Gavi in 30 slides

1. About vaccines About Gavi Healthy communities Closing the immunisation gap www.gavi.org Name of presenter Place, date 1. About vaccines 2. About Gavi 3. Healthy communities 4. Closing the immunisation gap Gavi, the Vaccine Alliance

2. About vaccines About Gavi Healthy communities Closing the immunisation gap About vaccines About vaccines

3. About vaccines About Gavi Healthy communities Closing the immunisation gap The world before vaccines Flu pandemic 1918-1920 > 50-100 million deaths worldwide Smallpox epidemic INDIA 1974 15,000 deaths Yellow fever PHILADELPHIA 1793 >5,000 deaths Cholera pandemic EUROPE 1829-1851 >200,000 deaths About vaccines Polio NEW YORK 1916 6,000 deaths Examples of major disease outbreaks

4. About vaccines About Gavi Healthy communities Closing the immunisation gap What is a vaccine? Vaccines use the body’s natural defenses to safely develop immunity About vaccines weakened form of disease antibodies 2 actual disease antibodies 3 1 weakened form of disease

5. About vaccines About Gavi Healthy communities Closing the immunisation gap Smallpox 1798 Rabies 1885 Typhoid 1886 Cholera 1896 Plague 1897 Tuberculosis (Bacille Calmette-Guérin) 1927 Typhus 1938 Tetanus toxoid Pertussis 1926 Diphtheria toxoid 1923 Influenza 1936 Yellow Fever 1935 Polio (injected inactivated) (1955) Mumps, live (1967) Anthrax, secreted proteins (1970) Pneumococcus polysaccharides (1977) Hepatitis B (plasma derived) (1981) Tick-borne encephalitis (1981) Hepatitis B surface antigen recombinant (1986) Typhoid (salmonella Ty21a), Live (1989) 13 valent pneumococcal conjugates (2010) Zoster, live (2006) Rotavirus (attenuated and new reassortants (2006) Human papillomavirus recombinant quadrivalent (2006) Cold-Adapted Influenza (2003) Rotavirus reassortants (1999) Meningococcal conjugate* (group C) (1999) Acellar pertussis, various (1996) Hepatitis A, inactivated (1996) Cholera, live attenuated (1994) Typhoid (Vi) polysaccharide (1994) Japanese encephalitis, inactivated (1992) Polio (oral live) (1963) Measles, live (1963) Rubella, live (1969) Meningococcal polysaccharides (1974) Adenovirus (1980) Rabies, cell culture (1980) H. influenza type B polysaccharide (1985) H. influenzae conjugate* (1987) Varicella (1995) Cholera (recombinant Toxin B) # (1993) Cholera (WC-rBC) (1991) Lyme OspA, protein (1998) Pneumococcal conjugate, heptavalent* (2000) Japanese encephalitis (Vera-cell) (2009) Cholera (WC only) (2009) Human papillomavirus recombinant bivalent (2009) Meningococcal quadrivalent conjugates* (2005) Quadrivalent influenza vaccines (2012) Meningococcal C and Y and Haemophilus influenza type b (2012) Meningococcal B (2013) Influenza vaccine (baculovirus) (2013) Human papillomavirus, 9-valent (2014) Enterovirus (2015) Dengue (2015) Cumulativenumberofvaccines Acceleration in vaccine development Sources: timeline as of the end of 2010: Plotkin SA, Plotkin SL. The development of vaccines: how the past led to the future. Nature Reviews Microbiology, AOP, 2011, 1–5. 2011-2015: US Food and Drug Administration (FDA) About vaccines 50+ licensed vaccines1798–2015

6. About vaccines About Gavi Healthy communities Closing the immunisation gap Fully protecting children with vaccines 1. Bacillus Calmette Guerin (BCG) (1 dose) 2. Diphtheria (3 doses) 3. Tetanus (3 doses) 4. Pertussis (3 doses) 5. Hepatitis B (3–4 doses) 6. Hib (3 doses) 7. Pneumococcal (3 doses) 8. Polio (OPV and/or IPV, 3–4 doses) 9. Rotavirus (2–3 doses) 10. Measles (2 doses) 11. Rubella (1 dose) 12. HPV (2 doses) (adolescent girls) Recommended for children in all countries About vaccines

7. About vaccines About Gavi Healthy communities Closing the immunisation gap 1980 2017 Vaccines have changed our lives Note: shows reduction in the number of reported cases. Source: WHO: Global and regional immunization profile, July 2018. Available at: http://www.who.int/immunization/monitoring_surveillance/data/gs_gloprofile.pdf Tetanus Diphtheria Pertussis Measles Polio About vaccines ~90% reduction in common vaccine-preventable diseases

8. About vaccines About Gavi Healthy communities Closing the immunisation gap Vaccines protect against common types of cancer About vaccines HPV vaccine cervical cancer Pentavalent vaccine liver cancer caused by hepatitis B

9. About vaccines About Gavi Healthy communities Closing the immunisation gap No other health intervention touches so many lives Worldwide, over 30 vaccine doses are given every second 00:01 About vaccines

10. About vaccines About Gavi Healthy communities Closing the immunisation gap 10 About Gavi About Gavi

11. About vaccines About Gavi Healthy communities Closing the immunisation gap in lower-income countries by increasing equitable use of vaccines and protecting people’s health Saving children’s lives Gavi’s mission About Gavi

12. About vaccines About Gavi Healthy communities Closing the immunisation gap Vaccine Alliance partners About Gavi IMPLEMENTING COUNTRY GOVERNMENTS DONOR COUNTRY GOVERNMENTS CIVIL SOCIETY ORGANISATIONS VACCINE MANUFACTURERS PRIVATE SECTOR PARTNERS RESEARCH AGENCIES

13. About vaccines About Gavi Healthy communities Closing the immunisation gap 100%100% 72% High-income countries Low-income countries % countries with national Hib vaccine programmes Note: Only countries with universal national programmes are included. World Bank 2016 country classification has been applied to the whole time series. Source: The International Vaccine Access Center (IVAC) VIMS database. Data as of 31 December 2017. Why Gavi was launched: creating equal access to vaccines About Gavi 2017 High-income countries Low-income countries 3% 2000

14. About vaccines About Gavi Healthy communities Closing the immunisation gap How Gavi supports countries About Gavi Health system strengthening support Tailored technical support Vaccine support About vaccines Healthy communities Closing the immunisation gap

15. About vaccines About Gavi Healthy communities Closing the immunisation gap Continued support The Gavi business model: reinventing aid Country Country Country Country Country Country Pooling demand of poorest countries Strengthening vaccine delivery platforms Long-term funding Donor base Co-financing Market shaping Shaping markets Supply Demand Accelerating access to vaccines Sustaining immunisation Transition out of support About Gavi

16. About vaccines About Gavi Healthy communities Closing the immunisation gap Gavi’s resource mobilisation model: a three-pronged approach About Gavi US$ 330m US$ 696m US$ 1,505m $ US$ 32m US$ 136m 2000 2010 2017 growing donor contributions 1 increasing country co-financing 3

17. About vaccines About Gavi Healthy communities Closing the immunisation gap Accelerating access: our vaccine portfolio About Gavi Year of first introduction/ use of stockpile PNEUMO- COCCAL MULTIVALENT MENINGITIS INACTIVATED POLIO JAPANESE ENCEPHALITIS ORAL CHOLERA HPV (CERVICAL CANCER) MEASLES- RUBELLAMENINGITIS A YELLOW FEVER HEPATITIS B PENTAVALENT HIB 2001 2002 2007 2008 2010 2013 2015 20172009 20142003 2004 2005 2006 2011 2012 2016 2018 2019 Gavi 1.0 Gavi 2.0 Gavi 3.0 Gavi 4.0 >400 introductions and campaigns since 2000EBOLA TYPHOID MEASLES 2ND DOSE ROTAVIRUS

18. About vaccines About Gavi Healthy communities Closing the immunisation gap Affordable and sustainable vaccine prices Cost to immunise a child with a full course of: About Gavi Approx. USA price: US$ 1,100 ~US$ 28 HEPATITIS B PENTAVALENT HIB ROTAVIRUS PNEUMOCOCCAL INACTIVATED POLIO MEASLES RUBELLA HPV (CERVICAL CANCER) DTP

19. About vaccines About Gavi Healthy communities Closing the immunisation gap 0 20 40 60 80 100 Immunisationcoveragerate(%) 1980 1985 1990 1995 2000 2005 2010 2017 Immunisation coverage: closing the gap About Gavi . Note: Includes DTP-containing vaccines, such as pentavalent vaccine. Source: WHO/UNICEF Estimates of National Immunization Coverage, 2018 Expanded Programme on Immunization takes off Stagnating immunisation coverage Gavi support to world’s poorest countries High-income countries Global average 96% 85% 80% Launch of Gavi Post-Gavi increase 2000-2017 21% points Lowest-income countries Gavi-supported countries

20. About vaccines About Gavi Healthy communities Closing the immunisation gap Improving health systems: key ingredients About Gavi Integrated service delivery Health service workforce Health information systems Demand promotion & community engagement Management & coordination Vaccine supply chain

21. About vaccines About Gavi Healthy communities Closing the immunisation gap Gavi catalyses new partnerships and innovation About Gavi Immunisation cold chainVaccine innovation Data and technology

22. About vaccines About Gavi Healthy communities Closing the immunisation gap 22 Healthy communities, healthy economies Healthy communities

23. About vaccines About Gavi Healthy communities Closing the immunisation gap Vaccines: saving lives and boosting economies Healthy communities Reduced sickness Improved learning Reduced burden on families Healthcare savings Increased productivity Increased economic & political stability

24. About vaccines About Gavi Healthy communities Closing the immunisation gap Healthy communities, healthy economies: Gavi’s impact Gavi-supported countries, 2000–2018 Healthy communities 700 million children immunised keep people healthy >10 million future deaths averted vaccines save lives >150 billion US$ economic benefits generated stronger economies ~20 countries set to transition out of Gavi support by 2020 sustainable future

25. About vaccines About Gavi Healthy communities Closing the immunisation gap Pre-school education Community health workers Calculating immunisation’s return on investment Public infrastructure Immunisation 3x 7x 9x 18x (cost of illness) 48x (full income approach) The Economic Benefits of Public Infrastructure Spending in Canada. The Centre for Spatial Economics, September 2015 The rate of return to the HighScope Perry Preschool Program. Department of Economics, University of Chicago, April 2009 Strengthening primary health care through community health workers… Dessalegn H, Chambers R, Clinton C, Phumaphi J, Sirleaf J, Evans T, et al. 2015 Return on investment from childhood immunizations in low- and middle-income countries, 2011-20. Health Affairs. 35(2):199-207. Ozawa S, Clark S, Portnoy A, Grewal S, Brenzel L, Walker D. 2016 Healthy communities In Gavi-supported countries, 2011–2020

26. About vaccines About Gavi Healthy communities Closing the immunisation gap 26 Closing the immunisation gap Closing the immunisation gap

27. About vaccines About Gavi Healthy communities Closing the immunisation gap The immunisation gap 19.9 million are not fully protected with basic vaccines ~140 million children born every year ~80% are in Gavi-supported countries Nigeria India Pakistan Indonesia Other Gavi Rest of world Number of children globally not receiving the third dose of DTP-containing vaccine in 2017. Sources: WHO/UNICEF Estimates of National Immunization Coverage and UNPD, 2018 Closing the immunisation gap 1 in 5 children in Gavi-supported countries do not get a full course of basic vaccines

28. About vaccines About Gavi Healthy communities Closing the immunisation gap Increase domestic resources for immunisation Improve data quality Optimise supply chains Strengthen country leadership Shape markets Accelerate vaccines Gavi’s strategy for closing the gap Closing the immunisation gap STRATEGIC GOALS FOCUS AREAS: EXAMPLES Strengthen immunisation delivery Improve sustainability Focus on vaccine coverage and overcoming inequity to reach every child

29. About vaccines About Gavi Healthy communities Closing the immunisation gap 2000–2020: ever accelerating impact Future deaths prevented Closing the immunisation gap 1 million +4 million +3 million +5-6 million 13-14 million 90 million +280 million +200 million +300 million ~900 million Children immunised 2001- 2005 2006- 2010 2011- 2015 2016- 2020 Gavi’s strategic periods 2001- 2005 2006- 2010 2011- 2015 2016- 2020 Sources: Gavi strategic demand forecasts 9 and 10, Investing together for a healthy future: the 2016–2020 investment opportunity

30. About vaccines About Gavi Healthy communities Closing the immunisation gap www.gavi.org Thank you

Gavi in 30 slides

Gavi in 30 slides

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