Beyond vaccine introduction: Working together for sustainable, resilient immunization programs Manufacturer perspective IAIM Regional Meeting for the Americas and Europe 1 February 2017 Anupama Tantri Global Policy and Partnerships Merck Vaccines
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A vaccine lifecycle is governed by a complex, interconnected ecosystem with multiple, people and policies Knowledge and skills Funding Clinical trial infrastructure R&D Industry Academia Patient advocacy groups research institutes Technology Equipment Supply managemen t regulatory agencies Industry Trade associations Ministries of industry / trade / commerce Funding Expertise Human resources Licensure regulatory agencies European Medicines Agency Expertise Human resources WHO prequalification Manufacturing Recommendations technical advisory groups WHO SAGE / global / regional institutions Medical societies Advocacy groups Funding Management Procurement / regional governments Health care providers / Pooled procurement entities UNICEF / Gavi Cold chain Logistics Delivery and Storage immunizatio n programs Health care providers / NGOs Trained workforce Accessible venues Vaccination immunization programs Health care providers School nurses Community health workers Vaccine safety Information Disease surveillance Monitoring and Surveillance Ministries of health Regulatory agencies Industry WHO / global / regional institutions Communication campaigns Funding Scale up and Sustainability Ministries of health Academia Industry WHO / global / regional institutions Advocacy groups and NGO
Several trends influence and shape the vaccine ecosystem and vaccine introduction, access, uptake and program sustainability and resiliency Ageing Populations Transforming Health Systems Health Budget Pressures and Economic Crises 4 Emerging Infections and Non- Communicable Diseases Source: http://apps.who.int/iris/bitstream/10665/111548/1/9789241506892_eng.pdf Vaccine hesitancy and confidence
Working together: Strategies to promote sustainable, resilient immunization programs Create new and optimize existing vaccines Generate and disseminate data about the burden of disease, safety, efficacy and value of vaccines Strengthen program implementation Promote vaccine confidence and resilient vaccine eco Promote evidence-informed immunization policies and best practices
Strengthening programs, generating data and building vaccine confidence Nicaragua 1 Philippines 2 Partnership: MoH and MSD (2006-2009) Facilitated introduction of rotavirus vaccine Generated data on effectiveness and evaluated public health impact Supported program implementation (education and training) Achieved >90% national coverage by 3 years Collaboration with public sector, NGOs, medical societies (2006 - current) Supported comprehensive cervical cancer prevention programs Promoted resilient program and vaccine confidence Supported implementation of HPV vaccination program (training, best practices) Achieved >75% coverage for first dose 6 1. Khawja, et al. Evaluating the health impact of a public-private partnership to reduce rotavirus disease in Nicaragua. Human Vaccines & Immunotherapeutics 8:6, 777-782; June 2012. 2. http://www.msd.com.ph/newsroom/pages/doh%e2%80%99s-school-based-hpv-vaccination-initiative-now-complete-as-300-baguio-city-girlsget-final-dose.aspx
Disseminating data, strengthening communications and building vaccine confidence Fig 1: Map showing global transmission of: 1) Information about other countries HPV situation reported in the Japanese media; and 2) reporting and discussion on the Japanese suspension of the HPV vaccine recommendation outside of Japan. (January 2014-July 2014). From: Larson, et al. Tracking the global spread of vaccine sentiments: The global response to Japan's suspension of its HPV vaccine recommendation. Hum Vaccin Immunother. 2014 Sep; 10(9): 2543 2550. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4977439/ 7
Promoting evidence-informed immunization policies and best practices ALOHA: Acting for Longevity and Healthy Ageing Pan-European partnership across 10 countries with 22 public and private partners Aim to inform, educate and engage HCPs, public to prevent infectious diseases in seniors www.aloha-academy.eu AVAC: Adult Vaccine Access Coalition Coalition of >50 HCPs, vaccine makers, pharmacies, public health orgs, patient and consumer groups Aim to inform and engage policymakers to strengthen and enhance access to and utilization of adult immunization services across health system http://www.adultvaccinesnow.org/ 8
9 Thank you! We cannot step aside and say that we have achieved our goal by inventing a new drug or a new way by which to treat presently incurable diseases We cannot rest till the way has been found, with our help, to bring our finest achievement to everyone. - George Merck