What we measure

The 2017 Access to Vaccines Index evaluates how 8 major vaccine companies are improving access to preventive vaccines for 69 priority diseases – including HIV/AIDS, Ebola and Zika – in 107 high-need countries. Find out more about the scope of the Index research.

Company scope: 8 vaccine manufacturers and developers

The 2017 Access to Vaccines Index measures 8 vaccine companies: eight large research-based pharmaceutical companies based in mature markets and one vaccine manufacturer based in an emerging market. These companies were identified by the Index team and through stakeholder discussions as having the potential for improving access to existing and future vaccines.

The Index team first examined the pipelines and portfolios of large research-based pharmaceutical companies to identify those with a large vaccine business or subsidiary; as well as those with relevant, high-need vaccines on the market or in their pipelines. The Index team also sought advice from experts on other major players in the vaccine market that should be included. Stakeholders confirmed that the Index should focus on the largest global players in the vaccine market.

The Index evaluates each company in relevant research areas only. All eight companies in scope were evaluated in research & development. Six companies have vaccines on the market for diseases in scope and sales in countries in scope. These six were therefore suitable for evaluation in the remaining Research Areas: pricing and registration, and in manufacturing and supply.

Table 2 List of companies included in the 2017 Access to Vaccines Index - 9 companies

Companies evaluated in all Research Areas

  • GSK
  • Johnson & Johnson
  • Merck & Co., Inc.
  • Pfizer Inc.
  • Sanofi
  • Serum Institute of India

Companies evaluated in R&D only:

  • Daiichi Sankyo
  • Takeda Pharmaceutical Co.

Disease scope: 69 diseases

The disease scope of the 2017 Access to Vaccines Index consists of 69 diseases that are vaccine preventable, and have the highest priority when it comes to improving access to immunisation. The list comprises 44 diseases where no vaccines yet exist on the market, and 25 diseases where vaccines exist but with issues surrounding accessibility. The disease scope covers:

  • Diseases recommended by the WHO for routine immunisation,
    such as cholera, diptheria, measles, mumps, typhoid, tetanus
  • Diseases identified by the WHO as having a high need for further vaccine R&D,
    such as malaria, influenza, tuberculosis, dengue, HIV/AIDS
  • Diseases suitable for prevention via maternal immunisation,
    such as meningococcal disease, plague, tetanus, viral hepatitis
  • Emerging infectious diseases,
    such as Ebola, Zika, SARS, Marburg virus
  • Diarrhoeal diseases,
    such as rotavirus, typhoid, cholera, amoebiasis, infections with C. difficile, E. coli
  • Lower respiratory infections,
    such as adenovirus, RSV, pneumococcal disease
  • Neglected Tropical Diseases,
    such as rabies, Buruli ulcer, soil-transmitted helminthiasis

Geographic scope

Access to vaccines is needed equally in all countries in the world. Yet lower income countries face a tougher challenge when it comes to successfully immunising their populations. The Index covers countries with the highest perceived need for greater access to vaccines: namely, the poorest countries, the least developed countries, and countries with the highest levels of inequalities.

Figure 5 List of countries in the 2017 Access to Vaccines Index - 107 countries 

These categories were defined following four steps:

Step 1: All countries defined by the World Bank as low income or lower-middle income are included. For the 2017 Index, this step accounts for the lion’s share of the geographic scope, bringing 82 countries into scope.

Step 2: All countries defined by the UNDP as either low or medium human development are included. This ensures that several central measures of human development (life expectancy, education and standard of living) are taken into account. This resulted in a further 11 inclusions. 

Step 3: All countries that receive a score of less than 0.6 on the UN Inequality-Adjusted Human Development Index are included. This measure takes account of how health, education and income are distributed within each country. This resulted in 13 inclusions. 

Step 4: The final step is to include all least developed countries (LDCs), as defined by the Committee for Development Policy of the UN Economic and Social Council (ECOSOC). This brings Tuvalu into scope. Although Tuvalu is classed by the World Bank as being an upper-middle income country, it is also an LDC.   

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