The GAVI countries have spoken. And they want pneumococcal conjugate vaccine.

In late March, GAVI issued a brief letter to all 72 GAVI eligible countries asking if they would be interested in introducing 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, 30 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.

30 GAVI countries that expressed interest to use pneumococcal conjugate vaccines by 2010 are:

For more on the GAVI expressions of interest, or to find out more about pneumococcal disease and its prevention, visit our website, www.preventpneumo.org