Overview of Measlescontaining. through UNICEF. Overview of [VACCINE] through UNICEF

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1 Overview of Measlescontaining vaccines through UNICEF Overview of [VACCINE] through UNICEF Children wait to be immunized against measles and rubella at the Losikito primary school in Tanzania. Source: BBC world news.

2 Measles-containing vaccine - UNICEF Supply Division supports global activities led by Measles and Rubella Initiative. - Secure availability of all Measles-containing vaccines for all activities, including Routine immunisation, mass campaigns and urgent deliveries to control outbreaks. - We work in partnerships with global initiatives, country programmes and donors to ensure programme needs are met in terms of availability, product presentations and product introductions.

3 Historical procurement of Measles-containing vaccine through UNICEF Significant growth in demand in for MR vaccine due to currently GAVI-funded introductions which is expected to continue. Demand for Measles vaccine remains high due to the current epidemiology resulting in larger age group campaigns and vaccinations following outbreaks as well as introduction of Measles Second Dose. Growth in demand for MMR vaccines to be linked to the scaling up of the routine immunization and expected to increase.

4 WAY FORWARD and beyond - Demand for Measles monovalent vaccine will remain high until all countries have introduced MR in immunisation schedule. - MR demand will peak but stabilise after all countries have introduced MR. - The main uncertainty is still on timing of MR introductions for the remaining countries. - In long-term, MMR demand will eventually increase to occupy a larger portion of routine requirements.

5 WAY FORWARD and beyond Main challenges and issues Way forward To forecast accurately MR introductions and understand its impact on Measles monovalent demand as the decision is country-driven and dependent on country priorities To forecast accurately the overall demand due to changing rapidly epidemiology of measles Maintain frequent two-way communication on forecasts and production capacity Offer new vaccine presentations, for example: using 5-dose vials to reduce wastage rates and increase coverage UNICEF will welcome new entrants to Measles-containing vaccines market (MV, MR & MMR)

6 Tetanus-containing vaccines

7 Supporting Maternal and Neonatal Tetanus Elimination activities through supply UNICEF Supply Division works in supports of the Global Maternal and Neonatal Elimination Programme founded in The initiative is a partnership with WHO, UNFPA, funding partners and national governments. Since then, 38 out of 59 high risk countries have achieved MNTE by end August A lot of activities are to be conducted in the remaining 21 countries. We support all MNTE activities in all countries, including routine and campaigns. 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 Source: WHO/UNICEF Database Date of slide : 7 July 2015 Map production: Immunization Vaccines and Biologicals, (IVB), World Health Organization

8 Where are we? doses Overall demand for Tetanus-containing vaccines remains high between 140M and 160M doses per year There is a clear trend of increased Td uptake; however the switch from TT to Td vaccines is taking place at a slower rate than forecasted

9 WAY FORWARD and beyond doses Tender for supply is finalised and awards are made. Challenges To forecast accurately the switch from TT to Td vaccine as the decision is based on country s acceptance of the WHO recommendation and is dependent on countries priorities.

10 HOW CAN YOU ENGAGE WITH UNICEF TO MEET THE NEEDS OF CHILDREN? Maintain high quality and production capacity with affordable vaccines Visibility on production plans and their milestones as well as flexibility to facilitate countries decision-making on switch from TT to Td

11 Overview of Yellow Fever Vaccine through UNICEF

12 YFV procurement through UNICEF Supply at same level since countries Affectedby manufacturers suspension / re-activation of their WHO PQ status(2013/2014)

13 Issues and Challenges / Mitigating actions Issues and Challenges Current YFV supply offers to UNICEF not sufficient to meet the total country requirements for preventative campaigns (routine and emergency stockpile needs covered) Country demand concentrated at the beginning of the year, whereas supply is more readily available during the second half of the year Mitigating actions UNICEF will continue to review YFV supply availability against demand requirements to assess YFV allocation UNICEF will continue to share country forecasts with manufacturers in order to improve visibility on supply and demand UNICEF and partners will continue to encourage the production through potential new manufacturers and/or increased production capacity

14 WAY FORWARD and beyond New tender will be issued in 2017 for period Driver 2016/2017 Planned campaigns in Nigeria and Sudan

15 HOW CAN YOU ENGAGE WITH UNICEF TO MEET THE NEEDS OF CHILDREN? Secure adequate supply in order to meet demand for future years Offer the countries preferred presentation of 10 doses vials Maintain quality of production and product Continue focus on offering affordable pricesin a frame of increasing supply

16 Overview of Meningococcal Vaccine through UNICEF

17 Context: Meningococcal vaccine Meningococcal A Conjugate Campaigns/Routine Nm-A historically predominant for epidemics in the Africa Meningitis belt: MenA Conj from 2010 Mass campaigns, Routine immunization(start in 2016) and Mini catch-up campaigns: 26 countries by 2018 Meningococcal Emergency Stockpile - Outbreaks Serotypes (A, C, W) request vary depending on epidemiological data. Polysaccharide International Coordinating Group (ICG) determines the needs for vaccines every year 2015: Unexpected increase in Nm-C cases + Short supply to outbreaks 2016: 5 Mio.ds of C and W-containing vaccines (polysaccharide and conjugate) (1.5 Mio.ds MenA Conj)

18 Meningococcal A Conjugate vaccine Procurement through UNICEF -Campaigns Demand (Campaigns/Routine) In the long-term, total routine demand will be about 30 million doses of vaccine per year

19 Meningococcal Emergency Stockpile Procurement through UNICEF - Outbreaks Demand

20 Issues and Challenges / Mitigating actions Issues and Challenges Mitigating actions Meningococcal A Conjugate Demand shifting from campaign-driven volumes to routine programmes Sole supplier, perpetuating the current single source scenario Meningococcal A Conjugate Efficient communication with partners on the planning the different programmes. The supplier has capacity above Gavi-supported countries peak demand in 2016/2017 Meningococcal Emergency Stockpile Procurement of meningococcal multivalent polysaccharide vaccines in 2015 exhausted WHO PQ ed available supply Vaccine shortage challenges the access to the 5 million doses stockpile requirements for 2016(ICG) Meningococcal Emergency Stockpile In discussion with the industry to meet the objectives of secure supply and increase long term availability and number of WHO PQ ed suppliers Awaiting results of the current tender

21 HOW CAN YOU ENGAGE WITH UNICEF TO MEET THE NEEDS OF CHILDREN? Secure adequate supplyin order to meet demand for future years Availability of multivalent polysaccharide vaccine to respond to meningococcal outbreaks Maintain quality of production and product and seek WHO PQ n Secure that your company can respond for immediately delivery (48 hrs) Make prices affordable

22 Overview of Oral Cholera Vaccine through UNICEF

23 Current status of OCV supply and demand Until 2014, minor and few annual OCV requirements to UNICEF SD; few countries Milestone: Creation of OCV stockpile (2013/2014) + revitalization of the Global Task Force for Cholera Control(GTFCC)(2014) UNICEF SD tender objective: Secure supply of OCV for the period (Gavi investment) emergency stockpile(outbreaks and humanitarian crises) and; non-emergency reserve(preventive campaigns in hot spot areas) This requirement does not constitute a firm demand and both components will be reviewed on an annual basis by the partners in order to determine annual demand

24 Issues and Challenges / Mitigating actions Issues and Challenges OCV demand in the long term is uncertain, although increasing requests for preventive campaigns / outbreaks (Iraq, DRC, Tanzania, etc.) Limited availability and reduced supplier base of WHO pre-qualified vaccine Price per dose not decreasing despite higher supply Mitigating actions UNICEF will continue to encourage potential new OCV market entrants to seek WHO prequalificationand increase supply UNICEF will continue to encourage the current manufacturer with awarded supply to plan and expand production capacity With the new manufacturers coming into the market, UNICEF should achieve cost savings

25 HOW CAN YOU ENGAGE WITH UNICEF TO MEET THE NEEDS OF CHILDREN? Share information with UNICEF on updates of your future plans for producing OCV Maintain UNICEF informed of your submission to WHO for pre-qualification

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