No abstract

The COVID-19 pandemic has highlighted the importance of vaccines as public health and pandemic preparedness tools and amplified the importance of issues ranging from equitable distribution to reliable supply of quality, affordable vaccines. These issues however are not new. Delays in time from the first dose in a high-income country to introduction at scale in a low-income country can take years. These delays are driven by several challenges, some of which are unique to the vaccine development ecosystem. The patenting and overall intellectual property (IP) protection are complex, regulatory oversight is rigorous, manufacturing processes require technical support or know-how transfer from the innovator, and market dynamics create obstacles to delivering at scale. However, there are opportunities to accelerate the introduction of vaccines at scale in low and middle-income countries. To identify those opportunities, this paper provides an overview of the vaccine research and development process and where reform of the current system could increase access [1] .

Demographic changes and decentralization of health care provision have led to a higher demand for General Practitioners (GP) services in the Nordics. As a result, many countries report that recruiting and retaining GPs are increasingly difficult. Coupled with younger GPs increasingly valuing work/life balance, the Nordic countries are now looking at different policies that can ensure a sustainable GP supply going forward. Relevant policy measures depend on the GP systems in place, which also differs between the countries. We provide an overview of reforms and policies that have been planned or implemented in the last 10 years and use a theoretical framework to discuss their potential effects on recruitment and effort. Our focus is on remuneration schemes, GPs’ working conditions and practice quality as policy levers to incentivize effort and to attract additional GPs. We show that policies that have a positive effect on recruiting GPs can have a negative effect on the effort GPs exert. Since reduced effort might have a negative effect on the services patients receive, the total effects of the policies are uncertain. We further show that the dominating effect is sensitive to preferences and characteristics of the GPs, providing important insights for policy makers who want to increase GP supply.