Equitable Access Toolkit
As shown in GHIAA’s Equitable Access Pyramid, there are many agreement provisions that need to work together to support the achievement of a funder or PDP’s equitable access policy. However, before entering into detailed negotiations for provisions addressing matters such as affordable pricing and product supply, it can be helpful for the parties to a funding agreement to agree upon some fundamental principles for the conduct of the project, including the parties’ intention to ensure equitable access to the product developed under the agreement and/or other results of the project.
To establish the importance of equitable access as an outcome of the funded project, agreements often include a statement in the preamble and/or a provision in the main body of the agreement setting out a mission statement or a definition of access according to the funder’s policy. This definition might be tied to a particular product or field of use depending on the funder’s mission and the purpose of the agreement.
Examples from the MAPGuide
“Global Access” means: (a) the knowledge and information gained from the Project will be promptly and broadly disseminated; and (b) the Funded Developments will be made available and accessible at an affordable price (i) to people most in need within developing countries, or (ii) in support of the U.S. educational system and public libraries, as applicable to the Project.
Source: this is the standard Global Access definition referenced in the Bill & Melinda Gates Foundation’s Global Access Statement. These provisions can be found in a number of the Foundation’s grant agreements such as this one with Arsanis for the preclinical development of a monoclonal antibody treatment for respiratory syncytial virus infections.
[Funder] is committed to achieving equitable access to the results of all [Funder]-supported programmes pursuant to the “Equitable Access Policy” referenced in [Funder]’s Third Party Code. Equitable Access means that a Project Vaccine is available first to populations at risk when and where they are needed at affordable prices.
Source: taken from a development funding agreement between CEPI (Funder) and Novavax (Developer) for a COVID-19 vaccine. Read in context.
The Recipient acknowledges that the objective of the Project is to ensure that the Health Products are made widely available, as quickly as possible and on a continuing basis, at an affordable and sustainable price, to the Public Sector seeking to supply them to LMICs and in sufficient quantities to meet the needs of LMICs (the “Access Objective”). The Recipient will make best efforts to ensure that the Health Products are developed and commercialised in a manner which is consistent with the Access Objective.
Source: taken from the sample terms and conditions for Unitaid (Funder) funding for Recipients (Developer) under the UnitaidExplore program. Read in context.
The mission of [Funder] is to accelerate the development of a [disease] vaccine for pediatric indications and ensure its availability, affordability and accessibility for the developing world. The objective of the [Funder] [disease] program is to reduce the number of deaths and hospitalizations of children in the developing world due to [disease] infection through advanced development and introduction of safe, affordable and efficacious new [disease] vaccines.
Source: taken from a development funding & collaboration agreement between PATH (Funder) and Aridis (Developer) for the formulation development of a rotavirus vaccine. Read in context.
Certain key purposes of the Investment are to provide relief to the poor and distressed, improve the health of those living in Low and Lower-Middle Income Countries (as defined by the World Bank and if approved by the Global Access Committee) (“Target Countries”), and educate health practitioners and public health officials on cost-effective technologies that will improve the health and safety of poor and low-income individuals globally (the “Global Health Objectives”).
Source: taken from a global health agreement between the AXA Prime Impact Master Fund (Funder/Investor) and Revelation Biosciences (Developer) for the development of a therapeutic for allergic rhinitis and a diagnostic for respiratory virus infections. Read in context.
As part of the research to develop this Equitable Access Toolkit, GHIAA conducted a review of a range of funder and PDP equitable access policies to identify how different organizations define the components of equitable access.
This toolkit has been built based on the data in the MAPGuide and the GHIAA team’s experience of negotiating and implementing agreements. We intend that the toolkit will evolve and expand over time based on input from MAPGuide users and availability of new agreements showing examples of alternative approaches. We welcome ongoing constructive dialogue around these materials and encourage you to contact us or fill in our feedback survey to share your thoughts, questions and suggestions.
Author: Bridie Telford
First publication date: December 7, 2022