MedAccess Guarantee Ltd
| ISIN | 🆔 |
|---|---|
| Industry | Global health, development finance |
| Founded 📆 | 2017 |
| Founder 👔 | |
| Headquarters 🏙️ | London, UK |
Area served 🗺️ | |
Key people | Helen Rees (Board chair), Michael Anderson (CEO) |
| Members | |
Number of employees | 22 |
| 🌐 Website | www |
| 📇 Address | |
| 📞 telephone | |
MedAccess is a social finance company based in London. It is capitalized at $200 million, enabling it to provide loans and financial guarantees designed to increase access to health products, including vaccines, therapeutics, and diagnostic tests, for patients in low- and middle-income countries.
MedAccess’ financial products reduce market risks facing manufacturers and procurers. One of its most commonly used products is a volume guarantee.[1] In return for guaranteed sales, manufacturers provide long-term price reductions and assurances of supply security. MedAccess’ guarantees also aim to strengthen markets. Patients benefit from lower costs and more availability as new manufacturers enter the markets, while existing manufacturers reduce their prices to compete for market share.
The company had provided nine guarantees by the end of 2022. The guarantees support access to health products that tackle COVID-19, HIV, malaria, syphilis, and tuberculosis, particularly in Africa and South Asia.[2]
History
The early 2000s saw renewed global focus on improving access to lifesaving health products. New financing mechanisms such as Gavi, the Vaccine Alliance, the Global Fund to fight AIDS, Tuberculosis and Malaria, and Unitaid increased access to products against major killer diseases like HIV and childhood pneumonia.
Although these organizations succeeded in increasing access to products in many countries, market failures continued to hamper efforts to scale up access to a broader range of healthcare products around the world. The Department for International Development, with design input from the Bill & Melinda Gates Foundation and the Clinton Health Access Initiative, developed initial concepts for a new capital fund to support market shaping activities. The UK's then-CDC Group (now British International Investment) incubated the concept and developed a company limited by shares.[3]
MedAccess was founded as the Credit Facility for Access to Medicines in November 2017. BII provided initial paid-in capital of $200 million (over two tranches) and remains the company’s sole shareholder. MedAccess is part of BII’s Catalyst Strategies, which accept greater risks in return for higher development impact.
Michael Anderson was appointed CEO in November 2017. Anderson, a former director-general at DFID and CEO of the Children’s Investment Fund Foundation, had previously served as the UK Prime Minister’s envoy for the creation of the UN Sustainable Development Goals.[4]
The company changed its name to MedAccess Guarantee Ltd in 2018. It is independent and not-for-profit, with any operating surpluses invested into developing new agreements.
Agreements
| Disease area | Partner | Description | |
|---|---|---|---|
| HIV, Viral Hepatitis, HPV | Hologic | In July 2018, MedAccess announced its first volume guarantee agreement with Hologic, Inc.[5] As part of Hologic’s Global Access Initiative,[6] the guarantee is increasing access to viral load testing for HIV and viral hepatitis using the Hologic’s Panther System. In return for the guarantee, Hologic agreed to an all-inclusive price of $12 per test. This was the first time a manufacturer had committed to all-inclusive pricing, which covers installation, training and maintenance. This led to a significant market shift as major procurers such as PEPFAR changed their tender requirements to include all-inclusive pricing.
The guarantee was announced in July 2018 and ended in December 2022. |
|
| Malaria | BASF | In October 2019, MedAccess and the Bill & Melinda Gates Foundation announced a volume guarantee to increase access to BASF’s dual action mosquito nets.[7] The nets, which combine a new class of insecticide, called chlorfenapyr, with traditional pyrethroids are at the forefront of efforts to tackle resistance amongst mosquitos. In March 2022, a study from Tanzania showing the nets to be highly effective at reducing malaria incidence in areas of higher mosquito resistance, potentially leading to substantial cost savings for countries was published in the Lancet.[8]In March 2023, the WHO issued a strong recommendation for countries to use chlorfenapyr-pyrethroid nets to tackle malaria.
The guarantee was announced in October 2019 and ended in December 2022. |
|
| COVID-19 | UNICEF | Responding to the COVID-19 pandemic, in July 2020 MedAccess announced a $50 million guarantee to support UNICEF’s procurement of essential COVID-19 products and other health supplies was announced. The guarantee helped UNICEF to respond quicker to requests from countries who risked missing out as supply shortages led to market volatility and higher prices.
The guarantee was announced in July 2020. It was extended in 2021 and ended in December 2022. |
|
| Malaria | GlaxoSmithKline | In August 2021, MedAccess, GlaxoSmithKline and Gavi, the Vaccine Alliance announced a financing agreement to ensure continued production of antigen for RTS,S – the world’s first malaria vaccine.[9] Production was at risk of being halted ahead of policy and funding decisions. The World Health Organization recommended the vaccine for widespread use in Africa in October 2021[10] and Gavi’s Board approved an initial investment of US$155.7m to support the malaria vaccine introduction, procurement and delivery between 2022 and 2025.
The guarantee was announced in August 2021 and ended in December 2021 when Gavi's Board approved its investment. |
|
| Latent Tuberculosis | Macleods | In August 2021, MedAccess and CHAI announced a volume guarantee to increase access to Macleods’ 3HP latent tuberculosis treatment.[11] 3HP is a short-course preventive treatment for latent TB, taken over three months. This makes it easier for patients to complete the course compared to older, less tolerated treatments that could take 12–18 months. The agreement will help ensure stable supply for countries and contribute towards Unitaid’s IMPAACT4TB partnership, led by the Aurum Institute. | |
| HIV and syphilis | SD Biosensor | In November 2021, MedAccess and CHAI announced a volume guarantee to increase access to SD Biosensor's dual rapid diagnostic testing for HIV and syphilis.[12] The guarantee enabled SD Biosensor to lower its price below $1 per test, the first time such a price had been offered. Testing rates for syphilis are significantly below those for HIV in many countries. The dual test enables countries to leverage existing HIV testing infrastructure to test pregnant women for syphilis, a disease that causes more than 210,000 stillbirths and new-born deaths every year. | |
| COVID-19 | Gavi | In April 2022, MedAccess, Gavi and the Open Society Foundations announced a $200 million risk sharing facility to support the COVAX cost-sharing mechanism.[13] The facility supports COVAX's efforts to help 92 of the world's lowest-income countries to procure additional COVID-19 vaccine doses, over and above doses provided through the COVAX Advance Market Commitment, to increase vaccination rates and meet national coverage targets. MedAccess and the Open Society Foundations each provided guarantees of up to $100 million for the facility. | |
| HIV | Wondfo | In July 2022, MedAccess, Wondfo and CHAI announced an agreement to increase access to the Chinese manufacturer's HIV self-test. Announced on the eve of the International AIDS Society's 2022 conference in Montreal, the agreement saw Wondfo reduce the price of the test to $1, making it the lowest priced WHO prequalified HIV self test on the market.[14] | |
| Malaria | SD Biosensor | In September 2022, MedAccess, SD Biosensor and PATH announced a partnership to expand access to G6PD testing. The test is an important part of care for people with P. vivax malaria. Although effective treatments are available for people with P. vivax malaria, they can be harmful to people who are G6PD deficient. In the absence of G6PD testing, healthcare workers are often cautious, prescribing lower doses taken over longer periods or, sometimes, not prescribing at all. G6PD testing is essential for advancing progress towards P. vivax malaria elimination. |
Innovative finance tools
MedAccess uses innovative finance tools to immediately increase access to health products and shape markets in the longer term. Guarantees are approved by an investment committee based on needs assessments, impact analysis and partner alignment.
Volume guarantees
A volume guarantee is a legally binding contract that sets out a maximum price in return for assured sales volumes. It provides procurers with confidence that sufficient supply of the product will be available at a ceiling price, while providing manufacturers with assurance that they will not suffer losses should sales volumes not meet anticipated demand.
If product sales are less than the agreed upon target, MedAccess will either purchase the shortfall volume or make a payment to the supplier to compensate for losses due to the shortfall.
Procurement guarantees
Procurement guarantees enable procurers to enter into purchasing agreements that would otherwise have been out of reach due to individual organizations’ procurement and disbursement rules.
MedAccess enters into an agreement with a procurer to support its procurement or market shaping activity. A call can be made by the procurer if there is a shortfall in demand for the product or products covered by the guarantee.
Purchasers benefit from the terms agreed upon by the procurers and the manufacturers in the form of improved value for money, reduced lag time, and quality assurance on purchased products. Patients benefit from faster and wider availability of affordable high-quality health commodities.
Loans and loan guarantees
In May 2021, the MedAccess Board agreed to expand the company’s mandate to include loans, working capital and loan guarantees.
Development impact
MedAccess uses a bespoke development impact framework, validated by BlueMark,[15] to assess the impact of its transactions. The company uses the tool to calculate potential additional impact compared to the current standard of care in terms of lives changed, money saved, and markets shaped.
In June 2023, MedAccess reported that guarantees provided since its inception in 2017 have enabled healthcare products to reach 530 million people in over 95 countries, and saved procurers and governments more than $91 million.[16]
In its 2022 Annual Review, MedAccess reported its agreements contributed to:
- 932,000 people living with HIV who were not virally suppressed knowing their viral load after being tested using the Panther platform
- 11.8 million cases of malaria being averted over the lifetime of Interceptor® G2 mosquito nets provided through the BASF agreement. These cases were additional to those that would have been prevented by pyrethroid-only nets
- 419,000 additional people living with HIV completing 3HP treatment for latent TB
- 59,000 pregnant women with syphilis being identified through increased use of the lowest ever priced HIV and syphilis dual rapid diagnostic test
- 3,000 people with P. vivax malaria taking a G6PD test to help healthcare workers prescribe the most appropriate course of treatment
- procurement and distribution of more than 456 million vaccines through UNICEF, including COVID-19 vaccines and other vaccines against serious childhood illnesses
- continued production of antigen for the RTS,S malaria vaccine ahead of key policy and funding decisions, enabling Gavi to open applications for countries to start using the vaccine in routine immunisation programmes in 2024
- the COVAX cost-sharing mechanism’s response to requests from the world’s 92 lowest-income countries for additional COVID-19 vaccines at lower cost.
In addition, MedAccess projects that its guarantee for Wondfo’s HIV self-test will lead to an additional 8.1 million people being tested for HIV.
Impact of COVID-19
Global health organizations including the Global Fund have reported COVID-19 reversed decades of gains against diseases such as HIV, TB and malaria. MedAccess’ guarantees helped to ensure essential healthcare products continued to be available and the company reported minimal disruptions to supply in its 2020 Annual Report.
See also
- Foreign, Commonwealth and Development Office
- British International Investment
- Clinton Health Access Initiative
- Gavi, the Vaccine Alliance
- Bill & Melinda Gates Foundation
- Unitaid
- Innovative Vector Control Consortium
References
- ↑ "Volume guarantees". medaccess.org. Retrieved 2022-03-17.
- ↑ "MedAccess – 2020 Annual Report". annualreport.medaccess.org. Retrieved 2022-03-17.[permanent dead link]
- ↑ "MedAccess". British International Investment. Retrieved 2022-03-17.
- ↑ "Michael Anderson". GOV.UK. Retrieved 2022-03-17.
- ↑ "New CDC initiative to increase access to medical supplies in Africa and South Asia announces its first agreement". CDC Group. 2018-07-25. Retrieved 2022-03-17.
- ↑ "Global Access Initiative| Hologic, Inc". www.hologic.com. Retrieved 2022-03-17.
- ↑ "BASF, MedAccess, Bill & Melinda Gates Foundation Bring Mosquito Nets to Malaria-endemic Countries". Coatings World. Retrieved 2022-03-17.
- ↑ Mosha, Jacklin F.; Kulkarni, Manisha A.; Lukole, Eliud; Matowo, Nancy S.; Pitt, Catherine; Messenger, Louisa A.; Mallya, Elizabeth; Jumanne, Mohamed; Aziz, Tatu; Kaaya, Robert; Shirima, Boniface A. (2022-03-26). "Effectiveness and cost-effectiveness against malaria of three types of dual-active-ingredient long-lasting insecticidal nets (LLINs) compared with pyrethroid-only LLINs in Tanzania: a four-arm, cluster-randomised trial". The Lancet. 399 (10331): 1227–1241. doi:10.1016/S0140-6736(21)02499-5. ISSN 0140-6736. PMC 8971961 Check
|pmc=value (help). PMID 35339225 Check|pmid=value (help). - ↑ "New financing agreement boost for malaria vaccine". www.gavi.org. Retrieved 2022-03-17.
- ↑ Paton, James (6 October 2021). "First Malaria Vaccine Advances After Decades of Work". Bloomberg.com. Retrieved 17 March 2022. Unknown parameter
|url-status=ignored (help) - ↑ "Improving access to 3HP, patient-friendly treatment to prevent tuberculosis". Clinton Health Access Initiative. 2021-08-16. Retrieved 2022-03-17.
- ↑ Jerving, Sara (15 November 2021). "Cheaper HIV/syphilis combo tests aim to reduce newborn deaths". Devex. Retrieved 4 January 2023.
- ↑ "Open Society Helps COVAX Deploy Vaccines More Equitably". www.opensocietyfoundations.org. Retrieved 2023-01-04.
- ↑ Jerving, Sara (27 July 2022). "Price of HIV self tests lowered to $1". Devex. Retrieved 4 January 2023.
- ↑ "Development Impact Framework". medaccess.org. Retrieved 2023-07-07. Unknown parameter
|url-status=ignored (help) - ↑ "2022 Annual Review". medaccess.org. Retrieved 2023-07-07.
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