TT
TT Procured by UNICEF 2001 - 08
250,000,000
200,000,000
150,000,000
100,000,000
50,000,000
0
2001
2002
2003
2004
Routine
2005
SIA
2006
2007
2008
TT historical demand and forecast overview
Upcoming
Tender Period
Trends in TT vaccine offered to UNICEF
TT vaccine offered to UNICEF 1992-2009
250
Millions of doses
200
150
100
50
0
1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
•Good supplier base but still high dependency on one source
•One new supplier obtained WHO prequalification in end 2007, enhancing
supply availability and vaccine security
Summary
•Elimination by 2012
•MNT Investment Case (2007-2009) has given campaigns and
routine program a boost.
•Funds through IFFIM IC for vaccines are fully utilized
•Active fund raising for SIAs beyond 2009
•Routine demand for most part is funded through country financial
resources
TT Tender quantities 2010-12
TT
Routine
SIA
Total
Upcoming Tender Period
2009
2010
2011
2012
106,500,000 130,000,000 135,000,000 140,000,000
60,000,000 30,000,000 30,000,000 30,000,000
166,500,000 160,000,000 165,000,000 170,000,000
MEASLES
Measles procured by UNICEF 2001-2008
250,000,000
Number of Doses
200,000,000
150,000,000
100,000,000
50,000,000
0
2001
2002
2003
2004
Routine
2005
2006
Supplementary
2007
2008
Measles – Procurement Overview & Future demand
Upcoming
Tender Period
• Historically demand has been mainly driven by campaigns
• Large catch up campaigns in 2006-07 and some in 2008
• 2009-2010 Quantities do not include potential demand for India SIA
Trends in Measles vaccines offered to UNICEFavailability
Measles vaccine offered to UNICEF 1992-2009
300
Millions of doses
250
200
150
100
50
0
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Drastic reduction in the number of suppliers offering WHO pre-qualified vaccine to
UNICEF over the past 10 years
High dependency on one manufacturer
Measles containing vaccines are classified as high priority for WHO PQ
Mixed results in terms of affordability
Weighted Average Prices for Vaccines
BCG –stable demand, 4 suppliers, stable pricing
DTP, declining demand, 2 suppliers per presentation, increasing prices
TT – growing demand, 4 suppliers, adjusted prices, now stable
Measles – growing demand, 3 suppliers, increasing prices
Summary…
Global Measles mortality reduction by 74% need to Sustain
achievement
Expect stabilized demand with;
•
•
Increased routine, including 2 dose as per SAGE recommendation,
will add to routine demand.
Sustained follow-up campaigns, intervals based on 1st dose
coverage, but average every 3 years
* Both posing future funding challenges for countries
Measles campaign is often use as the main vehicle for integrated
campaigns
Continued monovalent measles vaccine supply needed in the
future
Measles Tender quantities 2010-12
Measles
Routine
SIA
Total
Upcoming Tender Period
2009
2010
2011
2012
75,500,000 70,000,000 75,000,000 75,000,000
79,800,000 95,000,000 70,000,000 50,000,000
155,300,000 165,000,000 145,000,000 125,000,000
MMR
MMR Historical demand and forecast overview
Upcoming
Tender Period
7,000,000
6,000,000
5,000,000
4,000,000
3,000,000
2,000,000
1,000,000
0
2003
2004
Original Quantity on LTA
Quantity Procured
Current Tender Quantity
2005
2006
2007
2008
2009
2010
2011
2012
Forecast to Suppliers at beginning of Year
Current Forecasted Quantity
•The main increase in 2009-12 demand is for 1 one country, introducing
MMR in their routine program as of 2009, therefore demand picture can
change substantially
•Increased quantity only partially due to MR campaigns in 2007
Summary
• Very limited availability / long lead-time for unplanned demand
•Countries are strain aware / sensitive
-There is strong strain preference from countries
-At times the preference been influenced / diverted based on price and
availability
• Large price differences between different products
• Limited sustainable external funding available – countries need
to include in their own budget
The projection / scenario for MR will not impact the MMR demand
MMR Tender quantities 2010-12
MMR
MMR 10
MMR 1
Total
Upcoming Tender Period
2009
4,855,000
795,000
5,650,000
2010
4,800,000
1,000,000
5,800,000
2011
4,900,000
1,000,000
5,900,000
2012
5,200,000
1,000,000
6,200,000
MR
MR – Procurement Overview - Future
30,000,000
Upcoming
Tender Period
25,000,000
20,000,000
15,000,000
10,000,000
5,000,000
0
2003
2004
2005
Original Quantity on LTA
Quantity Procured
Current Tender Quantity
2006
2007
2008
2009
2010
2011
2012
Forecast to Suppliers at beginning of Year
Current Forecasted Quantity
•Currently 2 WHO pre-qualified suppliers, high dependency on one
•Substantial portion of the demand in 2009 is for one country
campaign
MR Tender quantities 2010-12
MR
Routine
SIA
Total
Upcoming Tender Period
2009
1,351,623
4,500,000
5,851,623
2010
1,700,000
0
1,700,000
2011
1,700,000
2,000,000
3,700,000
2012
1,700,000
1,000,000
2,700,000
Future of MR vaccine?
June, 2008: Rubella as part of GAVI investment
strategy introduced to GAVI the Board (for
endorsement, not financial decision)
• Rubella: cause of congenital rubella syndrome (CRS) when
infected in early pregnancy
• It is estimated that there are 110,000 cases of CRS
each year and poses high disease burden on poorest
countries
Future of MR vaccine?
• October, 2008: Rubella part of the portfolio for GAVI
to consider for future investments (HPV, JE, Rubella,
Typhoid) at the October 08 Board
• Mindful of the current financial environment, the
Board deferred any financial commitment related to
the vaccine investment strategy for further review
MR VACCINE DEMAND GIVEN INTEGRATED ADOPTION
Rapid Impact
FORECAST
Vaccine Demand including Wastage
600
Doses (M)
500
400
300
200
100
0
2009
2010
Routine Vaccination
2011
2012
Catch-up Campaign
2013
2014
2015
Periodic Campaign
2016
2017
Boost Vaccination
2018
Buffer Stock
2019
2020
Stock Pile
Vaccine Demand including Wastage
Routine Vaccination
Catch-up Campaign
Periodic Campaign
Boost Vaccination
Buffer Stock
Stock Pile
Total
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
0
0
0
0
0
0
0
25
406
119
0
6
0
556
31
88
26
0
1
0
147
32
4
1
0
0
0
37
40
106
22
23
2
0
193
41
14
2
28
0
0
86
46
50
10
29
1
0
135
50
53
9
36
1
0
149
55
53
10
37
1
0
155
56
15
3
41
0
0
116
57
0
0
45
0
0
102
58
9
2
49
0
0
119
* Source: Applied Strategy – Oct 27, 2008
http://www.gavialliance.org/vision/strategy/vaccine_investment/index.php
MR INTEGRATED ADOPTION FORECAST
Vaccine Need: 72
VISP Scope: 46*
Rubella
# of Countries Adopting Vaccine
25
20
Bangladesh
Bhutan
Cambodia
Haiti
India
Mongolia
Nepal
Solomon Is
Tajikistan
Viet Nam
15
10
Indonesia
Korea, DPR
Myanmar
Yemen
5
Lesotho
Mali
Mozambique
Benin
PNG
Burkina Faso
Tanzania
Kenya
Timor-Leste
Niger
Zimbabwe
Senegal
Cameroon
Togo
Congo, DR
Côte d'Ivoire
Gambia
Eritrea
Ghana
Pakistan
Rwanda
São Tomé
and Principe
Uganda
Congo, Rep.
Guinea
Sierra Leone
Afghanistan
Comoros
Malawi
Zambia
Burundi
Djibouti
0
2009
2010
2011
* Source: Applied Strategy – Oct 27, 2008
2012
2013
2014
2015
2016
2017
2018
2019
2020
* 14 GAVI countries have already adopted rubella; 12 are not expected to
be eligible based on projected MCV coverage rates < 80% through 2020
A Possible scenario for MR introduction
through catch up campaigns…: 2013 - 18
70,000,000
60,000,000
50,000,000
mil ds
40,000,000
30,000,000
20,000,000
10,000,000
0
2013
2014
2015
2016
2017
Assumptions:
•
Delay the introduction by 3 years compared to rapid impact plan
•
Total 300 mil ds for 2013 - 2018
•
Distribute quantities throughout 5-6 years
2018
Total tender quantities of Measles
containing vaccines 2010 – 12
Measles
Total
2012
2011
2010
165,000,000 145,000,000 125,000,000
MR
Total
2010
1,700,000
2011
3,700,000
2012
2,700,000
2010
5,800,000
2011
5,900,000
2012
6,200,000
MMR
Total
UNICEF VACCINES
Thank You