Vaccines

ISSUE

APPROACH

Immunizing infants and children against a variety of vaccine-preventable diseases is one of the most cost-effective ways to save lives. CHAI works at both the global and national levels to ensure vaccines are affordable and available when and where they are needed.

The Issue

Immunization is one of the most successful and cost-effective public health interventions available, preventing up to three million deaths per year around the world. However, millions continue to die from vaccine-preventable diseases every year, many of them children in low-income countries.

The Approach

CHAI aims to ensure more children are protected from vaccine-preventable diseases by increasing the speed and efficiency with which new vaccines are introduced, improving vaccines cold chain and logistics systems, enhancing immunization strategy, and negotiating lower prices for vaccines and related equipment.

Issue

Immunization is one of the most successful and cost-effective public health interventions available, preventing up to three million deaths per year around the world. However, over three million people continue to die from vaccine-preventable diseases every year, many of them children. In fact, 1.5 million children die from vaccine-preventable diseases annually, more than 22 million children around the world are unimmunized against common diseases, and approximately 29 percent of global deaths of children under 5 are vaccine-preventable. A majority of these deaths occur in low-income countries where poverty, weak health and immunization delivery systems, and a lack of vaccine affordability limit universal access to lifesaving vaccines.

Planned and ongoing expansion of immunization programs in low- and lower-middle income countries has the potential to significantly increase the number of lives saved by vaccines. The recent addition of new vaccines—including pneumococcal, rotavirus, and HPV vaccines—to immunization programs in developing countries will avert millions of deaths in those countries. However, the planned introductions of these newer and relatively more expensive vaccines will also increase costs to fully immunize a child and place additional burdens on in-country vaccine cold chain and logistics systems. Barriers to achieving high immunization coverage rates for both traditional and newly introduced vaccines in developing countries include: the high cost of vaccines, insufficient supply of vaccines and other immunization commodities (e.g. syringes), and challenges in delivery of vaccines to target populations including weak immunization supply chains. Lack of technologies targeted for immunization supply chains in developing countries is also a major issue, and manufacturers need better feedback from countries on country-specific needs.

Approach

To address these barriers to access, CHAI is pursuing four strategic objectives to support governments to increase access to immunization, ensuring that more children are protected from vaccine-preventable diseases. These objectives are to:

1. Increase the speed and efficiency with which new vaccines are introduced in developing countries;
2. Enhance the performance and efficiency of vaccine cold chain and logistics systems;
3. Enhance planning, resourcing, and implementation of immunization strategy; and
4. Increase access to effective vaccines by negotiating lower prices for vaccines and immunization supply chain equipment.

CHAI pursues these goals through a combination of work globally and in focus countries, which include Cameroon, Ethiopia, Kenya, Mozambique, Nigeria, Tanzania, and Uganda.

1. Increase the speed and efficiency with which new vaccines are introduced.

CHAI’s work to accelerate the introduction of new vaccines is focused on the introduction of Haemophilus influenzae type b (Hib), rotavirus, and pneumococcal vaccines, which target the leading causes of child mortality: pneumonia and diarrhea. To date, approximately 135,000 deaths per year have been averted from CHAI-supported new vaccine introductions in our focus countries. In addition, CHAI is supporting governments to introduce the Inactivated Polio Vaccine (IPV) and switching the Oral Polio Vaccine (OPV) in use, which are critical steps to achieving polio eradication worldwide.

2. Enhance the performance and efficiency of vaccine cold chain logistics systems.

CHAI’s work to improve vaccine cold chain and logistics systems aims to increase and sustain effective immunization coverage of existing and new vaccines by improving the safety and potency of vaccines administered, the adequacy of immunization supplies when and where they are needed, and the efficiency of the vaccine delivery system. Since vaccines are very sensitive to temperature, it is crucial that they are kept in a cold chain at the right temperature until they are administered. CHAI supports governments to carry out robust cold chain planning, funding, and implementation; develop reliable temperature monitoring and control systems; accelerate adoption of impactful appropriate new cold chain products; and improve stock management and distribution systems.

3. Enhance planning, resourcing & implementation of immunization strategy

CHAI aims to improve the processes and capabilities of vaccines program in focus countries to develop and implement powerful immunization strategies and to sustainably improve outcomes. Specifically, CHAI supports governments to improve identification and planning of strategic and annual priorities, mobilization of resources towards those priorities, and implementation, monitoring, and evaluation of key interventions.

4. Lower prices of key vaccines and cold chain equipment

Through our partnerships with the Bill & Melinda Gates Foundation, UK Department for International Development (DFID), and the Canadian Departments of Foreign Affairs, Trade and Development (DFATD), CHAI has generated over US$1 billion in savings via negotiating lower vaccine and vaccine supply chain equipment prices for developing countries. CHAI is also supporting vaccine manufacturers in low-income countries to develop a pipeline of high-quality, affordable vaccines, and is working with manufacturers of vaccine supply chain equipment to develop products tailored to developing country contexts.

Change

CHAI-supported accomplishments have included:

  • CHAI worked with vaccine manufacturers, the Bill & Melinda Gates Foundation, GAVI, UNICEF, and other partners to negotiate vaccine price reductions for the pentavalent vaccine, rotavirus vaccine, and inactivated polio vaccine. These prices reductions are expected to save approximately US$1 billion by 2018. In particular:
  • CHAI helped to secure a 67 percent reduction in the price for rotavirus vaccine; the deal will result in an estimated US$680 million in savings over five years.
  • CHAI helped to secure a 45 percent reduction in the price for pentavalent vaccine; the deal will result in an estimated US$225 million in savings over five years.
  • CHAI supported negotiations led by the Bill & Melinda Gates Foundation that secured a 56 percent reduction in the price for inactivated polio vaccine; the deal will result in at least US$150 million in savings over five years.
  • CHAI-supported new vaccine introductions have averted approximately 135,000 deaths per year across five focus countries: Ethiopia, Kenya, Malawi, Nigeria and Tanzania.
  • CHAI has developed a combined cold chain inventory and stock management tool that is used in all 160 districts in Tanzania to track and update the status of cold chain equipment and enhance stock transparency, availability, and adequacy across the country.