2). As predicted, tissue-culture based technology requires significant capital investment, whereas

egg-derived LAIV requires the least investment. Although eggs can present a Libraries potential barrier to manufacture in resource-poor settings (e.g. importation of eggs and/or maintenance of hen flocks), the affordability of the final product is of prime importance and egg-based production appears to be the cheapest. One parameter not visible in Fig. 2 is how these costs would be affected by Erastin the use of adjuvants as these could multiply the number of pandemic IIV doses by at least 4-fold, for minimal capital investment. One of the WHO grantee manufacturers embarked on a programme for the transfer of an oil-in-water adjuvant technology from the Vaccine Formulation Laboratory in December 2010. LBH589 nmr Supporting selected developing countries to establish or expand pandemic influenza production capacity is not sufficient to ensure that all developing

countries have access to pandemic vaccine. Moreover, it is not possible, nor desirable to establish influenza vaccine production in each and every country. For this reason, WHO grants to manufacturers are contingent upon their agreement to sell at an affordable price 10% of their pandemic vaccine production to United Nations agencies such as WHO and UNICEF, if needed in a pandemic event, for distribution to developing countries without domestic production. Other issues require priority attention if the overall goal is to be achieved. The concomitant training and support for regulatory authorities in developing countries, for example, is needed to ensure that influenza vaccines produced there can be registered and licensed without unnecessary delays. Another issue of concern is the remaining geographical imbalance in global influenza vaccine production capacity, and thus access to pandemic influenza vaccine, particularly in countries in sub-Saharan

Africa. A third call for proposals to establish influenza vaccine production capacity in developing countries will target such regions. In response to growing interest by the global health community in the development all of local production to improve access to medicines, WHO undertook an analysis of vaccine-related technology transfer projects over the last two decades. The analysis identified over 100 such transfers to developing countries (principally to Brazil, China and India), the majority of which resulted in increased local production and use of the vaccine. A consultation held in December 2010 identified the following considerations for technology transfer to developing countries. Firstly, although local production does not necessarily mean lower prices, it should be seen as a strategic investment in health.