GAVI S VACCINE INVESTMENT STRATEGY Judith Kallenberg, Head of Policy PDVAC 22 June 2017, Geneva Reach every child www.gavi.org
Gavi finances vaccines and immunisation through three routes ($9 Billion in 2016-2020) Health Systems and Immunisation Strengthening Vaccines Technical assistance VIS Innovation 2
Gavi, the Vaccine Alliance, mission: To save children s lives and protect people s health by increasing equitable use of vaccines in lower income countries 3
Gavi supports 73 countries, reaching ~80 million children per year Since 2000: 600,000,000 children immunized 8,000,000 future deaths averted
Gavi s vaccine portfolio has diversified over time Pentavalent HPV RI Uptake of vaccines in RI/mass preventive campaigns Hepatitis B Hib YF routine PCV Rotavirus Measles 2 nd dose YF campaigns Typhoid JE Measles rubella Men A RI/MPC Measles campaigns YF campaigns HPV multi-age cohort JE routine Outbreak response YF stockpile Meningitis stockpile Measles outbreak response Cholera Ebola Learning agenda Rabies Malaria Elimination/ eradication 5 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016+ Year of investment decision IPV
Vaccine investments increasingly targeted at specific sets of countries Universal* Pentavalent Hepatitis B Hib PCV Rotavirus Measles 2 nd dose HPV RI Measles rubella Meningitis A RI/MPC IPV HPV multi-age cohort Targeted* Yellow Fever (YF) routine YF campaigns Typhoid JE Measles campaigns YF campaigns Other* YF stockpile Meningitis stockpile Measles outbreak response Rabies Cholera Malaria Ebola 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016+ 6 Year of investment decision *Universal: all Gavi countries; Targeted: focused on sub-set of GAVI countries; Other: outbreak response, learning agenda
VIS is aligned with Gavi s strategic cycle and financial replenishment 2011-2015 Strategic period 2016-2020 Strategic period 2021-2025 2008 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 VIS #1 MenA, JE, HPV Rubella, Typhoid conjugate VIS #2 YF mass campaigns, Cholera stockpile, Rabies/cholera studies, Malaria deferred RTS,S pilot funding decision VIS #3 7
A robust and evidence-based process will be conducted over the next 18 months Km 2: What is the appropriate vaccination strategy? Km 3: What is the demand in Gavi countries? Km 4: Would it be feasible and what would it cost? Km 5: What would be the impact? Km 6: How does it compare to other potential investments and current portfolio? EXIT Final Investment Decisions 8 Km 1: What is burden of disease? Oct 2017: decision framework(s) May 2018: shortlist Oct 2018: vaccine investment decisions
VIS 2013 9
WHO landscape analysis: the starting point Vaccines already licensed, not on GAVI list Vaccines that might be licensed by 2023 Incremental changes to existing policy or vaccines 10
Preliminary list to be further reviewed: Dengue Hepatitis A Hepatitis E Influenza seasonal, maternal (pandemic?) Malaria (refresh with no decision in 2018) Mening CYWX Mumps/MMR Rabies, Rabies Ig/mAb Typhoid RSV (& RSV mab?) Group B strep OCV Diphtheria (booster, maternal) Diphtheria antitoxin Hep B birth dose Pertussis (booster) PCV catchup IPV Tetanus toxoid (booster, maternal) Ebola (pre-emptive vaccination) Zika Norovirus ETEC HIV TB 2nd generation Chikungunya CEPI vaccines? 11
VIS has traditionally prioritised health impact, but opportunity to broaden investment lens Previous VIS Overall and U5 mortality Procurement cost per deaths averted Current VIS Additional lenses for health impact? Morbidity, AMR, strengthening delivery platforms Looking beyond direct health impact? Global public good vaccines (e.g., epidemics; eradication) 12
Should Gavi consider others investments or signalling beyond funding broad use? Global stockpile Learning agenda Signalling future priorities (vaccines in 5-10 year window) 13
Potentially taking a longer-term view within the VIS 2019-2023 VIS: 5 year scope Vaccine development: 10+ years Long-term guidance within the VIS? 14
Questions for discussion 1. How can we align Gavi and PDVAC prioritisation of pipeline vaccines? 2. To what extent can PDVAC help guide Gavi assessment of longer term ( VIS+ ) vaccine priorities? 3. What (non-binding) guidance from Gavi would be helpful to focus vaccine R&D and how does that fit in with WHO/PDVAC work on PPCs/TPPs? 15