The Advance Market Commitment for pneumonia vaccine, by Kremer, Levin, and Snyder

Advance Market Commitments: Insights from Theory and Experience
Michael Kremer, Jonathan D. Levin, Christopher M. Snyder
NBER Working Paper No. 26775
Issued in February 2020


Abstract: Ten years ago, donors committed $1.5 billion to a pilot Advance Market Commitment (AMC) to help purchase pneumococcal vaccine for low-income countries. The AMC aimed to encourage the development of such vaccines, ensure distribution to children in low-income countries, and pilot the AMC mechanism for possible future use. Three vaccines have been developed and more than 150 million children immunized, saving an estimated 700,000 lives. This paper reviews the economic logic behind AMCs, the experience with the pilot, and key issues for future AMCs.

And here's their concluding paragraph:

"The AMC moved from theory to practice in its first decade, and we now have a decade of learning from the pneumococcal pilot. While aspects of program evaluation are complicated, the best estimates suggest that the introduction of PCV saved 700,000 lives at a highly favorable cost. Iterations likely could improve AMC design, just as market designs have been refined in settings such as school choice and radio spectrum allocation. Policymakers may wish to consider offering a set of AMCs, perhaps each smaller in scale than the pilot pneumococcus AMC, where potential targets could range beyond health to address agricultural or sustainability problems specific to developing countries."