PRINCIPLES OF VACCINE PORTFOLIO PRIORITIZATION AND MANAGEMENT
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1 PRINCIPLES OF VACCINE PORTFOLIO PRIORITIZATION AND MANAGEMENT Product Development Boot Camp November 5, 2015 New York, New York 2014 Bill & Melinda Gates Foundation
2 Global Program Organization Global Health Functional Areas Trevor Mundel, President Discovery & Translational Sciences Chris Wilson, Director Vaccine Development and Surveillance Penny Heaton, Director Integrated Development Dan Hartman, Director Strategy, Planning & Management Toni Hoover, Director Kim Bush, Director Mark Suzman, President 1 Family Health 2 Maternal and Child Health 3 Water, Sanitation & Hygiene HIV TB Malaria NTD EDD Polio FH 1 MCH 2 FH 1 Nutrition WSH 3 Ag FSP 4 FP 5 4 Financial Services for the Poor 5 Family Planning Pneumo Global Program Strategy Teams Emilio Emini, Director Gilla Kaplan, Director Alan Magill, Director Trevor Mundel, Interim Director Anita Zaidi, Director Keith Klugman, Director Jay Wenger, Director Mariam Claeson, Director Shawn Baker, Director Brain Arbogast, Director Pamela Anderson, Director Roger Voorhies, Director Kellie Sloan, Director Life Sciences Partnerships Global Policy & Advocacy Country Offices Global Development Functional Areas Chris Elias, President Vaccine Delivery Orin Levine, Director Integrated Delivery Dana Hovig, Director Strategy, Planning & Management Hugh Chang, Director 2
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4 LIFE EXPECTANCY BY COUNTRY* Source: GBD 2013, IHME 2014 Bill & Melinda Gates Foundation 4
5 WHAT WE FOCUS ON What are the areas of greatest need? Where can we have the greatest impact? Bill & Melinda Gates Foundation 5
6 Source: WHO ( Bill & Melinda Gates Foundation 6
7 CHILDHOOD DEATHS ARE DECLINING WORLDWIDE BUT NEED MORE PROGRESS, PARTICULARLY IN NEONATES 20M 20 million 15M 10M 6.6 million 5M Source: The World Bank Bill & Melinda Gates Foundation 7
8 Leading Causes of Mortality in Children Under 5 6.3M deaths per year (2013) GAVI budget $6.5B ( ) (1) 1. Vaccine spend only. Excludes GAVI spend tied to VIS (e.g., Cholera Stockpile, YF Campaigns) as well as cash programs and business plan. Source: Under 5 mortality from GBD 2013 IHME; GAVI budget from GAVI Investment Opportunity 2015 Bill & Melinda Gates Foundation 8
9 SIMPLE RULES FOR VACCINE PORTFOLIO PRIORITIZATION Disease burden (disability-adjusted life years) Probability of success of vaccines as compared with other interventions Cost-effectiveness Co-Chair interests 2014 Bill & Melinda Gates Foundation 9
10 VACCINE DEVELOPMENT PRIORITIES Leading Causes of Mortality in Children Under 5 6.3M deaths per year (2013) Near-term Poliovirus vaccines Pneumococcal conjugate vaccines Rotavirus vaccines oral; parenteral HPV RSV GAVI budget $6.5B ( ) Mid- and long-term Other enterics ETEC, Shigella, Typhoid Malaria HIV TB Sustain legacy vaccines Penta, MR, YF, BCG, JE, Cholera Explore other maternal vaccines ap and Group B strep Bill & Melinda Gates Foundation 10
11 SIMPLE RULES FOR HIV VACCINE PORTFOLIO PRIORITIZATION Requirement to address novel or unique hypotheses regarding immune responses that may play a role in preventing or mitigating HIV infection Potential to be transformational Probability of success/robustness of data to date Orthogonal to what others are funding Of special interest 2014 Bill & Melinda Gates Foundation 11
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13 KEY ELEMENTS OF GH PROGRAM STRATEGY DEVELOPMENT Burden of disease at a subnational level in regions of interest, key risk factors, 25 year projections, comorbidities (e.g. HIV-TB), existing standards of care No regret or essential interventions (e.g. malaria SE Asia elimination, TB nutritional intervention) Dynamic model of disease demonstrates relative impact of potential interventions, provides key insights that motivate the strategy Cost effectiveness analysis of potential interventions Definition of high level intervention implementation plan (either key elements of product development plan or delivery plan, including identification of decision points and associated decision criteria) 2014 Bill & Melinda Gates Foundation 12
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