Rwanda’s vision to become a biotech hub” and the wider vision of “Africa becoming self-reliant in vaccine and medicine manufacturing”.
“RSSB is looking forward to deepening partnerships with EIB and other international institutions to build resilient healthcare ecosystems in Rwanda and in Africa.”
Vice President of EIB Thomas Ostros identified the Bank’s “close cooperation with public and private partners” to “accelerate development of innovative solutions”.
“The EIB is committed to further strengthening our partnership with local and international players, to scale up investment and support innovative technology together.”
Belen Calvo Uyarra, EU Ambassador to Rwanda, agreed that the investment was another “important milestone”.
“Through Global Gateway, the EU is focussed on advancing equitable access to health products and local manufacturing in Africa.”
For more from key players in efforts to establish local manufacturing capacities in Africa and champions of equitable access to health products, join us at the Congress in Barcelona later this month. Don’t forget to subscribe to our weekly newsletters here.
by Charlotte Kilpatrick | Oct 8, 2024 | Global Health |
A report from Coalition for Life Course Immunisation (CLCI) considers the financial and policy frameworks of various National Immunisation Programmes in Europe with a focus on sustainable financing and informed decision-making. The report addresses access and distribution disparities with “actionable strategies” to ensure everyone receives the vaccinations they need throughout their lives. CLCI describes the analysis as “crucial for stakeholders and policymakers” as a foundation for “advocating for robust, inclusive public health policies” that can be adapting to various healthcare challenges.
Financing and decision-making
The paper presents profiles for 16 European Union Member States: Austria, Belgium, Cyprus, Czechia, Denmark, France, Germany, Greece, Hungary, Italy, Lithuania, Norway, Poland, Romania, Spain, and the Netherlands. These countries are divided into Eastern and Western European nations.
The study finds that the seven Eastern countries had a lower over-65 influenza vaccination coverage rate than the nine Western countries (33% vs 54%). They also spent less of their GDP on healthcare (4.6% vs 6.2%) and less of the healthcare budget on prevention (7.6% vs 10%). Countries with decentralised health systems allocated a higher percentage of their GDP to healthcare and a larger proportion of their healthcare budget to prevention than centralised systems.
7 out of 16 countries reported ringfencing of funds for vaccination and prevention, a common approach for countries that have Ministry of Finance involvement in budgeting. Two countries reported using long-term, multi-year contracts to secure vaccine supply and stabilise financing.
Spotlight on Spain and the Netherlands
As The World Vaccine Congress Europe is taking place in Barcelona this year (2024) and Amsterdam next year (2025) we chose to look more closely at the country profiles of Spain and the Netherlands. The report offers a brief history and an insight into the potential future landscape for both countries:
- Spain – healthcare, including vaccination programmes, has been publicly funded since the establishment of the Spanish National Health System in 1986. Decentralisation in the late 20th century led to “variability” in programme implementation. Spain is “firmly focussed on vaccination as a cost-effective public health measure”. It is increasing investment in public health infrastructure and immunisation coverage will expand to include more diseases and eligible populations. It is also advancing digital transformation through national immunisation registries, enhanced data analytics for decision-making, and digital tools to improve uptake and surveillance.
- The Netherlands – the Dutch National Immunisation Programme (RVP) was established in 1957 to provide free vaccines to all children. This has expanded to include more vaccines. During the COVID-19 pandemic, the budget was allocated “immediately”. Current efforts are underway to “push more proactive allocated budgets to accommodate new vaccines more efficiently”. Demand is driven by an ageing population.
Head-to-head
|
Feature
|
Spain |
The Netherlands
|
|
Health system
|
Decentralised |
Decentralised
|
|
Stakeholders
|
The Public Health Commission of the Ministry of Health, the National Immunisation Technical Advisory Group (NITAG), and regional health authorities |
The Health Council, Dutch National Institute for Public Health and the Environment (RIVM), Ministry of Health
|
|
Introducing a new vaccine
|
New vaccines are evaluated by NITAG before the Public Health Commission recommends updates to the National Immunisation Plan (NIP) and final financing decisions made by regional Ministries of Finances. This means vaccine recommendations can vary between regions. |
New vaccine recommendations from the European Medicines Agency (EMA) go through the Minister of Health and State Secretary, who asks the Health Council to evaluate before funding is considered. After a recommendation from the Health Council, the MoH asks the RIVM to implement the vaccine in the National Immunisation Plan (NIP).
|
|
Primary funding sources
|
Regional governments |
Public funding
|
|
Critical financing challenges
|
High cost of new vaccines, decentralised health system, insufficient political will |
No set budget causes delays, economic pressures, and healthcare budget constraints
|
|
% of GDP spent on healthcare
|
10.4% |
10.2%
|
| % of healthcare budget spent on prevention |
9% |
3.5%
|
Calls to action
The report concludes that the landscape of vaccine financing and decision-making in Europe is “complex”, with “significant variations”. Notably, Ministries of Finance play a key role in healthcare budgeting.
“While some countries have implemented sustainability mechanisms, such as long-term contracts and split investments, budget limitations and political will remain significant barriers to expanding adult vaccination programmes.”
Decentralised health systems demonstrated higher healthcare spending and more investment in prevention; however, this did not necessarily correlate with broader adult vaccine coverage.
The report “advocates for an EU-wide integrated approach to enhance the efficacy of national vaccination strategies for adults” with four specific “calls to action”:
- Strengthen political commitment and sustainable financing
- Increase prevention budgets and foster unity
- Enhance understand and support for vaccination
- Promote comprehensive immunisation programmes
Is your country profile presented in the report? Do you find any of the results surprising, and do you agree with the calls to action? At the Congress in Barcelona this month we look forward to discussing different financing and decision-making approaches with global health experts. Get your tickets to join us for these conversations, and don’t forget to subscribe to our weekly newsletters here.
