Authors: Grace Chee, Miloud Kaddar, and Elizabeth Ohadi
The Learning Network for Countries in Transition (LNCT) and UNICEF’s Vaccine Procurement Practitioners Network (VPPN), in collaboration with the National Institute of Vaccines (NVI) Thailand, co-hosted its second regional procurement workshop in Yangon, Myanmar on September 12-13. Delegations from Indonesia, Lao PDR, Mongolia, Myanmar, Papua New Guinea, Philippines, Thailand, Timor Leste, and Vietnam gathered for a day and a half of focused exchanged prior to the 2019 Asian Vaccine Conference (ASVAC). Aligning with ASVAC, the theme for the workshop was the sustainable introduction of new vaccines to national immunization programs and vaccine security, to ensure the sustained, uninterrupted supply of affordable vaccines of assured quality. Country participants and facilitators from UNICEF, Gavi, WHO, PATH and CHAI engaged in discussions on vaccine decision-making, procurement options, market intelligence, registration and regulation, culminating in the development of country action plans to strengthen their procurement and regulatory processes.
We are grateful to the country participants and facilitators for their active engagement and thoughtful insights. Among their experiences and expertise shared during the workshop, a few key takeaways emerged, including:
- Countries must be strategic throughout the procurement process to ensure sustained access to high-quality, affordable vaccines. This includes accurate forecasting of vaccine needs, informed understanding of market dynamics, appropriate market authorization procedures and contractual arrangements, strategic selection of procurement mechanisms and solicitation of suppliers, and data-driven price benchmarking.
- Inadequate and unpredictable financial flows are a significant risk to immunization programs’ ability to ensure that a sufficient supply of vaccines is available to meet population needs.
- The quality of vaccines must never be compromised. Countries in the region can rely on WHO prequalification, UNICEF procurement services, and countries with mature NRAs to assure quality, while strengthening local NRAs to fulfill the required functions .
- Increased collaboration at the regional level in the areas of regional stockpiling, pooled procurement, regulation and improved information sharing would expand access to affordable vaccines and enhance vaccine security in the region.
Here are just a few highlights about what these countries are doing that other LNCT members might like to learn about:
- Indonesia uses e-procurement to improve accountability, transparency, and timeliness in the procurement process.
- Lao PDR has begun implementing ViVa and other electronic tools (such as M-supply) to manage vaccine forecasting and procurement through UNICEF or other vaccine suppliers.
- Mongolia has a fast-track registration process that takes only one month and has also successfully managed to build the political will to mobilize the resources to replace Gavi support once it transitioned to fully self-financing status.
- Philippines utilizes multiple sources of market intelligence to inform procurement. They use V3P (Vaccine Product, Price, and Procurement web platform), UNICEF Market Notes, and local market analysis. They also use the ViVa dashboard for stock analysis and consult with the local offices of WHO and UNICEF.
- Timor-Leste is interested in developing vaccine procurement capacities to enable SAMES (the public procurement entity importing and managing health products at central level) to have a more active role in vaccine procurement in the near future.
- Thailand has a strong NRA at maturity level 3. While it is a self-producing country, when it does need to source vaccines from outside of the country, its NRA uses a “Good Reliance Practice”, by borrowing from mature regulatory authorities (e.g., from US, Japan, Canada) as well as the WHO guidelines and standards to guide its regulatory decisions. This reliance reduces the duplication of work and speeds market authorization.
- Vietnam is developing a long-term procurement plan (5 years) including locally produced and imported vaccines. Vietnam is also interested in technology transfer to produce quality vaccines and to obtain WHO prequalification in the future.
As we saw at the procurement workshop in Tbilisi, Georgia, these small regional workshops are a fantastic opportunity for countries to explore possible solutions to their specific challenges with countries that are operating in similar contexts. We encourage participants to continue dialogue with partners in-country and with regional colleagues through the LNCT forum to address challenges and implement their procurement action plans. All of the presentation materials (including photos) are available on the LNCT and VPPN websites.