Basic facts about the GAVI Alliance Speaker Event/meeting Location, Date

Basic facts about the GAVI Alliance

Speaker

Event/meeting

Location, Date

Basic facts about GAVIDATE

Overview

1. About the GAVI Alliance

2. Accelerated vaccine uptake

3. Rising demand

4. Innovative financing

5. Shaping the market

6. Programmes of support for countries

7. Moving forward


The GAVI Alliance: an innovative partnership


The GAVI Alliance Board committee structure


GAVI’s mission

To save children’s lives and protect people’s health by increasing access to immunisation in poor countries

WHO/Jim Holmes


Four strategic goals

Accelerate the uptake and use of underused and new vaccines

Contribute to strengthening the capacity of integrated health systems to deliver immunisation

Increase the predictability of global financing and improve the sustainability of national financing for immunisation

Shape vaccine markets


GAVI making a difference

Catalysing accelerated uptake of vaccines Prevented more than 5 million future deaths Projected 288 million additional children immunised

Supporting increasing country demand Rising demand for new and underused vaccines US$ 5.9 billion committed to countries

Introducing innovative financing mechanisms IFFIm raised more than US$ 3 billion on capital markets AMC pilot accelerates access to pneumococcal vaccines

Shaping markets for vaccines More manufacturers producing more appropriate vaccines Increased capacity secures supply, decreases prices


Overview



3. Rising demand




7. Moving forward


Over five million future deaths prevented

Source: These estimates and projections are produced by the WHO Department of Immunization, Vaccines and Biologicals, based on the most up to date data and models available as of November 2010

Results from routine immunisation and one-off tactical investments, by vaccine


A strong platform

82% of children now reached through routine immunisation programmes

Immunisation closer to universal coverage than most other health interventions

Enables rapid introduction of life-saving vaccines

Important opportunity to deliver other child and maternal health services


A strong platform

Source: WHO; UN DESA, Population Division


Immunisation coverage continues to rise

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Source: WHO-UNICEF coverage estimates for 1980-2009, as of July 2010; WHO ICE- T coverage projections for 2010-2011, as of September 2010; World Population Prospects, the 2008 revision. New York, United Nations, 2009; (surviving infants).

DTP3, hepatitis B and Hib vaccine coverage in GAVI-supported countries, 2000-2011


Driving equity in vaccine access

Source: WHO, Vaccine introduction database.

Hepatitis B

Routine use of vaccines in high- and low-income countries

Hib


Impact on the ground

Eliminating Hib meningitis in Kenya (Kilifi district)

Source: Cowgill KD et al. 2006


Impact on the ground

Hib meningitis in Uganda drops 85% in 4 years (3 sentinel hospitals)

Source: Lewis et al. 2008


Overview



3. Rising demand




7. Moving forward


Rising country demand

Countries approved and eligible for GAVI support

Source: GAVI Alliance data as at 31 July 2010


US$ 5.9 billion committed to countries

Source: GAVI Alliance data as at 4 November 2010

As at 4 November 2010


Overview



3. Rising demand




7. Moving forward


International Finance Facility for Immunisation (IFFIm)

Uses long-term donor commitments to sell AAA rated vaccine bonds

Raised US$ 3 billion since 2006

Frontloads aid through GAVI for immunisation and health systems

Has disbursed US$ 1.6 billion (June 2010) to support GAVI programmes and targeted immunisation initiatives


IFFIm frontloading

IFFIm donor contributions and bond issuances

Source: World Bank, December 2010


DonorsUp to 20-year

grants

Financial management

Country-drivenImmunisationprogrammes

InvestorsCapital market

funding

Source: World Bank

How IFFIm works


IFFIm donor contributions

Donors Length of commitment

Grant amount

United Kingdom 20 years£1,380 million£250 million

France 20 years €1,240 million

Italy 20 years €473.5 million

Spain 20 years €189.5 million

Sweden 15 years SEK 276.2 million

Norway 5 yearsUS$ 27 millionNOK 1,500 million

South Africa 20 years US$ 20 million

Netherlands 7 years €80 million

Approx. US$ 5.9

billion

Note: In addition, Australia has pledged to commit Australian $ 250 million to IFFIm.


US$ 1 billion for expanded IFFIm to support health system strengthening

“Innovation can be the key to making significant progress on reaching the MDGs, strengthening health systems and improving millions of lives – especially the lives of women and children.”

Robert Zoellick, President, World Bank

GAVI/09/Olivier Asselin


Accelerates the manufacture and delivery of vaccines:

Donors commit funds for new vaccines at pre-agreed price

Manufacturers get incentive to invest in R&D for new vaccines

Vaccines must meet stringent criteria and be requested by developing countries

Manufacturers legally commit to supplying vaccines at lower price long term

Long-term price paid by beneficiary countries and GAVI

Advance Market Commitment (AMC)


How the pneumococcal AMC pilot works:

Italy, UK, Canada, Russia, Norway, the Bill & Melinda Gates Foundation have committed to supporting pneumococcal vaccine market with US$ 1.5 billion

Manufacturers agree to supply set quantities of the vaccine for 10 years

As GAVI countries demand the vaccine, companies receive US$ 7 per dose

Companies ensure supply of remaining doses at $3.50 per dose or less

First vaccines were delivered to countries in 2010


AMC commitments: US$ 1.5 billion

Source: GAVI Alliance, 2009

AMC commitments US$ millions

Italy 635

United Kingdom 485

Canada 200

Russian Federation 80

Norway 50

Bill & Melinda Gates Foundation 50

Total 1,500


Overview



3. Rising demand




7. Moving forward


Increased competition reduces vaccine price

Number of manufacturers and price decline of pentavalent vaccine

Source: UNICEF Supply Division, 2010


Tiered pricing

Source: UNICEF Supply Division; CDC


Sustainable immunisation safety

Source: UNICEF Supply Division, 2009


Country co-financing: exceeding commitments

Over 40 countries co-financed vaccines in 2009 17 countries paid more than required


Overview



3. Rising demand




7. Moving forward


How GAVI works


Programmes of support for countries

New and underused vaccines

Health system strengthening

Immunisation services

Civil society organisations

Injection safety GAVI/10/Jim Holmes


New and underused vaccine support

New vaccines: pneumococcal and rotavirus vaccines

Underused vaccines: Hib, hepatitis B, yellow fever, measles second dose. Also:

support for the 5-in-1 pentavalent formulation

meningitis and yellow fever vaccine stockpiles

Vaccines prioritised for future support: human papillomavirus (HPV), Japanese encephalitis, rubella and typhoid vaccines

72 GAVI countries have been approved for support for at least one vaccine


Hepatitis B vaccine


Approved for hepatitis B vaccine support 2000 – 2010


Haemophilus influenzae type b vaccine


Approved for Hib vaccine support 2000 – 2010


Pentavalent vaccine


Approved for pentavalent vaccine support 2000 – 2010


Yellow fever vaccine


Approved for yellow fever vaccine support 2000 – 2010


Pneumococcal vaccine


Approved for pneumococcal vaccine support 2000 – 2010


Rotavirus vaccine


Approved for rotavirus vaccine support 2000 – 2010


Four new vaccines in future portfolio

Human papillomavirus (HPV): leading cause of cervical cancer, 80% of cervical cancer cases are among women in developing world

Japanese encephalitis: serious brain infection transmitted by mosquitoes, particularly in Asia

Rubella: risk of pregnant women transmitting to unborn foetus causing death or deformity

Typhoid: serious public health problem, affecting 16-22 million people per year


Health system strengthening (HSS) support

Strong health systems essential to expand and sustain immunisation coverage

Examples:

Health workforce

Supply, distribution, maintenance

Organisation, management

New platform for funding HSS

Partnership with the Global Fund, the World Bank and WHO

Courtesy of Aga Khan Health Services, Pakistan


Support to civil society organisations (CSOs)

CSOs deliver up to 60% of immunisation services in some countries

GAVI provides support:

to involve local CSOs in planning and delivery of immunisation and other child health services

to encourage cooperation and coordination between the public sector and civil society

© UNICEF/NYHQ2007-1495 Anita Khemka


Immunisation services support (ISS)

Flexible cash support (two-three years) to scale up immunisation services, increase coverage

Performance-based reward: US$ 20 for each additional child vaccinated with 3 doses of DTP

Helped countries reach additional 2.4 million children with DTP3



Injection safety support (INS)

Catalytic: three-year funding

Sustainable: countries continue to procure Autodisable (AD) syringes after GAVI support ends

Affordable: decrease in price of AD syringes

Transformative: new standards for injection safety in GAVI-supported countries



Women’s health and immunisation


Child and maternal mortality inextricably linked

Immunisation a platform for other child and maternal health services

GAVI supported immunisation of 40 million women against maternal and neonatal tetanus

Prioritised HPV and rubella vaccines for future portfolio

Supports strengthening of health systems to better meet needs of women and children


Equal immunisation coverage of girls and boys

2010 study by WHO’s Strategic Advisory Group of Experts (SAGE) on gender and immunisation found

no significant difference in immunisation coverage in girls and boys at the global level

in some countries, low status of women prevents them from accessing immunisation services for their children.

GAVI instigated the SAGE study (in collaboration with WHO and PATH) to ensure that all girls and boys have equal access

to vaccines.


Overview



3. Rising demand




7. Moving forward


Source/credits: WHO/UNICEF coverage estimates 1980-2009, July 2010

Over 23 million children still unimmunised

Global number of under-five children unimmunised with 3 doses of DTP


Causes of child deaths in low-income countries

Source: WHO, World Health Statistics 2010


Vaccines against major child killer diseases


Projected GAVI vaccine expenditure 2011-2015


Potential impact 2011 – 2015

GAVI could prevent 3.9 million future deaths in the next 4 years


GAVI/10/Ricci Shryock

Thank you


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Documents

Basic facts about the GAVI Alliance Speaker Event/meeting Location, Date