Member Log-in

I forgot my password

Not a Member? Register

Sustaining Pneumococcal Vaccination After Transitioning from Gavi Support: A Modelling and Cost-effectiveness Study in Kenya

Background
In 2009, Gavi, the World Bank, and donors launched the pneumococcal Advance Market Commitment, which helped countries access more affordable pneumococcal vaccines. As many low-income countries begin to reach the threshold at which countries transition from Gavi support to self-financing (3-year average gross national income per capita of US$1580), they will need to consider whether to continue pneumococcal conjugate vaccine (PCV) use at full cost or to discontinue PCV in their childhood immunisation programmes. Using Kenya as a case study, we assessed the incremental cost-effectiveness of continuing PCV use.

Methods
In this modelling and cost-effectiveness study, we fitted a dynamic compartmental model of pneumococcal carriage to annual carriage prevalence surveys and invasive pneumococcal disease (IPD) incidence in Kilifi, Kenya. We predicted disease incidence and related mortality for either continuing PCV use beyond 2022, the start of Kenya’s transition from Gavi support, or its discontinuation. We calculated the costs per disability-adjusted life-year (DALY) averted and associated 95% prediction intervals (PI).

Findings
We predicted that if PCV use is discontinued in Kenya in 2022, overall IPD incidence will increase from 8·5 per 100 000 in 2022, to 16·2 per 100 000 per year in 2032. Continuing vaccination would prevent 14 329 (95% PI 6130–25 256) deaths and 101 513 (4386–196 674) disease cases during that time. Continuing PCV after 2022 will require an estimated additional US$15·8 million annually compared with discontinuing vaccination. We predicted that the incremental cost per DALY averted of continuing PCV would be $153 (95% PI 70–411) in 2032.

You May Also Like

LNCT Webinar Resources: Assessing Bottlenecks to Adequate and Predictable Vaccine Financing

On June 23, 2020, LNCT held a webinar, Assessing Bottlenecks to Adequate and Predictable Vaccine Financing. Diagnosing the root cause of constraints affecting the adequacy and predictability of vaccine financing is an important part of the Gavi transition. The World Bank created a tool that aims to help country counterparts pinpoint the root cause of … Continued

Comparing 3 Approaches for Making Vaccine Adoption Decisions in Thailand

Background: The World Health Organization (WHO) has developed the Total System Effectiveness (TSE) framework to assist national policy-makers in prioritizing vaccines. The pilot was launched in Thailand to explore the potential use of TSE in a country with established governance structures and accountable decision-making processes for immunization policy. While the existing literature informs vaccine adoption … Continued

Tackling the Triple Transition in Global Health Procurement

Abstract Global health procurement needs are evolving rapidly as countries face a triple transition: First, with income levels rising, low- and middle-income countries face the prospect of a transition from donor aid. Health products procurement, especially in low-income countries, remains heavily reliant on donors; making up for lost financing following donor exit will stretch already-strained national … Continued

Choose a Language