Gavi’s Vaccine Investment Strategy...•Enabling predictable vaccine programming and investment...
Transcript of Gavi’s Vaccine Investment Strategy...•Enabling predictable vaccine programming and investment...
www.gavi.org
Gavi’s Vaccine Investment Strategy
Judith Kallenberg
WHO Product Development for Vaccines Advisory Committee MeetingGeneva, Switzerland, 8-10 June 2016
Gavi-supported vaccines
2
Refers to the first Gavi-supported introduction of each vaccine.Refers to the first Gavi-supported introduction of each vaccine.
*Contribution towards cholera vaccine stockpile for outbreak response 2014-2018
*
Gavi-funded vaccine uptake
Number of national introductions or campaigns
3 #vaccineswork
* Five countries have introduced pentavalent vaccine independently of Gavi financing.
** Gavi has supported introductions of rubella vaccine into the routine systems in Lao People’s Democratic Republic and Nepal through
vaccine introduction grants.
Source: Gavi data as of 31 December 2015.
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Vaccine introductions and campaigns in 2014
Vaccine Investment Strategy (VIS)
Evidence-based approach to identifying new vaccines for
Gavi support
• Evidence review, analyses, stakeholder consultations, independent
expert advice
• Enabling predictable vaccine programming and investment decisions
(rather than first-come-first-serve)
• Ensuring predictability of Gavi programs to help long-term planning
by countries, industry and donors
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VIS occurs every five years, aligned with strategic cycle and replenishment
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VIS #1
HPV
Rubella
JE
Typhoid
conj.
MenA
VIS #2
YF mass campaigns
Cholera stockpile
Rabies/cholera
studies
Malaria – deferred
2011-2015 Strategic period
2011 2015
2008
2012 2013
$$$
2016 2017 2018 2020
2016-2020 Strategic period
VIS #3
$$$
2021
2021-2025
RTS,S
pilots?
Looking forward to VIS #3
Scope: licensure <5 years
Expected candidates for consideration
Returning candidates / incremental investments:
• Dengue
• (maternal) influenza
• rabies PEP
• Hepatitis E
• RTS,S
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• meningococcal multivalent
• Cholera
• DTP booster
• Hepatitis B birth dose
• Typhoid
• PCV catch-up
• Norovirus?
• ETEC?
New:
• RSV
• Group B Streptococcus
Data gathering to begin in 2017
VIS process
Analysis of WHO landscape vaccines for initial
prioritisation
In-depth analysis of shortlisted vaccines and development of
recommendations
External Expert Review vaccine analyses
PPC review prioritisation
approach and shortlist
Board decisionshortlist
Phase 1 stakeholder consultations Phase 2 stakeholder consultations
Technical Consultation Group Technical Consultation Group
Analysis
Governance
Consultations
PHASE I PHASE II
Jun-Dec 20182017- Jun 18
External Expert
Review VIS
PPC review VIS
Board decision VIS
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Category VIS Criteria Phase I Indicator
Healthimpact
Impact on child mortalityU5 future deaths averted, 2015 – 2030
U5 future deaths averted per 100,000 vaccinated population
Impact on overall mortalityTotal future deaths averted, 2015 – 2030
Total future deaths averted per 100,000 vaccinated population
Impact on overall morbidity
Total future cases averted, 2015 - 2030
Total future cases averted per 100,000 vaccinated population
Long-term sequelae
Additionalimpactconsid-erations
Epidemic potential Epidemic potential of disease
Global or regional public health priority Presence of global / regional (UN) resolution on elimination or eradication
Herd immunity Herd immunity threshold
Availability of alternative interventions Current use of alternative interventions for effective disease control (prevention and treatment) and potential for scale up
Socio-economic inequity Disproportionate impact on poor
Gender inequity Disproportionate impact on one gender
Disease of regional importance Burden concentrated in a subset of GAVI countries within the same region
Implement-ation
feasibility
Capacity and supplier base Capacity to meet GAVI demand and # of manufacturers by 2020
GAVI market shaping potential GAVI demand (by volume) as % of global demand
Ease of supply chain integration Packed volume (cm3)
Ease of programmatic integrationAlignment with other vaccine schedules and significant change in health worker practices/behavior required
Vaccine efficacy and safety Vaccine efficacy (as defined by clinical endpoints) and safety
Cost and value for money
Vaccine procurement cost1 Total procurement cost to GAVI and countries, 2015 - 2030
In-country operational cost Incremental in-country operational costs per vaccinated person
Procurement cost per event averted2 Procurement cost per death / case averted
Evaluation indicators (VIS 2013)
1. Procurement cost includes vaccine, syringe, safety box, and freight 2. Scoring based on cost per future death averted
Methodology for vaccine evaluation
1. Identify vaccination scenariosCONFIDENTIAL DRAFT
PPC_Malaria 10
Modelled vaccination scenarios
Doses Catch-up target population
Routine target population
3 dose course in 1 month intervals
6 weeks old 5 to <18M
5 to < 18M N/A
Legend
Base case
Alternative
scenario
Excluded because less attractive / not
feasible
CONFIDENTIAL DRAFT
15Flu for IEC_March 15 v3.pptxPPC_Dengue
Cumulative GAVI demand estimated to be
~610M doses through 2030
Note: Includes demand from countries that graduate from GAVI support during 2015-2030 (following GAVI supported introduction)
200
150
100
50
0
2030
16
61
2029
18
5 1
2028
19
4 1
2027
20
4 0
2026
20
3 0
2025
21
3 0
2024
60
2 0
2023
198
1 0
2022
41
1 0
2021
152
0 0
2020
1 00
2019
1 00
2018
120 0
2017
0 00
2016
0 00
2015
0
Demand (M doses)
00
GAVI financed Country co-financed Graduated country financed
2. Develop demand forecast
4. Develop cost
estimates
3. Develop impact
estimates
5. Assess other
disease/vaccine
features
Lessons learned
Varied data availability and data quality a challenge for
comparisons
Uncertainty of projections for pipeline vaccines, e.g.
Typhoid
Improve communication of Gavi data needs to inform
vaccine research priorities pre-VIS
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Key inputs needed for the VIS
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RELEVANCE / DEMAND
• Expected demand from Gavi-eligible countries over 10-year
timeframe?
o Priority vs. other (outstanding) vaccine introductions, other public
health priorities, and available alternative interventions?
VACCINATION STRATEGY & COVERAGE
• Likely vaccination strategy in Gavi-eligible countries? Target
population, dosing, schedule, national/sub-national
• What coverage could realistically be achieved in the target
population? Key barriers to reaching the target population?
IMPACT
• Efficacy, duration of protection, disease burden in Gavi countries?
• Impact on inequity? Outbreak preparedness?
COST
• Per dose or per target person cost range?
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?
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