Pneumococcal vaccine support

A child receives an injection of pneumococcal vaccine at an event marking the vaccine's introduction into Central African Republic's national immunisation programme (30 June 2011). Source: Elouma/GAVI/2011.

Rollout across three continents

The rollout of pneumococcal vaccines in the developing world is underway across three continents:  Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, The Gambia, Guyana, Honduras, Kenya, Mali, Malawi, Nicaragua, Rwanda, Sierra Leone, Yemen, Burundi and Ethiopia are among the first GAVI-eligible countries to start rolling out pneumococcal vaccines since 2010.

The new pneumococcal vaccines are highly complex and sophisticated vaccines that in the past might otherwise have taken several years to reach low-income countries. Thanks to the work of GAVI, its donors and partners, the world's poorest children can be protected today.

90 million children immunised by 2015

Following the May 2011 round, almost 70% of GAVI countries have sought support for PCV introduction. A total of 37 GAVI-eligible countries have been approved for GAVI support to introduce pneumococcal conjugate vaccine into their national immunisation programmes.

With an additional 18 countries approved as of September 2011, pneumococcal vaccines will soon be administered in more than half of GAVI eligible countries. This is an unprecedented rapid ramp up.

To date, 16 countries in the developing world have begun the introduction of pneumococcal vaccines. By rapidly scaling up the number of countries and the number of children receiving the vaccines, GAVI and its partners can immunise 90 million children with pneumococcal vaccines by 2015.

Advance Market Commitment

The introduction of these vaccines is largely thanks to the generosity of Italy, the United Kingdom, Canada, the Russian Federation, Norway, and the Bill & Melinda Gates Foundation who together contributed US$ 1.5 billion through an innovative financing mechanism, called the Advance Market Commitment (AMC) for pneumococcal vaccines.

The aim of the AMC is to stimulate the development and manufacture of new vaccines for developing countries.

Two manufacturers have thus far committed to supply 600 million doses over the next 10 years.  It is expected that additional manufacturers will have new pneumococcal vaccines ready to participate in the AMC.

Map of countries approved for GAVI's pneumococcal vaccine support

More on this topic

From the GAVI site

About the pneumococcal AMC

 

From other sites

• PneumoACTION

• WHO | Immunization surveillance, assessment and monitoring

• WHO | Immunization, Vaccine and Biologicals | Vaccine Position Papers

• WHO | Initiative for Vaccine Research | Acute Respiratory Infection

• WHO | New and Under-utilized Vaccines Implementation | Streptococcus pneumoniae

• WHO | Vaccine Safety | Pneumococcal conjugate vaccines

Causes of under-5 child deaths in low-income countries.
Source: WHO, World Health Statistics 2011

World's biggest child killer

Streptococcus pneumoniae, commonly known as pneumococcal disease, is the leading cause of pneumonia – the world’s number one killer of under fives.

WHO estimates that more than 500,000 young children die each year from pneumococcal infection, with the vast majority of these deaths occuring in developing countries.

In addition to pneumonia, pneumococcal disease is also responsible for meningitis, which can leave survivors with permanent disabilities, including mental retardation and seizures.

The bacterium also causes sepsis (blood poisoning) and otitis media (infection of the middle ear), which can lead to permanent deafness.

Safe, affordable vaccines

The most effective way to prevent these deaths is to ensure that all children have access to safe, affordable vaccines. This was recognised in the 2007 WHO recommendation that pneumococcal vaccines be introduced into all national immunisation programmes, particularly in countries with high child mortality.

Yet while a vaccine against pneumococcal disease has been widely used in Europe and the United States since 2000, it was not optimal for developing countries. This is because it lacks serotypes or different strains of pneumococcal bacteria, known to be common in developing countries.

Map showing global burden of pneumococcal disease

Economic burden

The disability associated with pneumococcal disease in childhood reduces a child's future economic potential; caring for children left disabled by the disease is an additional burden on families. Health systems in developing countries are severely overstretched by the numbers of patients suffering from pneumococcal disease and pneumonia.

More on this topic

From the GAVI site

About the pneumococcal AMC

 

From other sites

• PneumoACTION

• WHO | Immunization surveillance, assessment and monitoring

• WHO | Immunization, Vaccine and Biologicals | Vaccine Position Papers

• WHO | Initiative for Vaccine Research | Acute Respiratory Infection

• WHO | New and Under-utilized Vaccines Implementation | Streptococcus pneumoniae

• WHO | Vaccine Safety | Pneumococcal conjugate

Pneumococcal AMC

To accelerate the development and production of a new generation of  pneumococcal  vaccines, more targeted at the needs of developing countries and more affordable, GAVI, the World Bank and donors launched the pneumococcal Advance Market Commitment (AMC) in 2009.

Thanks to contracts between GAVI and two manufacturers signed in March 2010, the Alliance and developing countries will pay a maximum US$3.50 per dose of pneumococcal vaccines procured in the coming years - more than 90% less than the cost of the same vaccines currently being sold in the European Union and United States.¹

GAVI expects additional manufacturers from emerging markets to submit new pneumococcal vaccines for for participation in the AMC in the near future.

The AMC was designed to give manufacturers an incentive to invest in:

• finalising pneumococcal vaccines which include the additional serotypes required to combat the most common and fatal strains of the disease in low-income countries;
• increasing manufacturing capacity to provide the appropriate pneumococcal vaccines in sufficient quantities to meet demand.

At the same time, developing country governments can budget and plan for their immunisation programmes, knowing that vaccines will be available in sufficient quantity and at a price they can afford in the long-term.

PneumoADIP and AVI

Parallel to the AMC and to help developing countries lay the groundwork for introducing pneumococcal vaccines as soon as they become available, GAVI set-up the Accelerated Development and Introduction Plan for pneumococcal vaccine (PneumoADIP) in 2003. 

Based at the John Hopkins Bloomberg School of Public Health at Baltimore in the United States, the PneumoADIP has worked to increase the understanding in low-income countries about the severity of pneumococcal disease and the need for immunisation.

Since 2009, the PneumoADIP's work has transitioned to the Accelerated Vaccine Introduction (AVI) initiative, which continues to advocate for accelerated uptake of new vaccines - including pneumococcal vaccination - in developing countries.

Routine immunisation support

In the same year, following an investment case developed by the PneumoADIP, GAVI decided to offer financial support for the introduction of pneumococcal vaccines through its new and underused vaccine programme.

From 2010-2015, GAVI has endorsed up to US$ 1.3 billion to fund pneumococcal vaccines that are suitable for low-income countries through the AMC.

To be AMC eligible, vaccines must meet specific criteria developed by WHO and be approved by the Independent Assessment Committee (IAC) of the AMC.

 ¹ For approximately 20% of doses, companies will receive an additional payment of US$3.50 for each dose they provide; donor commitents will cover the extra cost.

More on this topic

From the GAVI site

Pneumococcal vaccine support

 

From other sites

• PneumoACTION

• WHO | Immunization surveillance, assessment and monitoring

• WHO | Immunization, Vaccine and Biologicals | Vaccine Position Papers

• WHO | Initiative for Vaccine Research | Acute Respiratory Infection

• WHO | New and Under-utilized Vaccines Implementation | Streptococcus pneumoniae

• WHO | Vaccine Safety | Pneumococcal conjugate vaccines