CEO Board report Seth Berkley MD CEO

Transcription

1 CEO Board report Seth Berkley MD CEO Dhaka, Bangladesh, November 2011

2 Bangladesh, November 2011

3 Meningitis Incidence Children < 12 months Dhaka Shishu / Shishu Shahsta Catchment Area Cases per 100, (95% CI 203, 799) Before HIB Vaccine in EPI Since HIB Vaccine in EPI We estimate 17,500 cases of meningitis averted across Bangladesh in the first year of routine HIB vaccination % CI 18,135 Slide: icddr,b Dhaka, Bangladesh 0 Pyogenic Meningitis HIB Confirmed Meningitis

4 First 90 days

5 Overview of presentation New results Accelerated activities Expenditure and resources horizon view Opportunities and challenges Board agenda: key decisions and themes for discussion

6 Taking stock: the immunisation gap 136 million surviving newborns in 2010: Source: Johns Hopkins Bloomberg School of Public Health; UN,DESA, Population Division; WHO/UNICEF

7 Over 19 million children still unimmunised Global number of under-five children unimmunised with 3 doses of DTP Source: WHO/UNICEF coverage estimates 2010 revision. July 2011

8 GAVI has supported countries in preventing more than 5.5 million future deaths Source: These estimates and projections are produced by the WHO Department of Immunization, Vaccines and Biologicals, based on the most up-to-date data and models available as of 30 September *Polio estimate includes deaths averted by vitamin A supplements supported by GAVI.

9 Immunisation coverage continues to rise DTP3 coverage in GAVI-supported countries, Source: - WHO-UNICEF coverage estimates for , as of July 2011; coverage projections for , as of September 2011; World Population Prospects, the 2010 revision. New York, United Nations, 2010; (surviving infants) Note: This estimate includes all 76 countries that have ever been eligible for GAVI support.

10 Country demand: record number of vaccine applications approved Source: GAVI Alliance data as at 30 September 2011

11 GAVI/11/Daniel Thornton GAVI/11/Doune Porter GAVI/11/Otele Emile Accelerating vaccine rollouts Sudan, Cameroon, Benin, Ethiopia...

12 World Pneumonia Day, Malawi 12 November 2011 Bright Masambo Chisale, first baby to receive pneumococcal vaccine

13 Pneumococcal vaccine introductions: introduced, approved and forecast Moldova Georgia Armenia Azerbaijan Pakistan Nicaragua Honduras Guyana Senegal Gambia Sierra Leone Mali Niger Yemen Sudan Djibouti Ethiopia CAR Benin Ghana Cameroon Uganda Sao Tome Democratic Kenya Republic of Rwanda the Congo Burundi Tanzania Kiribati. Bolivia Angola Malawi Zambia Zimbabwe Mozambique Madagascar 30 number of countries per year Introduced Approved Forecast

14 Rotavirus vaccine introductions: introduced, approved and forecast Moldova Georgia Armenia Nicaragua Honduras Niger Sudan Yemen Djibouti Guyana Ghana Cameroon Republic of the Congo Angola Rwanda Burundi Malawi Ethiopia Tanzania Bolivia Madagascar Number of Countries per year Introduced Approved Forecast Source: Demand forecast v 4.0

15 Rotavirus mortality in children under five, 2008 estimate 95% of deaths occur in GAVI-eligible countries Source:Tate J, Burton A, Boschi-Pinto C et al estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. The Lancet Infectious Diseases, Early Online Publication, 25 October 2011.

16 Health Systems Funding Platform Nepal - new health plan rolling out Proposals received from Ethiopia, Tanzania and Vietnam to pilot new window IRC recommended Vietnam for support Applications invited August 2011 for end year Applications accepted from 2012 according to country timetables

17 Expenditure and resources

18 Expenditure and resources

19 Outlook through 2020 (current portfolio) 2,000 1,800 GAVI Cash Outflows Estimates (US$ millions) : $1.7 bn per year : $1.5 bn per year Includes HPV, rubella, JE and typhoid vaccines 1,600 1,400 1,200 1, Vaccines Programmes Cash Based Programmes Business Plan

20 Comparison: new vaccines versus pentavalent, pneumococcal and rotavirus Comparison of GAVI costs by year

21 Comparison: new vaccines versus pentavalent, pneumococcal and rotavirus Comparison of GAVI costs by year

22 Comparison: new vaccines versus pentavalent, pneumococcal and rotavirus Comparison of GAVI costs by year

23 Comparison: new vaccines versus pentavalent, pneumococcal and rotavirus Comparison of GAVI costs by year

24 Comparison: new vaccines versus pentavalent, pneumococcal and rotavirus Comparison of GAVI costs by year

25 Comparison: new vaccines versus pentavalent, pneumococcal and rotavirus Comparison of GAVI costs by year

26 Opportunities Strong financial foundation engaging donors and new donors long-term plan to Board 2012 Accelerating country demand Continuing immunisation advocacy campaigns Leveraging synergies across immunisation

27 Immunisation advocacy Decade of Vaccines - Global Vaccine Action Plan US Immunisation summit GAVI Partners Forum New York, 19 September 2011 Photo courtesy of Insider Images

28 The immunisation landscape Synergies and shared learnings Polio eradication Traditional vaccines Measles elimination New vaccines Regional vaccines R&D: vaccine improvements R&D: future vaccines

29 Optimizing Assets to Overcome Barriers GPEI Technical Assistance for Immunization Data as of Oct 2011 WHO staff (3657) International technical staff National technical staff General staff / Driver

30 Children Paralyzed by Wild Polioviruses Last 6 Months Wild virus type 3 Wild virus type 1 Endemic country Country with importation case India: > 9 months with no polio for 1 st time in history. data at end-oct 2011

31 Reported measles cases (all ages) and coverage with the first dose of measles (children aged <1 year) - WHO African Region,

32 Reported Measles Incidence Rate* and Large Outbreaks, Jan 2010 to Sept 2011 Canada: 749 Cases Romania: 2765 Cases Bulgaria: 22,005 Cases Afghanistan: 3563 Cases France: 19,675 Cases Spain: 1637 Cases Bangladesh: 28,849 Cases Philippines: 12,129 Cases Italy: 5161 Cases Niger: 10,523 Cases Nigeria: 26,989 Cases DR Congo: 123,537 Cases Southern African (7 countries): 176,139 Cases <0.1 (71 countries or36%) <1 (37 countries or 19%) 1 - <5 (39 countries or 20%) 5 (39 countries or 20%) No data reported to WHO HQ (9 countries or 5%) Ethiopia: 10,360 Cases Indonesia: 40,263 Cases Somalia: 14,358 Cases *Rate per 100'000 population Data sources: surveillance DEF file, reports from countries and regions Data in HQ as of 12 October 2011 The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. WHO All rights reserved.

33 The challenge of rigorous data DTP3 coverage: Ethiopia Country estimate IHME estimate Data courtesy of Institute for Health Metrics and Evaluation; WHO/Unicef 2010 estimates; Preliminary 2010 DHS

34 Board meeting Key decision points: New vaccine windows: HPV and rubella Vaccine supply and procurement strategy Performance-based funding for cash support Business plan budget Key themes for discussion and guidance: Eligibility and wider access to affordable vaccines Private sector fundraising Large countries and other customised opportunities

35 Current cervical cancer mortality Source: Globocan 2008, International Agency for Research on Cancer. Courtesy of Progress in Cervical Cancer Prevention: The CCA Report Card, August 2011

36 Introduction of HPV vaccine Status: July 2011 Source: Courtesy of Progress in Cervical Cancer Prevention: The CCA Report Card, August 2011

37 Rubella: global disease burden An estimated 112,000 CRS (Congenital Rubella Syndrome) cases occurs globally; 90,000 in GAVI eligible countries Number of CRS cases < < < < ,000 or more Number of CRS cases born in 2008 No data Source: Vynnycky, Adams et al (in preparation)

38 Supply strategy overview Analyse markets Define interventions and targets Vaccine Roadmap Considerations for start of GAVI engagement Prioritise objectives Considerations for end of GAVI engagement

39 Performance-based funding programme design GAVI s cash support will be split into two different types of payments Fixed Performance Fixed % of funds provided as fixed payments depends on DTP3 coverage at baseline Lower coverage = higher % of funds as fixed Higher coverage = lower % of funds as fixed

40 Step-change in activity since Increase US$ million Actual Forecast Budget on 2010 Business Plan % Programme Expenditure , % Total Expenditure ,532 Business Plan as % of Total 17% 16% 10% 20% Business Plan as % of Total Expenditure $1.5bn +123% $1.0bn 15% $0.5bn +23% $0.0bn 10% 2010 Actual 2011 Forecast 2012 Budget 2010 Actual Business Plan 2011 Forecast 2012 Budget Programme Expenditure

41 No. of countries : 94 introductions versus 50 in the business plan - an increase of 88% MenA, 8 JE, 2 Rubella, 2 Penta, 4 Rota, v2 MenA, 6 JE, 3 Rubella, 9 Penta, 7 Rota, 30 Pneumo, 37 v4 MenA JE Rubella HPV Penta Rota Pneumo

42 Strategy and business plan: new dashboard

43 Impact of raising eligibility threshold from US$ 1,500 to US$ 2,000

44 Unimmunised children by national income 86% of unimmunised children in LMIC are in GAVI-eligible countries A further 7% are in GAVI graduating countries Source: WHO/Unicef DTP3 coverage estimates; World Bank national income categories

45 Private sector fundraising

46 India: Reaching universal coverage Vaccine coverage disparities between regions: Average for India for : 44% of children fully immunised by 24 months Range for all Indian states in that year: 21%-81% National Family Health Survey, India, 2007 (most recent available figures)

47 Why we are here... GAVI/08/Olivier Asselin

48 2011 Swedish assessment of GAVI Ministry for Foreign Affairs Sweden 11 November 2011

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