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Vaccine Landscape

Vaccine Landscape. Implications for 202X. 2. Vaccine Landscape (1920 – 1979). Rabies (1880s). Measles (1963). DTP (1948). Vaccine Characteristics Relatively low price for most vaccines (<$1.00/treatment) Large multi-dose vial sizes (minimize cost/dose and immunization logistics impact)

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Vaccine Landscape

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  1. Vaccine Landscape Implications for 202X

  2. 2 Vaccine Landscape (1920 – 1979) Rabies (1880s) Measles (1963) DTP (1948) • Vaccine Characteristics • Relatively low price for most vaccines (<$1.00/treatment) • Large multi-dose vial sizes (minimize cost/dose and immunization logistics impact) • Typically high wastage (25 – 70%) Rubella (1969) FIRST Vx LICENSURE Smallpox (1903) OPV (1963) Yellow Fever (1948) Mumps (1967) BCG (1926) IPV (1955) MMR (1971) EPI catalyzed the strengthening of country supply logistics systems <5% of infants immunized globally each year EPI Introduced (BCG, DTP, Measles, OPV) (1974)

  3. 3 Vaccine Landscape (1980 – 1999) Rabies (1880s) Measles (1963) DTP (1948) Rubella (1969) DTP-HepB+Hib Pentavalent Vaccine (1998) Hib (1988) Smallpox (1903) FIRST Vx LICENSURE OPV (1963) Yellow Fever (1948) HepB (1981) Mumps (1967) BCG (1926) IPV (1955) MMR (1971) • Vaccine Characteristics • Hib 1st of the higher priced vaccines (>$3.00/dose) • High wastage comes at a higher cost  trend toward smaller multi-dose vials • Shift to pentavalent combination vaccine <5% of infants immunized globally each year EPI Introduced (BCG, DTP, Measles, OPV) (1974)

  4. 4 Health Systems Investments (1980-1999) BMGF established CCL training modules VVMs available Joint statement on AD syringes WHO standardized immunization schedules WHO PQ established Equipment info sheets TechNet e-Forum Building Blocks of a Highly Functional Health System* WHO GAG established TechNet established EPI introduced GPV established SAGE established PAHO Revolving Fund established UNICEF Vaccine Independence Initiative established * Everybody’s Business: Strengthening Health System's to Improve Health Outcomes, WHO’s Framework for Action, 2007

  5. 5 Investment = Impact (1980 – 2000) Source: WHO Global Atlas http://apps.who.int/globalatlas/dataQuery/default.asp

  6. 6 Vaccine Landscape (2000 – 2010) PCV 13 (2009) Gardasil (2006) Rabies (1880s) PCV 10 (2009) RotaTeq (2006) Measles (1963) DTP (1948) MenA (2009) RotaRix (2006) FIRST Vx LICENSURE DTP-HepB+Hib Pentavalent Vaccine (1998) Smallpox (1903) Rubella (1969) Cholera (2009) OPV (1963) Hib (1988) Yellow Fever (1948) HepB (1981) Cervarix (2007) Mumps (1967) BCG (1926) PCV7 (2000) IPV (1955) JE (2010) MMR (1971) • Vaccine Characteristics • Multinational suppliers targeting low income markets earlier than in past • Prices >$3.00 per dose becoming the norm • Different product profiles for vaccines targeting the same disease

  7. 7 Health Systems Investments (2000 – 2010) BMGF established CCL training modules WHO PQS devices and equip specs Joint statement on AD syringes VVMs available WHO standardized immunization schedules WHO PQ established Effective Vx Mgmt rollout Equipment info sheets FSP rollout Effective Vx Stores Mgmt rollout TechNet e-Forum cMYP rollout VMA rollout CCEM rollout Project Optimize initiated GAVI ISS GAVI HSS Building Blocks of a Highly Functional Health System* WHO GAG established TechNet established VPPAG established GPV established SAGE established UNICEF includes VVMs in tender & bundles AD syringe for each dose EPI introduced IPAC established CCL Task Force established PAHO Revolving Fund established UNICEF Vaccine Independence Initiative established GAVI Alliance established Global Health Workforce Alliance created * Everybody’s Business: Strengthening Health System's to Improve Health Outcomes, WHO’s Framework for Action, 2007 7

  8. 8 Investment = Impact (2000-2010) *2009 and 2010 forecasted data for Pol3 not available 8

  9. 9 Vaccine Landscape (2000 – 2019) Malaria (~2014-2016) Leishmaniasis (~2016-2018) HPV (2006) Rabies (1880s) Shigella (~2011-2015) Typhoid PS (2011) Measles (1963) DTP (1948) Rota (2006) Typhoid Conjugate (~2013) DTP-HepB+Hib Pentavalent Vaccine (1998) Smallpox (1903) Rubella (1969) MenA (2009) FIRST Vx LICENSURE Dengue (~2015-2016) OPV (1963) Hib (1988) Yellow Fever (1948) Cholera (2009) HepB (1981) rBCG (~2014-2018) Pneumo (2000) Mumps (1967) BCG (1926) IPV (1955) JE (2010) MMR (1971) ETEC (~2013-2016) 1920 – 1939: 1 vaccine 1940 – 1959: 3 vaccines 1960 – 1979: 4 vaccines 1980 – 1999: 3 vaccines 2000 – 2019: >13 vaccines 9

  10. 10 New Vaccine Characteristics

  11. 11 CURRENT VACCINE LANDSCAPE BCG rBCG YF Lower priced IPV OPV MCV Hexavalent DTwP-HepB-Hib-IPV Td / TT DTP-HepB Pneumo (conjugates) Pneumo (common protein) Pneumo (Killed whole cell) Hib Pneumo Rotavirus Rotavirus (116E) Rotavirus (BRV) MenA Cholera JE Typhoid conjugate HPV Typhoid Flu (Lentigen) Malaria (RTS,S) BCG Boost ETEC Leishmaniasis Shigella Hookworm Dengue

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