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Affordable and Sustainable Vaccines for Transition

Gavi defines a successful transition as one in which countries have successfully expanded their national immunization programs with vaccines of public health importance and sustain these vaccines post-transition with high and equitable coverage of target populations, while having robust systems and decision-making processes in place to support the introduction of future vaccines.

To meet these performance objectives, countries must ensure a vaccine supply that is adequate, safe, reliable, and affordable. Doing so requires accurately forecasting vaccine, transportation, and storage needs from the national store to the health facility level; understanding and effectively engaging with global vaccine markets; choosing a mix of vaccine procurement methods that best suits the country’s needs and resources; establishing effective and efficient vaccine procurement policies governing the solicitation of bids and the contracting of suppliers; and strengthening and streamlining policies for vaccine regulation.

LNCT focuses on the following areas to support affordable and sustainable vaccines for transitioning countries:
Global vaccine supply, product and pricing information: Understanding and engaging with global vaccine markets to make strategic decisions about vaccine purchases.
Vaccine procurement methods, policies and procedures: Strengthening and streamlining contracting, regulatory, and payment procedures to successfully procure quality vaccines at affordable prices in a timely manner.
Vaccine forecasting and planning: Improving capacity to correctly predict how much vaccine is needed where and when to avoid stock-out or over-stock of vaccine supplies.

Managing the Gavi transition

Gavi’s vision for a successful transition is one in which countries have successfully expanded their national immunization programs with vaccines of public health importance and sustain these vaccines post-transition with high and equitable coverage of target populations, while having robust systems and decision-making processes in place to support the introduction of future vaccines.

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Financing immunization programs during transition

Ensuring the financial sustainability of immunization programs to meet the goal of successful transition requires securing new domestic resources for immunization and strengthening the planning, budgeting, and financial management capacity of immunization programs.

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Strengthening immunization program performance for transition

Ensuring the sustainability of immunization programs post-transition requires maintaining or strengthening core immunization program functions during and after transition. These include collecting, analyzing, and using program, coverage and surveillance data to make decisions; establishing and regularly consulting advisory bodies to improve governance and decision-making; ensuring an adequate pipeline of skilled immunization professionals at all levels of the health system; and advocating for immunization in the context of larger health program changes, such as primary healthcare reform.

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Partners Working in this Area

Global vaccine supply, product and pricing information

In order to make strategic decisions about which vaccine products to purchase, countries need access to information about what product options are available, the security of the supply of these options, and the prices they should expect to pay. In recent years, global organizations have endeavored to increase the transparency of vaccine markets and develop tools to help countries understand their options whether they procure their vaccines through UNICEF or on their own.

Click the button below to find information about estimating the unit cost of vaccine delivery given different delivery strategies using the Immunization Costing Action Network (ICAN)’s Immunization Delivery Cost Catalogue, vaccine market and price updates from the WHO’s Market Information for Access to Vaccines (MI4A) or UNICEF’s Market Updates, and other resources.

Vaccine procurement methods, policies and procedures

LNCT member countries have identified vaccine procurement as a high-priority topic during transition. According to the World Health Organization, “the objective of vaccine procurement is to receive products of assured quality at affordable prices in a timely manner, making it possible to optimize immunization program performance and reduce mortality and morbidity caused by vaccine preventable diseases”. To meet this objective, countries need to be able to define their needs, including the quantity, characteristics, and timing of vaccines required. Then, they must identify potential suppliers, collect and evaluate bids consistent with national regulations, create and sign contracts, make payments on time, and receive delivery. During this process, they may run into a wide variety of obstacles, such as:

  • Unreliable forecasts of vaccine needs.
  • Incomplete knowledge of vaccine and device prices or presentations available.
  • Complex national procurement laws and regulations that suppliers are required to meet.
  • Delayed or incomplete release of funds from the national budget to the procurement agency, resulting in delayed payment.
  • Weak cold chain capacity, limiting the amount of vaccine that can be stored.
  • Small countries’ inability to access competitive prices due to their small market size.

Almost all LNCT countries procure at least some of their vaccines through UNICEF Supply Division, which pools country demand to access lower prices and handles the process of choosing, contracting, and paying suppliers. Some LNCT countries also subscribe to UNICEF’s Vaccine Independence Initiative, which allows countries more flexible payment options by providing short-term credit to purchase through the Supply Division. Many LNCT countries also have a long-term goal of increasing their capacity to self-procure or produce their own vaccines.

LNCT works closely with UNICEF Supply Division’s Vaccine Procurement Practitioners Network (VPPN) to help countries build their procurement capacity, whether they choose to procure through UNICEF or on their own. In May and July 2018, LNCT hosted a series of webinars on accessing information about vaccine markets, using vaccine forecasting and budgeting tools, and vaccine prices post-transition. Click the button below to access these and other resources.

Vaccine forecasting and planning

An important first step in the vaccine procurement process is understanding how much vaccine is needed, where and when it is needed, and the options for transportation, storage and cold chain capacity as vaccines travel from the national store to the health facility. Many LNCT countries are working to use population data to better understand their vaccine needs, develop electronic systems for stock management, and improve their forecasting process.

LNCT collaborates with UNICEF and the Clinton Health Access Initiative (CHAI) to share learning around good practices in vaccine forecasting. Click the button below to find these and other resources.

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