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.

As of October 2008, the GAVI Alliance has officially approved support for pneumococcal vaccine introduction into eight countries - Central African Republic, Democratic Republic of the Congo, Gambia,  Guyana, Honduras, Kenya, Nicaragua, and Rwanda – and announced conditional approval for three other countries – Cameroon, Congo and Yemen.  Additional approvals and applications are expected shortly for GAVI eligible countries.  Greater awareness about the disease and vaccine, support for surveillance and availability of GAVI funding have all contributed to the acceleration of vaccine introduction and WHO, UNICEF and others have provided crucial support to countries in developing 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.

Countries Continue to Express Interest in Introducing Pneumococcal Vaccines

In late March, 2007, 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 countries that accounted 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 based on PneumoADIP-supported surveillance) and included projections of the expected impact of vaccination. These responses indicate that many health and technical leaders in GAVI countries recognize pneumonia and pneumococcal disease as an urgent child survival problem and see the value of the vaccine for its prevention.

Continuing to turn this interest into actual vaccine introduction will require much more work. Initial responses are “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.

8 Countries Approved for GAVI Funding to Use Pneumococcal Conjugate Vaccine:

• Central African Republic
• Democratic Republic of the Congo
• Gambia
• Guyana
• Honduras
• Kenya
• Nicaragua
• Rwanda

3 Countries With Conditional Approved for GAVI Funding to Use Pneumococcal Conjugate Vaccine:

• Cameroon
• Congo
• Yemen
  
  

25 Additional GAVI Countries That Expressed Interest to Use Pneumococcal Conjugate Vaccines:

• Afghanistan
• Benin
• Burundi
• Cote d'Ivoire
• Cuba
• Djibouti
• Ethiopia

• Ghana
• Indonesia
• Madagascar
• Malawi
• Mali
  Moldova
  Mongolia
  

• Pakistan
• Sao Tome and Principe
• Senegal
• Solomon Islands
  Sri Lanka
  Sudan
  Tanzania
  

• Timor Leste
• Togo
• Uganda
• Zimbabwe

GAVI-Funded Pneumococcal Vaccine Introduction

In 2009, the first of the GAVI countries, Rwanda and the Gambia, are expected to introduce 7-valent pneumococcal conjugate vaccines.  These introductions are soon to be followed by 10- and 13-valent vaccines which are expected to be available in the next 1-2 years.