PAHO’s board this week is set to discuss “a long-standing system that makes vaccines affordable to middle-income Latin American countries” because of growing concerns that the policy “deters manufacturers from offering deeper discounts on such products to the world’s least developed countries,” the Financial Times reports.

The “revolving fund” for vaccine purchases negotiates significant discounts with manufacturers on prices in richer countries, “offering in exchange significant volumes, predictable demand and funding,” the newspaper writes. The policy includes language demanding vaccines be made available at the “lowest possible price,” which makes it “impossible for producers to propose still lower prices to poorer countries,” according to the Financial Times.

Wider use of some vaccines has been delayed because of disagreement between PAHO and the Global Alliance on Vaccines and Immunizations (GAVI). “The principle has come into increasing conflict with efforts by manufacturers of recently launched vaccines to meet international demands for access to the poor through ‘tiered’ pricing tied to local incomes,” writes the Financial Times.

For example, problems arose last year over Wyeth’s vaccine against pneumonia and meningitis, which was offered to the revolving fund at $26 per dose – less than a third of its price in richer countries. But the fund’s “demand for the lowest possible price clashes with negotiations at $7 a dose for countries served by GAVI – with gross national income less than $1,000 a head,” the Financial Times report (Jack, Financial Times, 6/22).