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Expanded Programme on Immunization
Global Progress
Expanded Programme on Immunization
Global Progress
Vaccine Industry ConsultationUnicef, Copenhagen26-27 October 2015
Vaccine Industry ConsultationUnicef, Copenhagen26-27 October 2015
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of the Decade of mission "The
Vaccines is to extend, by 2020 and
beyond, the full benefits of
immunization to all people,
regardless of where they are born,
who they are, or where they live."
a world in which all vision“We en
individuals and communities enjoy lives
free from vaccine-preventable diseases".
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Goals of the Global Vaccine Action PlanGoals of the Global Vaccine Action Plan
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Development of Regional Action PlansDevelopment of Regional Action Plans
� EUR: European Vaccine Action Plan
– adopted October 2014
� WPR: Regional Framework for Implementation
– adopted October 2014
� AFR: Regional Strategic Plan for Immunization
– adopted November 2014
� AMR: Plan de Acción sobre Inmunización
– adopted September 2015
� EMR: Eastern Mediterranean Vaccine Action Plan
– adopted October 2015
� African Ministerial Meeting (AFR + EMR)
– planned for Feb 2016
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Global Immunization 1980-2014, DTP3 coverageglobal coverage at 86% in 2014
Source: WHO/UNICEF coverage estimates 2014 revision. July 2015Immunization Vaccines and Biologicals, (IVB), World Health Organization.194 WHO Member States. Date of slide: 21 July 2015.
SAGE : Progress is off-track !
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DTP3 COVERAGE: IMPROVEMENT IN NUMBER OF UNVACCINATED CHILDREN
DTP3 COVERAGE: IMPROVEMENT IN NUMBER OF UNVACCINATED CHILDREN
� Number of unimmunized children now ~18 m (~22m in 2013):
– Revision of coverage estimates for India
• reflects increase in coverage since 2009, based on latest coverage estimates
– Increasing coverage in other large countries like Nigeria and Ethiopia
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100
200
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400
1985
1986
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2011
2012
2013
2014
Po
lio c
ases
(th
ou
san
ds)
125 Polio Endemic
countries
Wild Poliovirus Eradication (1988-2015)
19882014
Last Polio Case
in Nigeria
3 Polio Endemic
countries
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2015
Last type 2 polio
in the world
Last Polio Case in
India
2 Polio Endemic
countries
WPV 2 Eradicated
3 Years without WPV3
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All countries have committed to introduce IPVAll countries have committed to introduce IPV
Data source: WHO/IVB Database, as of 19 October 2015Map production Immunization Vaccines and Biologicals (IVB),
World Health Organization
Date of slide: 19 October 2015
The boundaries and names shown and the designations used on this map do not imply
the expression of any opinion whatsoever on the part of the World Health Organization
concerning the legal status of any country, territory, city or area or of its authorities, or
concerning the delimitation of its frontiers or boundaries. Dotted lines on maps
represent approximate border lines for which there may not yet be full agreement.
©WHO 2015. All rights reserved.
Introduced to date (114 countries or 58.8%)
Formal commitment to introduce in 2015 (45 countries or 23.2%)
Formal commitment to introduce in 2016 / Introduction delayed to 2016 due to global IPV vaccine shortage
(35 countries or 18%)
Not applicable
Since January 2013, the following countries have introduced IPV: Kazakhstan & Peru (July 2013); Micronesia (August 2013); Libya (April 2014); Albania & Panama (May 2014); Nepal & Tunisia (September 2014); Philippines (October 2014); China (December 2014); Comoros, Senegal & Serbia (January 2015); Colombia & Nigeria (February 2015); Bangladesh & Maldives (March 2015); DR Congo, DPR Korea & The Gambia (April 2015); Madagascar (May 2015); Cote d'Ivoire, Kiribati, St Vincent and the Grenadines & Sudan (June 2015); Bhutan, Cameroon, Niger, Pakistan & Sri Lanka (July 2015); Benin, Chad, Papua New Guinea, The Former Yug. Rep. of Macedonia (August 2015); Afghanistan, CAR, Dominica, Guyana, Iran, Jamaica, Seychelles & Solomon Islands (September 2015); Bahamas, Lao People's Dem. Republic & Samoa (October 2015)
46/126 countries have introduced since 1 January 201345 more countries will introduce in 2015
35 Countries will introduce in 2016
Switch from tOPV to bOPV in 155 countries
17 April – 1 May 2016
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Reduction in estimated measles deaths, 1985 - 2011
Reduction in estimated measles deaths, 1985 - 2011
0
200
400
600
800
1,000
1,200
1,400
1000s
Source: WER 2013; 88(3):29-36
86% drop from 1985-2011
71% drop from 2000-2011
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0.1
1.0
10.0
100.0
1,000.0
Me
asl
es
inci
de
nce
pe
r m
illi
on
po
pu
lati
on
(lo
g s
cale
)
GOAL
GLOBAL
needed
AFR
EMR
EUR
SEAR
WPR
AMR
2015 Goal
Projected 10-yr
trend
Trend to
reach goal
Progress towards measles eliminationProgress towards measles elimination
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MATERNAL AND NEONATAL TETANUS: 24 COUNTRIES YET TO ACHIEVE ELIMINATION IN 2014
MATERNAL AND NEONATAL TETANUS: 24 COUNTRIES YET TO ACHIEVE ELIMINATION IN 2014
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0 2,100 4,2001,050 Kilometers
PCV3 vaccine coverage, 2014PCV3 vaccine coverage, 2014
Source: WHO/UNICEF coverage estimates 2015 revision. Map production: Immunization Vaccines and Biologicals, (IVB). World Health OrganizationDate of slide: 16 July 2015
The boundaries and names shown and the designations used on this map do not imply the expression of any
opinion whatsoever on the part of the World Health Organization concerning the legal status of any country,
territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines
on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2015. All
rights reserved
<50% (11 countries or 6%)
50-79% (22 countries or 11%)
80-89% (20 countries or 10%)
>=90% (49 countries or 25%)
Not available / not in national immunization schedule (77 countries or 40%)
Not applicable
PCV in schedule but no coverage data available (15 countries or 8%)
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0 2,100 4,2001,050 Kilometers
Rotavirus Vaccine Coverage, 2014Rotavirus Vaccine Coverage, 2014
Source: WHO/UNICEF coverage estimates 2015 revision. Map production: Immunization Vaccines and Biologicals, (IVB). World Health OrganizationDate of slide: 16 July 2015
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on
the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or
concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there
may not yet be full agreement. © WHO 2015. All rights reserved
<50% (15 countries or 8%)
50-79% (15 countries or 8%)
80-89% (15 countries or 8%)
>=90% (20 countries or 10%)
Not applicable
Rotavirus vaccine in schedule but no coverage data available (9 countries or 5%)
Not available / not in national immunization schedule (120 countries or 62%)
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Addressing five priority problems will help bring the Global Vaccine Action Plan back on track
MOVING FORWARDMOVING FORWARD
Nationalteam
Strategiesto reach
Planningcycle
Fundingflow
Vaccinatorcapacity
Adequatesupply
Monitoringsystems
Beyond infancyvaccination
Nationalteam
Communityinvolvement
GlobalRoutine ImmunizationStrategies &Practices:
Nine GRISPTransformativeInvestments
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Integrated Approaches to Disease ControlIntegrated Approaches to Disease Control
New vaccines target important, but not all, pathogens of major causes of morbidity and mortality
Non-vaccine interventions need to be scaled up
Synergies will maximize benefits
Use immunization contacts to deliver a package of interventions,
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40 countries have shared their vaccine price information with V3P40 countries have shared their vaccine price information with V3P
* Data collection ending 30th June 2015
Great progress done in 2015*…
Great momentum and an opportunity to move forward
� WHA resolution 68.6 (GVAP): all countries encouraged to share vaccine price data with WHO
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Research and DevelopmentResearch and Development
• Improve programme efficiencies
• Epidemiological and operational research
• Health information technologies
Short-term
• Support development, licensing and uptake of vaccines
• Improved vaccine thermostability
• Simplified vaccine delivery and product packaging
• Regulatory science
Medium-term
• Enable the development of new vaccines
• Immunological research on adaptive and innate systems
• Research into pathogens and their evolution
Long-term
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TPPs on emerging pathogensTPPs on emerging pathogens
� TPP provide guidance on WHO’s critical and preferred profiles for vaccine product
� TPPs are a higher risk product for WHO to develop, but more useful for developers: provide critical parameters
� TPPs when WHO wishes to provide more concrete guidance and products are more advanced
� PPCs when mandate/information for critical parameters are not yet available
� TPPs could be developed later for diseases where WHO starts with PPCs
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Target Product Profile - TPPTarget Product Profile - TPP
� First TPP being developed is the Ebola Vaccine
– Target audience is those working to improve characteristics of currently tested Ebola Vaccines, or products under development.
– This document will be finalised and published Q4 2015 http://www.who.int/immunization/research/committees/ebola_vaccine
_tpp/en/
� Others to follow: MERS ?
� Wherever possible public consultation will be part of process
� In next emergency, faster TPP process will be used
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