International Coordinating Group for vaccine provision. Emergency Vaccine Stockpiles

Transcription

1 International Coordinating Group for vaccine provision Emergency Vaccine Stockpiles

2 Existing Vaccine Stockpiles Vaccine Year Use Qty million doses Smallpox 1980 Epidemic response 35 WHO/ countries Storage Mechanism Funding WHO Donations Meningococcal 1997 Epidemic response 5 Producers ICG GAVI/ revolving fund Yellow Fever 2001 Epidemic response 6 Producers ICG GAVI/ revolving fund Influenza 2007 Epidemic response 10 % of prod capacity Virtual WHO/PIP PIP Cholera 2013 Epidemic response and humanitarian emergencies 2 Producers ICG GAVI/ revolving fund mopv Epidemic response 500 Producers SAGE WG GPEI Ebola (under discussion) 2016 Epidemic response? Producers ICG-like GAVI 2

3 ICG - History and Mission In 1996, Africa experienced the largest recorded outbreak of epidemic meningitis in history, with more than 200,000 cases and 20,000 deaths The emergency response fully exhausted international vaccine reserves IFRC, MSF, UNICEF and WHO established the ICG in to assure a well-coordinated and equitable distribution of meningococcal vaccines and related material during meningitis epidemics

4 ICG Objectives To ensure rapid access to vaccines bundled with injection materials for countries experiencing epidemics To promote the optimal use of these resources (especially when stocks are limited) To coordinate international efforts in preparing for, and responding to epidemics

5 ICG Basic principles 1. Timely arrival of vaccine for an effective outbreak response where is most needed 2. Fairest distribution of the vaccine. Careful assessment of risks and benefits. Global stock is managed by an international partnership 3. Work with manufacturers to ensure availability of an emergency stock of supplies at global level 4. Use and promotion of epidemiological and operational criteria for vaccine release 5. Standard operating procedures 6. Established financial mechanism to purchase emergency supplies and ensure sustainability

6 The ICG partnership An extended partnership with technical partners and vaccine producers: WHO CCs (CDC, NIPH-Oslo, IP Paris/Dakar) and other partners (AMP, CERMES, Epicentre, LSHTM, MVP, etc) Manufacturers: vaccines and antibiotics Donors: GAVI, ECHO, CERF The ICG executive sub-group: A core group of public health organizations acting at global level: IFRC, MSF, UNICEF, WHO (secretariat) Decision-making body

7 ICG Executive Sub-Group International Federation of the Red Cross and Red Crescent Societies (IFRC): Strong country presence: community health promotion, local social and resource mobilization, Support to states during disasters and epidemics Médecins Sans Frontières (MSF) An independent field-based NGO providing health care to populations in precarious and emergency situations (epidemiology, case management, vaccination, training, and evaluation) United Nations Children's Fund (UNICEF) Vaccination campaign planning and implementation Vaccine procurement and shippment World Health Organization (WHO) ICG Secretariat (Coordination) Advisory normative role; global public health; Stockpile management Technical support to countries: surveillance, preparedness and response to outbreaks

8 Criteria for membership in the ICG Executive Group o International public health agency or international non-governmental organization support to countries on health matters irrespective of race, religion, gender or political affiliation. o Active role in response: agencies and organizations must participate in response and control interventions. o Commitment and daily availability: be available for emergency consultation at any time o Respect of data ownership and confidentiality: agencies must commit to respect the confidentiality of country data o Lack of conflict of interest: any involvement with the vaccine industry e.g. perform consultancies for and/or receive funding from such manufacturers.

9 ICG mechanism - components

10 ICG stock management: Forecasting Carefull assessment of vaccine supply and production capacity Composition and size of the emergency stockpile of vaccines is estimated on a yearly basis by the ICG executive sub-group Work with manufacturers. Supply for preventive campaigns

11 ICG stock management: Storage The stockpiles are kept at the manufacturer warehouses at least 2 sites Quicker delivery (air connections) Shelflive optimization, rotating stocks Dubai Geneva warehouses Copenhagen (injection materials)

12 ICG - Applications ICG standard forms ICG partners work with countries Training, workshops in regional meetings

13 ICG - Decision-making 48 hours decision-making One organization = one vote Consensual decisions When disagreement: teleconferences convened to reach consensus ICG Decision: approval, partial approval, more information needed, disapproval

14 ICG - Criteria for Release Evidence of an ongoing outbreak Laboratory confirmation of the responsible pathogen Feasibility of conducting a vaccination campaign (security, partners in the field) Adequate storage conditions and resources A plan of action for mass vaccination

15 ICG Procurement and shipment Target: 7 days, vaccine ready in 48h + 5 days shipping UNICEF SD in Copenhagen MSF Bordeaux - Brussels WHO Kuala Lumpur

16 ICG - Financial management fund-raising appeals: limited success Unsustainable strategy 2003 started requesting reimbursement of costs to countries: Not a pre-requirement for request approval Promoted and implemented by the secretariat, but with little administrative resources Less than 50% reimbursement obtained? 2009 Vaccine stockpiles funded by GAVI including operational support for vaccination campaigns Establishment of a revolving fund in WHO (CERF, ECHO, UNICEF, MSF)

17 ICG process Vaccine stockpile Request more information Country request WHO ICG secretariat IFRC, MSF, UNICEF, WHO 1- Submission 2- Circulation 3- Decision in 48h ICG UNICEF SD 4- Approval 5- Procurement 10 days max Manufacturers Vaccines in country 6- Packing and shipment 7- Arrival 8 - Reimbursement

18 ICG - monitoring and performance ICG performance Lead times for ICG submission, decision making, procurement, shipping, vaccination. Forecasting Led to work with country: improved quality of requests ICG workshops, improved forms and guidelines, direct support to countries (including evaluations of epidemic detection and response) The ICG mechanism has contributed to reinforced surveillance and laboratory confirmation Impact of vaccination and response

19 The ICG value: why it works The ICG is an operational, solution-driven and creative partnership Grounded on pragmatism while adhering to strict epidemiological criteria and principles ICG members: Commitment and availability; Collaboration; Complementarity (global action and field presence) Real partnership Extended partnership with key technical organizations, manufacturers and donors ICG Mechanism: standardized, transparent, adapting ICG revolving fund: development of an autonomous financial system

20 Extra slides

21 Meningococcal vaccine stockpile Managed by the International Coordinating Group (ICG): established in 1997 Revolving stock: Men AC + ACW + ACWY + Men A conj. 70 million doses of vaccine have been channelled since 1997 Emergency stockpile : 45 million doses Financed by GAVI Revolving Fund mechanism to ensure sustainability beyond 2013

22 Yellow fever stockpile Managed by the International Coordinating Group (ICG): established in 2001 Revolving stock of YFV for outbreak and preventive campaigns 90 million doses of vaccine have been shipped since 2001 Emergency stockpile : 48 million doses Financed by GAVI Revolving Fund mechanism Unused vaccine used for preventive campaigns

23 Cholera stockpile Managed by the International Coordinating Group (ICG): established in 2013 Revolving stock of OCV for outbreak and preventive campaigns 3 million doses OCV Emergency stockpile : 8 million doses Financed by GAVI Revolving Fund mechanism Unused vaccine used for preventive campaigns