History of Vaccine Investment Strategy

In 2013, the Vaccine Alliance has again assessed potential new priorities for its vaccine support programmes in the next five years. A landscape analysis, conducted by the World Health Organization (WHO), identified fifteen vaccines not yet in Gavi’s portfolio or in development with an anticipated licensure date by 2019. Each vaccine was evaluated to estimate the potential health impact, cost and value for money alongside additional strategic and programmatic considerations. The outcomes from this initial analysis have been summarised in vaccine ‘scorecards’. 

With a view to prioritise vaccines providing good ‘value for money’ and with the highest impact on disease, the Gavi Board shortlisted five options for further evaluation: malaria vaccines, oral cholera vaccines, seasonal influenza vaccination for pregnant women, rabies vaccines (for post-exposure prophylaxis), and an investment in additional mass campaigns with yellow fever vaccines.

With input from over one hundred experts, Vaccine Alliance partners, in-country stakeholders and an Independent Expert Committee, Gavi undertook further, in depth analyses of these five options to inform investment recommendations. Detailed analyses for each of the five vaccines can be downloaded below.

At a meeting in Cambodia in November 2013, the Gavi Board reviewed the analyses and decided to:

• Make available new support for additional yellow fever campaigns.
• Contribute towards a global cholera vaccine stockpile during 2014-2018 to increase access to oral cholera vaccine in outbreak situations and to further a learning agenda on the use of cholera vaccine in endemic settings.
• With regards to a malaria vaccine (still in development), the Board noted that based on the current assessment, there would be a reasonable case for Gavi to support the vaccine. The Board will consider this if and when the vaccine is licensed, WHO prequalified and recommended for use by the joint meeting of the WHO Strategic Advisory Group of Experts (SAGE) and the Malaria Programme Advisory Committee (expected in 2015), taking into account updated projections of impact, cost and country demand.
• The Board concluded that further evidence is necessary on the impact and operational feasibility of supporting rabies and influenza vaccines for pregnant women. The Board agreed that Gavi will fund an observational study to address critical knowledge gaps around access to rabies vaccine and will monitor the evolving evidence base for maternal influenza vaccination in coming years.

Separately, the Gavi Board endorsed opening a window of support for inactivated poliovirus vaccine (IPV) for all countries benefitting from Gavi support.

Finally, the Board also took the decision to begin providing country support for a vaccine against Japanese encephalitis (JE). The decision to offer JE vaccine support was taken as part of the previous vaccine investment strategy, but a funding window could not be opened until a WHO prequalified product was available. In October, a Chinese manufacturer received WHO prequalification on its JE vaccine.

The next Vaccine Investment Strategy will be developed in 2018.