www.gavi.org

GAVI’S VACCINE INVESTMENT STRATEGY

Judith Kallenberg, Head of Policy PDVAC 22 June 2017, Geneva

Reach every child

Gavi finances vaccines and immunisation through three routes ($9 Billion in 2016-2020)

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Health Systems

and Immunisation

Strengthening

Vaccines Technical

assistance

VIS

Innovation

Gavi, the Vaccine Alliance, mission:

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“To save children’s lives and protect people’s health

by increasing equitable use of vaccines in lower

income countries”

Gavi supports 73 countries, reaching ~80 million children per year

Since 2000: 600,000,000 children immunized 8,000,000 future deaths averted

Gavi’s vaccine portfolio has diversified over time

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Uptake of

vaccines

in RI/mass

preventive

campaigns

YF

routine

Measles

2nd dose

Hib

Pentavalent

YF

campaigns

Hepatitis B

Rotavirus

PCV

YF

stockpile

Outbreak

response

Men A RI/MPC

HPV RI

Measles rubella

JE

Typhoid

Meningitis

stockpile

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016+

Learning

agenda

Cholera

Malaria

Rabies

YF

campaigns

Year of investment decision

Elimination/

eradication IPV

Measles

campaigns

JE routine

Ebola

Measles

outbreak

response

HPV

multi-age

cohort

Vaccine investments increasingly targeted at specific sets of countries

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Targeted*

Universal*

Yellow Fever

(YF) routine

Measles

2nd dose

Hib

Pentavalent

YF

campaigns

Hepatitis B Rotavirus

PCV

YF

stockpile

Meningitis

stockpile

HPV

multi-age

cohort

Measles

rubella

JE

Typhoid

Meningitis A

RI/MPC

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016+

Other*

Cholera

Malaria

Rabies

YF

campaigns

IPV

Measles

campaigns

Ebola

Year of investment decision

Measles

outbreak

response

*Universal: all Gavi countries; Targeted: focused on sub-set of GAVI countries; Other: outbreak response, learning agenda

HPV RI

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VIS is aligned with Gavi’s strategic cycle and financial ‘replenishment’

VIS #1 MenA,

JE, HPV

Rubella,

Typhoid

conjugate

VIS #2 YF mass campaigns,

Cholera stockpile,

Rabies/cholera studies,

Malaria – deferred

2011-2015 Strategic

period

2011 2015 2008 2012 2013 2016 2017 2018 2020

2016-2020 Strategic

period

VIS #3

2021

2021-2025

2014

RTS,S pilot

funding

decision

2022 2023 2024 2025 2019

A robust and evidence-based process will be conducted over the next 18 months

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Km 1: What

is burden of

disease?

Km 2:

What is the

appropriate

vaccination

strategy?

Km 3:

What is the

demand in

Gavi

countries?

Km 4:

Would it be

feasible and

what would it

cost?

Km 5:

What would

be the

impact?

Km 6:

How does it

compare to other

potential

investments and

current portfolio?

EXIT

Final

Investment

Decisions

Oct 2017: decision framework(s)

May 2018: shortlist

Oct 2018: vaccine investment decisions

VIS 2013

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WHO landscape analysis: the starting point

• Vaccines already licensed, not on GAVI list

• Vaccines that might be licensed by 2023

• Incremental changes to existing policy or vaccines

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Preliminary list to be further reviewed:

Dengue

Hepatitis A

Hepatitis E

Influenza seasonal, maternal (pandemic?)

Malaria (refresh with no decision in 2018)

Mening CYWX

Mumps/MMR

Rabies, Rabies Ig/mAb

Typhoid

RSV (& RSV mAb?)

Group B strep

OCV

Diphtheria (booster, maternal)

Diphtheria antitoxin

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Hep B birth dose

Pertussis (booster)

PCV catchup

IPV

Tetanus toxoid (booster, maternal)

Ebola (pre-emptive vaccination)

Zika

Norovirus

ETEC

HIV

TB 2nd generation

Chikungunya

CEPI vaccines?

VIS has traditionally prioritised health impact, but opportunity to broaden investment lens

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Additional lenses for health impact?

Morbidity, AMR, strengthening delivery

platforms

Looking beyond direct health impact?

“Global public good” vaccines

(e.g., epidemics; eradication)

Current VIS

Overall and

U5 mortality

Procurement

cost per

deaths

averted

Previous VIS

Should Gavi consider others investments or ‘signalling’ beyond funding broad use?

• Global stockpile

• Learning agenda

• Signalling future priorities (vaccines in 5-10 year window)

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Potentially taking a longer-term view within the VIS

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VIS: 5 year

scope

Vaccine development: 10+ years

2019 - 2023

Long-term

guidance within

the VIS?

Questions for discussion

1. How can we align Gavi and PDVAC prioritisation of pipeline

vaccines?

2. To what extent can PDVAC help guide Gavi assessment of longer

term (‘VIS+’) vaccine priorities?

3. What (non-binding) guidance from Gavi would be helpful to focus

vaccine R&D and how does that fit in with WHO/PDVAC work on

PPCs/TPPs?

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