GAVI S CONTINUED ROLE IN YELLOW FEVER CONTROL

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GAVI S CONTINUED ROLE IN YELLOW FEVER CONTROL BOARD MEETING Michael F Thomas, Abidjan, Côte d Ivoire Reach every child www.gavi.org

EVOLVING CONTEXT: THREATS AND OPPORTUNITIES Yellow fever is a global threat Endemic in 47 countries (30 Gavi eligible) worldwide with recent outbreaks International and intra-national transmission has occurred Potential for further expansion due to urbanisation, large population movements, climate change Gavi s investment to date has had a favorable impact on Yellow Fever in Africa From 2000 over $300M invested and over 200m immunised through 2015 Support has been aligned with global initiatives but largely reactive to needs Opportunities for improved coverage in 2017-2020 Three-pronged vaccination strategy Vaccine supply Accountability and coordination 2

LESSONS LEARNED FROM PREVIOUS YELLOW FEVER INITIATIVES The three-pronged vaccination strategy is effective when properly implemented Routine immunisation, mass preventive campaigns and emergency stockpile Recent supply constraints have resulted in sub-optimal implementation of effective YF control strategies Partial implementation of mass preventive campaigns in Ghana, Nigeria and Sudan Outbreaks in Angola and DR Congo Global processes need to be strengthened to meet the challenges of controlling Yellow Fever Governance, accountability and advocacy are required to ensure better country engagement and implementation of recommended strategies 3

YF vaccine doses (in 1000s) VACCINE SUPPLY LANDSCAPE EXPECTED TO IMPROVE Alliance efforts have resulted in a commitment to improved YF vaccine production after several years of insufficient supply Production anticipated to increase from 72m doses annually in 2015 to ~140m doses by 2020 Dynamic nature of supply and estimated country needs requires close coordination Gavi increment volumes requested are a subset of EYE global demand 200 000 180 000 160 000 140 000 120 000 100 000 80 000 60 000 40 000 20 000 0 Global available (mid point) 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Year Global demand - EYE 4

ELIMINATING YELLOW FEVER (EYE) OUTBREAKS STRATEGY, 2016-2026 Global in scope Strategic objectives New elements 47 endemic countries Active Gavi engagement with WHO in development stages Protect at risk populations Prevent international spread Rapidly contain outbreaks Risk classification Revolving stockpile Catch-up campaigns Strengthened governance and accountability International Health Regulation (IHR) 5

GAVI S APPROACH TO SUPPORT THE IMPLEMENTATION OF THE STRATEGY Work with WHO and stakeholders to strengthen oversight, governance and accountability Investment centred on improving sustainable immunisation in alignment with Coverage and Equity agenda Continue to work with manufacturers to realise supply increases through 2021 6

ESTIMATED GAVI SUPPORT INCREASES BY $150 MILLION Existing estimates U$278m Dec-15 Board 2016-2020 Estimated increment US$150m ~165m doses ~ 95m doses Ongoing support for YF RI in 15 countries Partial supply of YF RI in 4 new countries from 2019 or earlier Partial supply for SIAs in 3 countries Support for emergency stockpile Install 4 new RI programmes Supplemental doses for 3 approved SIAs; additional country SIA Increased support for revolving stockpile Total estimates US$ 428 million and 260 million doses

RECOMMENDATION The Gavi Alliance Programme and Policy Committee recommended to the Gavi Alliance Board that it: a) Agree that Gavi s support for Yellow Fever vaccine be based on the Eliminating Yellow Fever Epidemics Strategy developed by WHO (the EYE Strategy ). b) Note that due to increased supply availability and the identified need to improve Yellow Fever vaccine coverage in endemic countries to introduce, forecasted expenditure on Yellow Fever vaccine support in Gavi eligible countries in the period 2017-2020 will increase by approximately up to US$ 150 million. 8

Thank you Reach every child www.gavi.org