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Expanded Programme on Immunization

Global Progress

Expanded Programme on Immunization

Global Progress

Vaccine Industry ConsultationUnicef, Copenhagen26-27 October 2015

Vaccine Industry ConsultationUnicef, Copenhagen26-27 October 2015

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of the Decade of mission "The

Vaccines is to extend, by 2020 and

beyond, the full benefits of

immunization to all people,

regardless of where they are born,

who they are, or where they live."

a world in which all vision“We en

individuals and communities enjoy lives

free from vaccine-preventable diseases".

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Goals of the Global Vaccine Action PlanGoals of the Global Vaccine Action Plan

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Development of Regional Action PlansDevelopment of Regional Action Plans

� EUR: European Vaccine Action Plan

– adopted October 2014

� WPR: Regional Framework for Implementation

– adopted October 2014

� AFR: Regional Strategic Plan for Immunization

– adopted November 2014

� AMR: Plan de Acción sobre Inmunización

– adopted September 2015

� EMR: Eastern Mediterranean Vaccine Action Plan

– adopted October 2015

� African Ministerial Meeting (AFR + EMR)

– planned for Feb 2016

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Global Immunization 1980-2014, DTP3 coverageglobal coverage at 86% in 2014

Source: WHO/UNICEF coverage estimates 2014 revision. July 2015Immunization Vaccines and Biologicals, (IVB), World Health Organization.194 WHO Member States. Date of slide: 21 July 2015.

SAGE : Progress is off-track !

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DTP3 COVERAGE: IMPROVEMENT IN NUMBER OF UNVACCINATED CHILDREN

DTP3 COVERAGE: IMPROVEMENT IN NUMBER OF UNVACCINATED CHILDREN

� Number of unimmunized children now ~18 m (~22m in 2013):

– Revision of coverage estimates for India

• reflects increase in coverage since 2009, based on latest coverage estimates

– Increasing coverage in other large countries like Nigeria and Ethiopia

0

100

200

300

400

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Po

lio c

ases

(th

ou

san

ds)

125 Polio Endemic

countries

Wild Poliovirus Eradication (1988-2015)

19882014

Last Polio Case

in Nigeria

3 Polio Endemic

countries

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2015

Last type 2 polio

in the world

Last Polio Case in

India

2 Polio Endemic

countries

WPV 2 Eradicated

3 Years without WPV3

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All countries have committed to introduce IPVAll countries have committed to introduce IPV

Data source: WHO/IVB Database, as of 19 October 2015Map production Immunization Vaccines and Biologicals (IVB),

World Health Organization

Date of slide: 19 October 2015

The boundaries and names shown and the designations used on this map do not imply

the expression of any opinion whatsoever on the part of the World Health Organization

concerning the legal status of any country, territory, city or area or of its authorities, or

concerning the delimitation of its frontiers or boundaries. Dotted lines on maps

represent approximate border lines for which there may not yet be full agreement.

©WHO 2015. All rights reserved.

Introduced to date (114 countries or 58.8%)

Formal commitment to introduce in 2015 (45 countries or 23.2%)

Formal commitment to introduce in 2016 / Introduction delayed to 2016 due to global IPV vaccine shortage

(35 countries or 18%)

Not applicable

Since January 2013, the following countries have introduced IPV: Kazakhstan & Peru (July 2013); Micronesia (August 2013); Libya (April 2014); Albania & Panama (May 2014); Nepal & Tunisia (September 2014); Philippines (October 2014); China (December 2014); Comoros, Senegal & Serbia (January 2015); Colombia & Nigeria (February 2015); Bangladesh & Maldives (March 2015); DR Congo, DPR Korea & The Gambia (April 2015); Madagascar (May 2015); Cote d'Ivoire, Kiribati, St Vincent and the Grenadines & Sudan (June 2015); Bhutan, Cameroon, Niger, Pakistan & Sri Lanka (July 2015); Benin, Chad, Papua New Guinea, The Former Yug. Rep. of Macedonia (August 2015); Afghanistan, CAR, Dominica, Guyana, Iran, Jamaica, Seychelles & Solomon Islands (September 2015); Bahamas, Lao People's Dem. Republic & Samoa (October 2015)

46/126 countries have introduced since 1 January 201345 more countries will introduce in 2015

35 Countries will introduce in 2016

Switch from tOPV to bOPV in 155 countries

17 April – 1 May 2016

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Reduction in estimated measles deaths, 1985 - 2011

Reduction in estimated measles deaths, 1985 - 2011

0

200

400

600

800

1,000

1,200

1,400

1000s

Source: WER 2013; 88(3):29-36

86% drop from 1985-2011

71% drop from 2000-2011

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0.1

1.0

10.0

100.0

1,000.0

Me

asl

es

inci

de

nce

pe

r m

illi

on

po

pu

lati

on

(lo

g s

cale

)

GOAL

GLOBAL

needed

AFR

EMR

EUR

SEAR

WPR

AMR

2015 Goal

Projected 10-yr

trend

Trend to

reach goal

Progress towards measles eliminationProgress towards measles elimination

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MATERNAL AND NEONATAL TETANUS: 24 COUNTRIES YET TO ACHIEVE ELIMINATION IN 2014

MATERNAL AND NEONATAL TETANUS: 24 COUNTRIES YET TO ACHIEVE ELIMINATION IN 2014

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0 2,100 4,2001,050 Kilometers

PCV3 vaccine coverage, 2014PCV3 vaccine coverage, 2014

Source: WHO/UNICEF coverage estimates 2015 revision. Map production: Immunization Vaccines and Biologicals, (IVB). World Health OrganizationDate of slide: 16 July 2015

The boundaries and names shown and the designations used on this map do not imply the expression of any

opinion whatsoever on the part of the World Health Organization concerning the legal status of any country,

territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines

on maps represent approximate border lines for which there may not yet be full agreement. © WHO 2015. All

rights reserved

<50% (11 countries or 6%)

50-79% (22 countries or 11%)

80-89% (20 countries or 10%)

>=90% (49 countries or 25%)

Not available / not in national immunization schedule (77 countries or 40%)

Not applicable

PCV in schedule but no coverage data available (15 countries or 8%)

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0 2,100 4,2001,050 Kilometers

Rotavirus Vaccine Coverage, 2014Rotavirus Vaccine Coverage, 2014

Source: WHO/UNICEF coverage estimates 2015 revision. Map production: Immunization Vaccines and Biologicals, (IVB). World Health OrganizationDate of slide: 16 July 2015

The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on

the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or

concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there

may not yet be full agreement. © WHO 2015. All rights reserved

<50% (15 countries or 8%)

50-79% (15 countries or 8%)

80-89% (15 countries or 8%)

>=90% (20 countries or 10%)

Not applicable

Rotavirus vaccine in schedule but no coverage data available (9 countries or 5%)

Not available / not in national immunization schedule (120 countries or 62%)

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Addressing five priority problems will help bring the Global Vaccine Action Plan back on track

MOVING FORWARDMOVING FORWARD

Nationalteam

Strategiesto reach

Planningcycle

Fundingflow

Vaccinatorcapacity

Adequatesupply

Monitoringsystems

Beyond infancyvaccination

Nationalteam

Communityinvolvement

GlobalRoutine ImmunizationStrategies &Practices:

Nine GRISPTransformativeInvestments

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Integrated Approaches to Disease ControlIntegrated Approaches to Disease Control

New vaccines target important, but not all, pathogens of major causes of morbidity and mortality

Non-vaccine interventions need to be scaled up

Synergies will maximize benefits

Use immunization contacts to deliver a package of interventions,

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40 countries have shared their vaccine price information with V3P40 countries have shared their vaccine price information with V3P

* Data collection ending 30th June 2015

Great progress done in 2015*…

Great momentum and an opportunity to move forward

� WHA resolution 68.6 (GVAP): all countries encouraged to share vaccine price data with WHO

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Research and DevelopmentResearch and Development

• Improve programme efficiencies

• Epidemiological and operational research

• Health information technologies

Short-term

• Support development, licensing and uptake of vaccines

• Improved vaccine thermostability

• Simplified vaccine delivery and product packaging

• Regulatory science

Medium-term

• Enable the development of new vaccines

• Immunological research on adaptive and innate systems

• Research into pathogens and their evolution

Long-term

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TPPs on emerging pathogensTPPs on emerging pathogens

� TPP provide guidance on WHO’s critical and preferred profiles for vaccine product

� TPPs are a higher risk product for WHO to develop, but more useful for developers: provide critical parameters

� TPPs when WHO wishes to provide more concrete guidance and products are more advanced

� PPCs when mandate/information for critical parameters are not yet available

� TPPs could be developed later for diseases where WHO starts with PPCs

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Target Product Profile - TPPTarget Product Profile - TPP

� First TPP being developed is the Ebola Vaccine

– Target audience is those working to improve characteristics of currently tested Ebola Vaccines, or products under development.

– This document will be finalised and published Q4 2015 http://www.who.int/immunization/research/committees/ebola_vaccine

_tpp/en/

� Others to follow: MERS ?

� Wherever possible public consultation will be part of process

� In next emergency, faster TPP process will be used

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