accination is one of the most efficient public health interventions available and the main tool for primary prevention of communicable diseases. The COVID-19 pandemic has reinforced the health, social, and economic benefits from timely access to vaccines and other essential treatments. The pandemic has also highlighted two critical preconditions to delivering timely access: First, countries must have a responsive and transparent national immunization program; second, countries must establish procurement and financing arrangements that can rapidly execute commercial arrangements to secure supply.

Embedding these two conditions in countries across Asia Pacific is therefore the best way to ensure comprehensive access to the essential vaccines of today and prepare health systems to rapidly adopt the vaccines of the future. As we have witnessed over the last three years, this access is critical to the region’s economic growth and prosperity.

Analysis of this situation for this article reveals that pathways to inclusion in National Immunization Programs (NIPs) vary within and between markets in Asia Pacific. Japan, Korea, and Australia provide relatively consistent coverage via national programs, despite their different processes for reviewing, recommending, and reimbursing vaccines. In other cases, the reimbursement timeframe varies significantly for different vaccines within the same market. For example, China and Taiwan provide coverage at the regional level, which required engagement with multiple local authorities to enable access.

Healthcare is a priority across Asia Pacific, but prevention has received a relatively low level of investment. For example, the Australian government spends around 10% of GDP on healthcare but spends less than 2% of the healthcare budget on prevention. Across Europe, governments spend around 7% of GDP on healthcare; however, less than 3% of this is spent on prevention and only about 9% of the prevention budget (less than 0.5% of the total health budget) is spent on immunization.

Asian-Pacific countries are likely to continue increasing their spending on health, in line with GDP growth. However, we have not yet seen a corresponding commitment from all countries to increase their expenditures on prevention, including routine vaccination coverage. In fact, recent experience shows that the prevention budget is always at risk in volatile economic environments like we face today.

Along with increasing the resources available to fund the health sector, governments need financing approaches that strengthen efficiencies within healthcare systems and processes, promote population health, and support the development of innovation ecosystems. In fact, innovation can play a key role in offsetting budget constraints, improving care and patient outcomes, and delivering social and economic benefits.

A recent study in Australia found significant societal and economic benefits attributable to the population-wide COVID-19 vaccination rollout that were not captured in “traditional” value assessment methodology. Vaccines and other novel treatments can decrease overall costs to the health system by lessening the disease burden on societies and caregivers, and collectively freeing up human resources for other economic productivity. For example, seasonal influenza vaccination in Europe saves €250M to €330M in annual influenza-related costs by reducing the number of doctor’s visits, hospitalizations, and lost workdays.

Healthcare systems that can provide a sustainable pharmaceutical ecosystem which rewards innovation will realize earlier access to transformational medicines, including life-saving vaccines, which will consequently improve population health and have related economic benefits. We recommend the following actions toward achieving this outcome. The few pilot projects published at this stage are still in their infancy.

1. Support renewal of global, regional, and national commitments to universal health coverage to prioritize sustainable financing and prevention on policy agendas worldwide.
2. Develop heterogenous vaccine funding pathways in Asia by adopting the Asia-Pacific Economic Cooperation (APEC) Action Plan on Vaccination Across the Life-Course to increase vaccine coverage through alignment, collaboration, and improvement of reimbursement processes.
3. Strengthen value assessment frameworks for all medicines to ensure that decision makers adopt a holistic approach that considers the broader impact, including enhanced population health, that medicines provide.