Vaccine Industry Consultation

Humanitarian Mechanism for Access to Affordable Vaccines

Tania Cernuschi, IVB, WHO

www.who.int

September 2019

Establishment of Humanitarian Mechanism

2

Launched by WHO, UNICEF, MSF, Save the Children on 1 May 2017Following June 2016 meeting co-organised by MSF and WHO to address key barrier of obtaining affordable vaccines in humanitarian emergencies in timely manner

Main aim: Facilitate timely access to affordable supply for entities such CSOs, Governments or UN Agencies who procure on behalf of populations facing humanitarian emergencies

Current offers are for PCV vaccine from GSK and Pfizer at approximately US$ 3 per dose

3

Principles

• Ensure timely and affordable access to vaccine supply for humanitarian emergencies

• Align with WHO’s guidance: ‘Vaccination in acute humanitarian emergencies: A

framework for decision making’

• Enhance granting of lowest price to procuring entity while avoiding interference with commercial strategy of companies

• Enable any entity with procurement capacity to purchase vaccines directly from the manufacturer for speed and efficiency

• Promote information and transparency of manufacturers’ price offers for humanitarian emergencies and predictability of process

4

Key Features of the Humanitarian Mechanism

• Promotion of manufacturer supply commitments; price offers made publicly are recorded and published, including their terms and conditions as indicated by suppliers

• Management & coordination of requests: no duplication; rapid notification to all parties

• Request for access to supply is submitted to Verification Body at WHO: coordinated through WHE; collaboration between WHE and IVB

• Procurement: directly with manufacturer or through UNICEF SD• Annual monitoring of supply offers’ use; review modus operandi as required

5

Overview of Requests

• 32 request for a total of 856,000 doses

• Eight countries/emergency situations supplied

• 68% of doses going to non-GAVI, non-PAHO middle income (Algeria, Greece, Lebanon, Syria)

• Total population targeted: 740,000

Greece 2 requestsTotal target pop: 14,400

Syria - 8 requestsTotal target pop: 256,522

Algeria -1 request Total target pop: 5,680

CAR - 6 requestsTotal target pop: 153,141

Lebanon – 4 requestsTotal target pop: 103,872

Niger 3 requestsTotal target pop: 19,500 NIgeria 2 requests

Total target pop: 82,800

South Sudan - 4requestsTotal target pop: 48,140

6

Performance February 2017 to July 2019

1 11

3

6

114

11

2 1

CRA (via UNICEF)

IOM (via UNICEF)

MSF

MSF-Belgium

MSF-France

MSF-Greece

MSF-Spain

MSF-Switzerland

MSF-UNRWA

UNICEF

UNRWA (via UNICEF)

Figure. Requesting entities (n=32) Analysis of 32 requests• 14 in 2017, 8 in 2018, 10 in 2019 (so far)• Large majority of requests are submitted

by MSF (over 80%)

Equal split between PCV10 and PCV13• 16 requests for PCV 10 (GSK)• 16 requests for PCV13 (Pfizer)

Timeliness• Median time to from request to approval: 2

days• 1 delay over Christmas (25 days)

7

Analysis of 2017 and 2018 Reports

Implementation (14 reports available from MSF)

• 5 countries• Non-vaccination mainly due to security or

logistic issues (cold chain failure)• Some un-used doses still in MSF stock

available for use

0

20000

40000

60000

80000

100000

120000

140000

160000

180000

200000

CentralAfrican

Republic

Niger Nigeria NorthernSyria

South Sudan Syria

Doses used Doses procured

Figure. Doses procured and used per country (14 reports)

2017 2018 TOTALDoses Requested 296,002 38,400 334,402

Doses used 176,115 20,956 197 071

8

Does the mechanism meet its aim? • Demonstrated success in rapid and predictable access to PCV in

humanitarian emergencies and direct procurement for CSOs• Granted transparent and low price to countries and populations beyond

Gavi, while avoiding interference with commercial strategy of companies• Management & coordination of requests: rapid notification / approval • Collected important information on demand for vaccines in emergency and

related challengesBUT

• Need to further promote use beyond MSF & UNICEF• Need to further promote supply offers beyond PCV• How can we provide access also to Governments?

Lessons Learnt to Date

9

Supply - expand the vaccines available• The current priority vaccines are Typhoid and Rotavirus vaccines• Focus is on prequalified vaccines• Information letter going out to specific manufacturers of prequalified

vaccines and to DCVMN and IFPMA

Demand: • Strengthen demand quantification for PCV, Rotavirus and Typhoid

vaccines through implementation partners• Increase range of CSOs requesting vaccines from the mechanism –

information letter going out to humanitarian/emergency organisations

Way Forward

Thank you

WHO

20, Avenue Appia1211 Geneva

Switzerland