Gotham, D., et al. Understanding adjuvant supply chains for new TB and malaria vaccines. Vaccine, 2026 May 22, 82:128609. PMID: 42025104
This paper provides a comprehensive analysis of the global supply chain for quillay-derived saponin adjuvants, particularly QS-21, that are essential components of several high-impact vaccines for diseases like tuberculosis, malaria, COVID-19, and shingles. It highlights the fragility of the current supply system, which is dominated by a near-monopoly from a single supplier sourcing from a limited geographic region in Chile, raising concerns about potential bottlenecks amid rising demand. The authors advocate for diversification of sourcing methods, synthetic alternatives, and policies to democratize access, emphasizing that ensuring stable and equitable supply is crucial for rapid vaccine development and global health equity. This paper underscores the importance of treating adjuvants as global public goods and it underscores the critical need for resilient and sustainable supply systems to support future vaccine efforts.
The paper concludes that the supply chain for quillay saponins, particularly QS-21 used in adjuvants for TB and malaria vaccines, is currently sufficient to meet medium-term demand. However, the supply relies heavily on a near-monopoly, with a thin safety margin; any disruption could create bottlenecks. There is a need to diversify the supply chain and develop synthetic or alternative sources to avoid potential shortages. Efforts to democratize access to adjuvants and promote open science and technology transfer are essential to improve global vaccine development and equitable access. Global health actors should work toward policies that foster supply chain diversification and transparency.
Comment from DKI: Desert King has the capacity to meet any supply demand for pharmaceutical-grade QS-21 or other saponins, given its current and potential manufacturing capabilities. Additionally, its strategic partner, the Vaccine Formulation Institute (VFI), is committed to developing and sharing adjuvants as non-profit global public goods, aligning with efforts to break monopolistic barriers. This partnership exemplifies a model of cooperation that maximizes resource sharing, promotes equitable access, and accelerates vaccine development efforts worldwide.
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