Vaccine Introduction

Historically 15-20 years have passed before new vaccines reached children in developing countries. PneumoADIP is working with countries, donors, academia, international organizations, and industry to develop effective public-private partnerships in order to accelerate the introduction of pneumococcal vaccines. Millions of lives could be saved through earlier and faster access to pneumoccal vaccines.

In 2007, 31 countries expressed interest in pneumococcal vaccine introduction, and the GAVI Alliance announced it would give support to three of these countries for pneumococcal vaccine introduction: Guyana, Honduras, and Nicaragua. These three countries are the first to receive GAVI funding for pneumococcal vaccines. More countries are expected to apply for GAVI funding for pneumococcal vaccines in the coming years. WHO, UNICEF and others are crucial in supporting countries to develop the vaccine plans, financing strategies, and cold chain and systems capacity required for successful applications.

Steps In Accelerating Vaccine Introduction - Finding the Solution Space

• Step 1: Build a credible demand forecast to establish terms for affordable, sustainable supply and financing.
• Step 2: Donors and industry commit to binding agreements to finance and supply vaccines for developing countries.
• Step 3: Support evidence-based demand for vaccine introduction in developing countries.

31 GAVI Countries Expressed Interest to Use Pneumococcal Conjugate Vaccines by 2010

In late March, GAVI issued a brief letter to all 72 GAVI eligible countries asking if they would be interested in introducing the pneumococcal conjugate vaccine, beginning with the 7-valent vaccine, between 2008 and 2010. Countries were presented with a brief description of the vaccine’s characteristics (including cold storage requirements), expected health impacts, and the co-financing requirements, and were given just over 6 weeks to formulate their reply and return a letter to GAVI.

The response was tremendous. By May 25th, 31 of the 72 GAVI eligible countries had indicated an interest in introducing pneumococcal vaccines by 2010. Responses came from all over the world and the countries that responded account for >33% of all the childhood pneumococcal deaths worldwide (see Figure below). The most responses came from Africa, the region of the world with the highest incidence of pneumococcal disease. At least eight countries also expressed interest in rotavirus vaccine introduction.

The individual letters often cited local data on the burden of pneumonia and pneumococcal disease (often, but not always, based on PneumoADIP supported surveillance) and included projections of the expected impact of vaccination. If nothing else, these responses indicate that many health and technical leaders in GAVI countries recognize pneumonia and pneumococcal disease as urgent child survival problems and see the value of the vaccine for its prevention.

Turning this interest into actual vaccine introduction will require much more work. The responses were “expressions of interest” and non-binding – that is neither GAVI nor the countries are obligated to follow through – and it is possible that not all of the countries will submit applications, that not all applications will be approved, and/or that projected uptake dates will be delayed.

WHO, UNICEF and others will play critical roles in supporting countries to develop the vaccine plans, financing strategies, and cold chain and systems capacity required for successful applications. At PneumoADIP, we look forward to supporting these organizations and their country counterparts, and to the successful use of pneumococcal vaccines to save lives in GAVI countries, faster than ever before.

31 GAVI countries that expressed interest to use pneumococcal conjugate vaccines are:

• Benin
• Burundi
• Congo, Rep. of
• Cote d'Ivoire
• Djibouti
• DRC
• Ethiopia
• The Gambia

• Ghana
• Guyana
• Honduras
• Indonesia
• Kenya
• Madagascar
• Malawi
• Mali

• Mongolia
• Nicaragua
• Pakistan
• Rwanda
• Sao Tome and Principe
• Senegal
• Solomon Islands
• Sri Lanka

• Sudan
• Tanzania
• Timor Leste
• Togo
• Uganda
• Yemen
• Zambia

GAVI to Fund Guyana, Honduras and Nicaragua for Pneumococcal Vaccine Introduction

In November, 2007, the GAVI Alliance Board announced support for the introduction of pneumococcal vaccines into Nicaragua, Guyana, and Honduras. In order to build sustainability of immunization programs, all countries that receive GAVI vaccine introduction support share the cost of these vaccines by making small co-payments between $0.10 and 0.30 per dose. These introductions are expected as early as 2008 and will mark the first of their kind in GAVI countries. GAVI Fund Chair Graca Michel said, "The vaccines and good health that are regularly enjoyed by children in the north should equally be enjoyed by children in the south. The decisions taken today [29 November] and the ongoing hard work being undertaken by the GAVI Alliance partners bring us so much closer to providing just that."