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Technologies in Support of Immunization Programs. GAVI R&D Task Force August 2001. GAVI R&D Task Force.
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Technologies in Support of Immunization Programs GAVI R&D Task Force August 2001
GAVI R&D Task Force • The Task Force has been asked to select three technologies or categories of technology (not including new vaccines) that could have a major impact on immunization programs in the short (less than 5 years) or longer term (less than 10 years). • Input from Technet and SIGN members is requested in the selection of these technologies.
Unsafe administration Wasted vaccine Spoiled vaccine Additional vaccines Decaying cold chain Poor infrastructure Outreach - the most difficult ‘last mile’ Poor management Wars and conflicts HIV/AIDS Hostile environments Resistance to change Lack of disease burden data Challenges in Immunization
GAVI R&D Task ForceThree Teams • Vaccine Formulation & Process Solutions • Sugar/Glass stabilisers • Reduce number of • contacts • -adjuvants • -combinations • Formulations for • alternative routes of • administration • Safety : • Hardware Solutions • Prevent contamination • Prevent syringe re-use • Prevent heat damage • Prevent freezing • Safe disposal • Reduce wastage • Simplify systems, e.g. • Self-contained, unit-dose administration systems • Access, Management • & Operations: • Operational & Field Research & ICT solutions • Coverage • Management systems • Logistics • Management efficiency • Surveillance research
Team Members (* Coordinator) Safety : Hardware Solutions Michael Free* Gordon Larsen Umit Kartoglu Bruce Weniger Ticky Raubenheimer Rudolph Cumming Punnee PitisuttithumJohn John Lloyd Access, Management & Operations: Op & Field & ICT solutions To be selected* Steve Landry Deborah Lans Hans Everts Robert Steinglass Soren Spanner Serge Ganivet Souleymane Kone Vaccine Formulation & Process Solutions Gordon Dougan* Reinhard Gluck Richard Strugnell Peter Carrasco (R. Kerry) (Rip Ballou)
GAVI Survey (41 responses) Short Term • Improved management and tracking systems in the field • Temperature stability technologies • Combination vaccines • Fix cold chain • Monodose/self-contained unit-dose administration`systems (SCUDAS) • Sharps management Longer Term • Non-invasive administration • More Temperature stability • More combination vaccines
Focus for Technology • Safe and effective vaccines • Safe administration • Vaccine accessibility • System efficiency
No heat damage Vaccine vial monitors (VVMs) Fail-safe refrigeration Ice-free cooling Vaccine stability No freezing damage Fail-safe refrigeration Freeze indicators No contamination ‘Monodose’ Self-contained unit dose administration systems (SCUDAS) Auto-disable reconstitution syringes Auto-reconstitution Assuring Safe and Effective Vaccines at Point of Administration
Assuring Safe Administration • Assuring Sterile Injections • Auto-disable Syringes • Heat re-enabled sterilizable syringes • Self-contained Unit Dose Administration Systems • ( SCUDAS, e.g. Uniject, Oral, Transdermal, Nasal dispenser etc.) • Preventing Collateral Sharps Injury • Needle-free administration • Needle extraction (‘defanging’) • Low capacity waste destruction systems • Anti-stick devices • Waste collection infrastructure
Increasing Vaccine Accessibility • Adequate and timely delivery of supplies • Outsourced transport and logistics systems • IT for logistics management information • Freight tracking technologies • Assured availability of means of administration • ‘Bundling’ of indispensable commodities • SCUDAS • Adequate storage capacity • Some vaccine (with VVM) at ambient temp. • More frequent deliveries • High-efficiency solar refrigeration • Adequate outreach capacity • Adapted motorcycles, ATVs or boats • Ice-free cooling systems
Achieving System Efficiency • Fewer administrations • Reduced cold chain dependency • No vaccine wastage • Simplified logistics • Reduced training burden • Minimum equipment down time
R&D (5-10 years) Alternative thermo-stability technologies Auto-reconstitution Non-invasive SCUDAS Multivalent vaccines Applications Development (1-7 years) Glassification drying Injection SCUDAS Reconstitution ADs Adapted sharps disposal solutions Status of Technologies
Validation (1-3 years) High-efficiency fridge Ice-free cooling Outsourced logistics Out-of-the-cold chain protocols Multi-dose jet injectors (next generation) Roll Out (0-3 years) Monodose vials Injection SCUDAS -HBV,TT VVMs -all vaccines AD syringes for routine Outsourced transport Bundling of ADs and waste solutions Multivalent vaccines Status of Technologies (continued)