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TT
TT Procured by UNICEF 2001 - 08
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
2001 2002 2003 2004 2005 2006 2007 2008
Routine SIA
TT historical demand and forecast overview
Upcoming Tender Period
Trends in TT vaccine offered to UNICEF
TT vaccine offered to UNICEF 1992-2009
0
50
100
150
200
250
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Mill
ion
s o
f d
os
es
•Good supplier base but still high dependency on one source•One new supplier obtained WHO prequalification in end 2007, enhancing supply availability and vaccine security
Summary
•Elimination by 2012
•MNT Investment Case (2007-2009) has given campaigns and routine program a boost.
•Funds through IFFIM IC for vaccines are fully utilized
•Active fund raising for SIAs beyond 2009
•Routine demand for most part is funded through country financial resources
TT
2009 2010 2011 2012Routine 106,500,000 130,000,000 135,000,000 140,000,000SIA 60,000,000 30,000,000 30,000,000 30,000,000Total 166,500,000 160,000,000 165,000,000 170,000,000
TT Tender quantities 2010-12
Upcoming Tender Period
MEASLES
Measles procured by UNICEF 2001-2008
0
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
2001 2002 2003 2004 2005 2006 2007 2008
Nu
mb
er o
f D
ose
s
Routine Supplementary
• Historically demand has been mainly driven by campaigns • Large catch up campaigns in 2006-07 and some in 2008• 2009-2010 Quantities do not include potential demand for India SIA
Measles – Procurement Overview & Future demand
Upcoming Tender Period
Measles vaccine offered to UNICEF 1992-2009
0
50
100
150
200
250
300
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Mill
ion
s o
f d
os
es
Trends in Measles vaccines offered to UNICEF- availability
Drastic reduction in the number of suppliers offering WHO pre-qualified vaccine to UNICEF over the past 10 years
High dependency on one manufacturerMeasles containing vaccines are classified as high priority for WHO PQ
Mixed results in terms of affordability
Weighted Average Prices for Vaccines
BCG –stable demand, 4 suppliers, stable pricingDTP, declining demand, 2 suppliers per presentation, increasing pricesTT – growing demand, 4 suppliers, adjusted prices, now stableMeasles – growing demand, 3 suppliers, increasing prices
Summary…
Global Measles mortality reduction by 74% need to Sustain achievement
Expect stabilized demand with; • Increased routine, including 2 dose as per SAGE recommendation,
will add to routine demand.• Sustained follow-up campaigns, intervals based on 1st dose
coverage, but average every 3 years
* Both posing future funding challenges for countries
Measles campaign is often use as the main vehicle for integrated campaigns
Continued monovalent measles vaccine supply needed in the future
Measles
2009 2010 2011 2012Routine 75,500,000 70,000,000 75,000,000 75,000,000SIA 79,800,000 95,000,000 70,000,000 50,000,000Total 155,300,000 165,000,000 145,000,000 125,000,000
Measles Tender quantities 2010-12
Upcoming Tender Period
MMR
MMR Historical demand and forecast overview
•The main increase in 2009-12 demand is for 1 one country, introducing MMR in their routine program as of 2009, therefore demand picture can change substantially•Increased quantity only partially due to MR campaigns in 2007
0
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Original Quantity on LTA Forecast to Suppliers at beginning of YearQuantity Procured Current Forecasted Quantity Current Tender Quantity
Upcoming Tender Period
Summary
• Very limited availability / long lead-time for unplanned demand
•Countries are strain aware / sensitive -There is strong strain preference from countries-At times the preference been influenced / diverted based on price and availability
• Large price differences between different products
• Limited sustainable external funding available – countries need to include in their own budget
The projection / scenario for MR will not impact the MMR demand
MMR Tender quantities 2010-12
MMR
2009 2010 2011 2012MMR 10 4,855,000 4,800,000 4,900,000 5,200,000MMR 1 795,000 1,000,000 1,000,000 1,000,000Total 5,650,000 5,800,000 5,900,000 6,200,000
Upcoming Tender Period
MR
MR – Procurement Overview - Future
•Currently 2 WHO pre-qualified suppliers, high dependency on one•Substantial portion of the demand in 2009 is for one country campaign
0
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
30,000,000
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Original Quantity on LTA Forecast to Suppliers at beginning of YearQuantity Procured Current Forecasted Quantity Current Tender Quantity
Upcoming Tender Period
MR
2009 2010 2011 2012Routine 1,351,623 1,700,000 1,700,000 1,700,000SIA 4,500,000 0 2,000,000 1,000,000Total 5,851,623 1,700,000 3,700,000 2,700,000
MR Tender quantities 2010-12
Upcoming Tender Period
June, 2008: Rubella as part of GAVI investment strategy introduced to GAVI the Board (for endorsement, not financial decision)
• Rubella: cause of congenital rubella syndrome (CRS) when infected in early pregnancy
• It is estimated that there are 110,000 cases of CRS each year and poses high disease burden on poorest countries
Future of MR vaccine?
Future of MR vaccine?
• October, 2008: Rubella part of the portfolio for GAVI to consider for future investments (HPV, JE, Rubella, Typhoid) at the October 08 Board
• Mindful of the current financial environment, the Board deferred any financial commitment related to the vaccine investment strategy for further review
MR VACCINE DEMAND GIVEN INTEGRATED ADOPTION FORECAST Rapid Impact
Vaccine Demand including Wastage2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Routine Vaccination 0 25 31 32 40 41 46 50 55 56 57 58Catch-up Campaign 0 406 88 4 106 14 50 53 53 15 0 9Periodic Campaign 0 119 26 1 22 2 10 9 10 3 0 2Boost Vaccination 0 0 0 0 23 28 29 36 37 41 45 49
Buffer Stock 0 6 1 0 2 0 1 1 1 0 0 0Stock Pile 0 0 0 0 0 0 0 0 0 0 0 0
Total 0 556 147 37 193 86 135 149 155 116 102 119
0
100
200
300
400
500
600
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Dos
es (M
)
Vaccine Demand including Wastage
Routine Vaccination Catch-up Campaign Periodic Campaign Boost Vaccination Buffer Stock Stock Pile
http://www.gavialliance.org/vision/strategy/vaccine_investment/index.php* Source: Applied Strategy – Oct 27, 2008
0
5
10
15
20
25
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
# of
Cou
ntri
es A
dopti
ng V
acci
ne
Rubella
MR INTEGRATED ADOPTION FORECAST
* 14 GAVI countries have already adopted rubella; 12 are not expected to be eligible based on projected MCV coverage rates < 80% through 2020
Bangladesh
Bhutan
Cambodia
Haiti
India
Mongolia
Nepal
Solomon Is
Tajikistan
Viet Nam
Indonesia
Korea, DPR
Myanmar
Yemen
Burundi
Eritrea
Ghana
Pakistan
Rwanda
São Tomé and Principe
Uganda
Malawi
Zambia
Cameroon
Congo, DR
Côte d'Ivoire
Gambia
Benin
Burkina Faso
Kenya
Niger
Senegal
Togo
Lesotho
Mali
Mozambique
PNG
Tanzania
Timor-Leste
Zimbabwe
Afghanistan
Comoros
Djibouti
Congo, Rep.
Guinea
Sierra Leone
Vaccine Need: 72
VISP Scope: 46*
* Source: Applied Strategy – Oct 27, 2008
A PossiblePossible scenario for MR introduction through catch up campaigns…: 2013 - 18
Assumptions:
• Delay the introduction by 3 years compared to rapid impact plan
• Total 300 mil ds for 2013 - 2018
• Distribute quantities throughout 5-6 years
0
10,000,000
20,000,000
30,000,000
40,000,000
50,000,000
60,000,000
70,000,000
2013 2014 2015 2016 2017 2018
mil
ds
Total tender quantities of Measles containing vaccines 2010 – 12
Measles
2010 2011 2012Total 165,000,000 145,000,000 125,000,000
MR
2010 2011 2012Total 1,700,000 3,700,000 2,700,000
MMR
2010 2011 2012Total 5,800,000 5,900,000 6,200,000
UNICEF VACCINES
Thank You