Update from GAVI - UNICEF from GAVI Vaccine Industry ... Lesotho Mauritania Nigeria ... HPV vaccines delivered to adolescent girls: US$ 2.40 per girl in target population ...

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<ul><li><p>Aurelia Nguyen </p><p>Update from GAVI </p><p>Vaccine Industry Consultation </p><p>(Copenhagen, Denmark, 27 June 2012) </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>GAVI vaccine support </p><p> Currently supported vaccines: pentavalent, </p><p>pneumococcal, rotavirus, meningitis A, human </p><p>papillomavirus (HPV), rubella, yellow fever and </p><p>measles second dose and selected campaigns </p><p> Also: meningitis and yellow fever vaccine stockpiles </p><p> Prioritised for future support: Japanese encephalitis </p><p>(c.2015) and typhoid (c.2017) vaccines </p><p> Monitoring development: malaria (c.2016), dengue </p><p>(c.2017) </p><p> New options: cholera and polio IPV </p><p>(year of potential first introduction) </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>June Board update: Outlook through 2020 </p><p>(current portfolio) </p><p> (current portfolio) </p><p>3 </p><p>Includes the new </p><p>vaccine windows </p><p>(MR, HPV, JE, typhoid) </p><p>Prior to any other </p><p>new vaccines (and </p><p>measles option) </p><p>2011-15: $8.0 bn </p><p>2016-20: $7.9 bn Indicative </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>GAVI Alliance Board update </p><p> Rotavirus and pneumococcal supply constraints </p><p> Enhancing GAVIs investment in measles prevention </p><p> Vaccine introduction grant and operational support for </p><p>campaigns </p><p> Polio </p><p> Cholera </p><p> Lower Middle Income Countries </p></li><li><p>Rotavirus forecast v 5.0 unconstrained </p><p>3 1 1 8 15 </p><p>5 </p><p>9 8 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>2009 2010 2011 2012 2013 2014 2015</p><p>* Source demand forecast v5.0 </p><p>Number of </p><p>Countries per </p><p>year </p><p>Forecast </p><p>Introduced </p><p>Approved </p><p>Sudan </p><p>Nicaragua </p><p>Honduras </p><p>Guyana </p><p>Bolivia </p><p>Burundi </p><p>Djibouti </p><p>Zimbabwe </p><p>Zambia </p><p>Togo </p><p>Tanzania </p><p>Sierra Leone </p><p>Niger </p><p>Madagascar </p><p>Haiti </p><p>Guinea-Bissau </p><p>Congo Republic </p><p>Cen. Afr. Rep. </p><p>Cameroon </p><p>Angola </p></li><li><p>Rota: supply constrained annual introductions </p><p>* Source demand forecast v5.0 </p><p>Number of </p><p>Countries per </p><p>year </p><p>Forecast </p><p>Introduced </p><p>Approved </p><p>Sudan </p><p>Nicaragua </p><p>Honduras </p><p>Guyana </p><p>Bolivia </p><p>Burundi </p><p>Djibouti </p><p>Zimbabwe </p><p>Zambia </p><p>Togo </p><p>Tanzania </p><p>Sierra Leone </p><p>Niger </p><p>Madagascar </p><p>Haiti </p><p>Guinea-Bissau </p><p>Congo Republic </p><p>Cen. Afr. Rep. </p><p>Cameroon </p><p>Angola </p><p>3 1 1 3 </p><p>5 5 </p><p>13 18 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>2009 2010 2011 2012 2013 2014 2015</p></li><li><p>Pneumo demand v 5.0 unconstrained </p><p>introductions </p><p>16 14 </p><p>5 </p><p>2 1 </p><p>13 16 </p><p>19 </p><p>5 2 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>2009 2010 2011 2012 2013 2014 2015</p><p>Number of </p><p>Countries per </p><p>year </p><p>Forecast </p><p>Introduced </p><p>Approved </p><p>Democratic </p><p>Republic of </p><p>the Congo </p><p>Gambia </p><p>Mali </p><p>Sierra Leone </p><p>Burundi </p><p>Benin </p><p>CAR Ethiopia </p><p>Guyana </p><p>Honduras </p><p>Nicaragua </p><p>Rwanda </p><p>Yemen </p><p>Kenya </p><p>Malawi </p><p>Cameroon </p><p>Pakistan </p><p>Madagascar </p><p>Ghana </p><p>Georgia </p><p>Moldova </p><p>Armenia Azerbaijan </p><p>Sudan </p><p>Zimbabwe Mozambique </p><p>Angola </p><p>Tanzania </p><p>Zambia </p><p>Niger Senegal </p><p>Bolivia </p><p>Sao Tome </p><p> Djibouti </p><p> Kiribati. </p><p>Bangladesh </p><p>Guinea Bissau </p><p>Haiti </p><p>Lao PDR </p><p>Lesotho </p><p>Mauritania </p><p>Nigeria </p><p>Togo </p><p>Papua New </p><p>Guinea </p><p>Uganda </p><p>* Source forecast based on SDF v5.0 </p></li><li><p>Pneumo: supply constrained annual </p><p>introductions </p><p>Number of </p><p>Countries per </p><p>year </p><p>Forecast </p><p>Introduced </p><p>Approved </p><p>Democratic </p><p>Republic of </p><p>the Congo </p><p>Gambia </p><p>Mali </p><p>Sierra Leone </p><p>Burundi </p><p>Benin </p><p>CAR Ethiopia </p><p>Guyana </p><p>Honduras </p><p>Nicaragua </p><p>Rwanda </p><p>Yemen </p><p>Kenya </p><p>Malawi </p><p>Cameroon </p><p>Pakistan </p><p>Madagascar </p><p>Ghana </p><p>Georgia </p><p>Moldova </p><p>Armenia Azerbaijan </p><p>Sudan </p><p>Zimbabwe Mozambique </p><p>Angola </p><p>Tanzania </p><p>Zambia </p><p>Niger Senegal </p><p>Bolivia </p><p>Sao Tome </p><p> Djibouti </p><p> Kiribati. </p><p>Bangladesh </p><p>Guinea Bissau </p><p>Haiti </p><p>Lao PDR </p><p>Lesotho </p><p>Mauritania </p><p>Nigeria </p><p>Togo </p><p>Papua New </p><p>Guinea </p><p>Uganda </p><p>* Source forecast based on SDF v5.0 </p><p>2 1 </p><p>13 10 5 </p><p>12 17 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>2009 2010 2011 2012 2013 2014 2015</p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>GAVIs commitments strengthen measles </p><p>control </p><p> $197M since 2004, primarily to the </p><p>Measles Initiative for campaigns </p><p> Routine second dose of measles </p><p> Investments in health systems and </p><p>improving immunization coverage </p><p> Support for measles-rubella through wide-</p><p>age campaigns </p><p> Performance-based funding mechanism </p><p>includes measles coverage indicator </p><p> 9 </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>Enhanced support </p><p> Six large countries estimated by WHO at high </p><p>risk of outbreaks prior to introducing MR </p><p>vaccine </p><p>10 </p><p>Country DTP3 </p><p>(2010) </p><p>Measles1 </p><p>(2010) </p><p> Afghanistan 66 62 </p><p> DR Congo 63 68 </p><p> Chad 59 46 </p><p> Ethiopia 86 81 </p><p> Nigeria 69 71 </p><p> Pakistan 88 86 </p><p> Response to outbreaks and emerging needs </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>Projected Cost Estimates (US$ millions) </p><p>11 </p><p>2012 2013 2014 2015 2016 2017 Total </p><p>Outbreak funds - Pass </p><p>to MR Initiative </p><p>5 10 10 10 10 10 55 </p><p>Funds for vaccines by </p><p>proposals up to 6 </p><p>countries ($0.42/dose) </p><p>0 21 3 17 1 - 42 </p><p>Funds for operational </p><p>costs up to 6 </p><p>countries </p><p>($0.65/person) </p><p>0 33 4 26 1 - 65 </p><p>Total potential </p><p>commitment by year </p><p>5 65 17 53 12 10 162 </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>Vaccine introduction grant and operational </p><p>support for campaigns </p><p>12 </p><p> Objective </p><p> Facilitate timely, effective implementation of critical activities: </p><p> Before new vaccine introductions </p><p> For delivery during campaigns </p><p> One-time investments, covering a share of the cost </p><p> Scope </p><p> All new GAVI-supported vaccines </p><p> Activities driven by country needs </p><p> Does not cover recurrent costs </p><p> Operating guidelines </p><p> Flexible, timely, simple, separate from other cash support, not </p><p>used for co-financing </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>$0.0</p><p>$0.6</p><p>$1.2</p><p>$1.8</p><p>$2.4</p><p>$3.0</p><p>Infantvaccines</p><p>HPVvaccines</p><p>Operational supportcampaigns</p><p>x </p><p>New policy: what has changed? </p><p>13 </p><p>Total cost estimate: </p><p>80% 80% </p><p>80% </p><p>New policy </p><p>GAVI support: </p><p>x </p><p>Current policy </p><p>New policy </p><p>Current policy </p><p>(per child) (per girl) (per target) </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>New policy: funding levels </p><p>14 </p><p>1. Vaccine introduction grants: </p><p> Vaccines delivered to infants: US$ 0.80 per child in birth cohort </p><p>(min. US$ 100,000) </p><p> HPV vaccines delivered to adolescent girls: US$ 2.40 per girl </p><p>in target population (min. US$ 100,000) </p><p>2. Operational support for campaigns: </p><p> US$ 0.65 per individual in target population </p><p>3. Product switches after first introduction: </p><p> One third of full grant for transition to new product, provided </p><p>criteria are met </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>Polio </p><p> GAVI support to polio efforts - investment case providing </p><p>financing for operational costs and stockpiling of vaccines </p><p> Intensify support to health systems strengthening in polio-</p><p>affected countries </p><p> Potential role for GAVI to play to support the new polio end-</p><p>game strategy </p><p> IPV funding in the context of a tOPV to bOPV switch </p><p> Update to Board and review following November SAGE </p><p>meeting </p></li><li><p>Major cholera outbreaks &amp; hotspots, 2005-2011 </p><p>2005 West Africa </p><p>&gt; 76 000 cases 2006 /07 Angola </p><p>&gt; 86 000 cases </p><p>2008/09 Zimbabwe </p><p>&gt; 98 000 cases </p><p>2006 / 07 </p><p>Horn of Africa </p><p>&gt; 130 000 cases </p><p>2005 Afghanistan </p><p>&gt; 155 000 cases </p><p>annually : </p><p>Bangladesh </p><p> 100 - 300 000 </p><p>cases </p><p>India? Pakistan? </p><p>2007 / 08 Iraq </p><p>&gt; 4700 cases + AWD </p><p>Oct 2010 - Dec 2011 Haiti </p><p>500 000 cases </p><p>2009/10 </p><p>Papua New Guinea </p><p>&gt; 10 000 cases </p><p>Nov 2009 - Dec 2011 </p><p>Central Africa </p><p>&gt; 129 000 cases </p><p>annually: DRC </p><p>13 000 30 000 cases </p><p>Areas reporting cholera outbreaks, 2010-2011 </p><p>Source: Global Task Force on Cholera Control, WHO </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>Estimated size and cost of a potential cholera </p><p>vaccine stockpile </p><p> 2013 -2014 2015-2016 2017-2020 Total (2012-2020) </p><p>Doses in </p><p>stockpile 2 m/year 5 m/year 10 m/year 54 million </p><p>Cost $5.5 m/year </p><p>$13.6 </p><p>m/year $23-27 </p><p>m/year ~ $138 million </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>Low- and Lower Middle-Income countries </p><p>and GAVI support </p><p>36</p><p>21</p><p>1421</p><p>0</p><p>20</p><p>40</p><p>60</p><p>GAVIeligible</p><p>GAVIgraduating</p><p>Not supportedLMICs</p><p>Nu</p><p>mb</p><p>er </p><p>of </p><p>cou</p><p>ntr</p><p>ies</p><p>Low income and Lower-middle income countries &amp; GAVI support</p><p>Lower-middle-income countries (n=56)Low income countries (n=36)</p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p></li><li><p>Vaccine Industry Consultation </p><p>Copenhagen, 27 June 2012 </p><p>2012-2013: 94 introductions versus 50 in the </p><p>business plan - an increase of 88% </p><p>14 </p><p>Pneumo, 37 </p><p>Rota, 19 </p><p>Rota, 30 </p><p>Penta, 4 </p><p>Penta, 7 </p><p>Rubella, 2 </p><p>Rubella, 9 </p><p>JE, 2 </p><p>JE, 3 </p><p>MenA, 8 </p><p>MenA, 6 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>40</p><p>50</p><p>60</p><p>70</p><p>80</p><p>90</p><p>100</p><p>v2 v4</p><p>MenA</p><p>JE</p><p>Rubella</p><p>HPV</p><p>Penta</p><p>Rota</p><p>Pneumo</p><p>No. </p><p>of countr</p><p>ies </p></li><li><p>21 </p><p> 8 roll outs in 2012 </p><p> Currently predict 2-5 will </p><p>introduce in 2013 </p><p> 2014-15 will see intros back </p><p>on track </p><p> Up to 9 approved countries </p><p>delayed for a year </p><p> Future bottleneck readiness </p><p>Rota: cumulative introductions </p><p>versus business plan </p><p>4 5 </p><p>16 </p><p>23 28 </p><p>33 </p><p>4 5 </p><p>13 </p><p>18 </p><p>31 </p><p>49 </p><p>40 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>40</p><p>50</p><p>60</p><p>70</p><p>B-Line 2011 2012 2013 2014 2015</p><p>Business Plan </p><p>Actual and Supply Constraint Adjusted SDF v5.0 </p></li><li><p>Pneumo: cumulative introductions </p><p>versus business plan </p><p>22 </p><p> 16 roll outs in 2011 </p><p> 10 roll outs in 2012 </p><p> Currently predict 5 will </p><p>introduce in 2013 </p><p> 2014-15 will see intros back </p><p>on track </p><p> Delays of a year effecting up </p><p>to15 countries </p><p> Readiness is the future </p><p>bottleneck 3 </p><p>19 </p><p>32 35 </p><p>36 </p><p>45 </p><p>3 </p><p>16 </p><p>26 </p><p>31 </p><p>43 </p><p>60 </p><p>50 </p><p>0</p><p>10</p><p>20</p><p>30</p><p>40</p><p>50</p><p>60</p><p>70</p><p>B-Line 2011 2012 2013 2014 2015</p><p>Business Plan </p><p>SDF v5.0 supply constrained </p></li></ul>

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