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Improving routine immunisation, reaching zero-dose children

By Chukwuma Muanya
29 December 2022   |   4:03 am
The Board of Gavi, the Vaccine Alliance has approved an evolution of its current five-year programme strategy that will see renewed focus on routine immunisation and reaching zero-dose children, new vaccine introductions, a strengthened Alliance role in outbreak and pandemic

[FILES] Immunisation CREDIT:

•Gavi affirms role in fighting outbreaks, pandemic preparedness, response, current COVID-19 vaccination strategy
The Board of Gavi, the Vaccine Alliance has approved an evolution of its current five-year programme strategy that will see renewed focus on routine immunisation and reaching zero-dose children, new vaccine introductions, a strengthened Alliance role in outbreak and pandemic preparedness and response, alongside continued COVID-19 vaccinations in the 92 lower income countries supported by the Gavi COVAX Advance Market Commitment. Chair of the Board, Prof. José Manuel Barroso, was confirmed for a second, three-year term.

The two-day meeting, which concluded last week, also approved a re-launch of the Alliance’s HPV vaccination programme. An ambitious plan to support sustainable regional vaccine manufacturing, particularly in Africa, was also adopted.

The Board also gave a green light to leverage Gavi’s decades-long experience combatting the continuum of outbreaks, epidemics and pandemics, including with the recent learnings from COVAX, for pandemic preparedness and response (PPR) – in particular working towards equitable access to outbreak and pandemic vaccines, strengthening health systems, accelerating at-risk innovative financing and supporting diversification of global vaccine manufacturing.

A decision to continue ensuring COVID-19 vaccines are accessible to the 92 AMC countries was also approved by the Board. While the current priority remains to help countries raise coverage levels and boost high-risk groups, the Board also endorsed plans to start preparing now for future evolutions of the virus. While COVAX continues to have in place plans for worst case scenarios, the Board agreed, in principle, to explore integrating future COVID-19 vaccinations into Gavi’s core programming – to improve synergies, be more responsive to countries’ needs and reduce the additional burden a specialised emergency response places on countries. This approval in principle will help Gavi engage with countries and partners on what shape a future programme would take, while also remaining flexible in case of further developments in 2023.

Chair of the Board of Gavi, Prof. José Manuel Barroso, said: “Never before have Gavi-supported countries administered as many vaccines as the billions of doses they did in 2021. Yet routine immunisation has been impacted hard by the pandemic for two consecutive years and it is essential that we help countries to address this. The decisions taken at this week’s meeting will help the Vaccine Alliance enter a Year of Renewal; not only its historical mission to leave no one behind with immunisation but of the Alliance itself, introducing new innovations and ways of working, learned from the pandemic.”

Further details on the decisions made at the Board Meeting include:

•Gavi’s Board expressed overwhelming support for the re-launch of the HPV vaccine programme with over $600 million investment. The money will go towards funding vaccines, strengthening health systems and providing technical and learning support. With cervical cancer causing 342,000 deaths in 2020, 90 per cent of which occurred in low- and middle-income countries, the HPV vaccine is one of the most impactful vaccines in Gavi’s portfolio. With the new funding in place, the Alliance has set an ambitious goal to reach over 86 million girls by 2025, aiming to avert over 1.4 million future deaths from cervical cancer.

•A plan to support the development of a regionally diversified vaccine-manufacturing ecosystem was also approved. Based on three pillars; support for strategic antigen selection by manufacturers/countries, market shaping and demand creation, the initiative represents a major step forward in addressing one of the critical challenges faced during the pandemic: how to ensure all regions of the world have the ability to manufacture vaccines. The initiative, supported by the African Union, Africa CDC, G7 and other stakeholders, also envisages the possibility of a fourth pillar, the design of a new financial instrument in the form of an Advance Market Commitment (AMC) for African vaccine manufacturing. This will be developed over the coming year, for potential approval and launch in 2023.

•Recognising that countries and communities face increased fragility and multiple challenges, the Board sought to balance ensuring access with sustainability through Gavi transition and co-financing policies. The Board extended timeframes for countries scheduled to transition out of Gavi support, put in place lower, time-limited, co-financing requirements for new malaria vaccines, extended the Gavi eligibility and co-financing exemptions for inactivated polio vaccine (IPV) in support of polio eradication efforts, and confirmed zero co-financing requirements for outbreak response and refugee populations currently not integrated into national plans.

Chief Executive Officer (CEO) of Gavi, Dr. Seth Berkley, said: “Gavi’s mission, working together as Alliance to deliver unparalleled impact, has always been to help countries protect their populations through immunisation.

As we move out of the emergency phase of the pandemic, this will mean catching up on essential and sustaining COVID-19 vaccinations, helping them plan and prepare for the increasing occurrence of outbreaks due to climate change and growing populations – and looking further ahead, putting in place a global health response that will enable us to address future pandemics and global health security threats much more effectively.”

Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world’s children against some of the world’s deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation – over 981 million children – and prevented more than 16.2 million future deaths, helping to halve child mortality in 73 lower-income countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningococcal and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation, above all the zero-dose children who have not received even a single vaccine shot. The Vaccine Alliance employs innovative finance and the latest technology – from drones to biometrics – to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency.

Gavi is a co-convener of COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, together with the Coalition for Epidemic Preparedness Innovations (CEPI), the World Health Organisation (WHO) and United Nations Children Fund (UNICEF). In its role, Gavi is focused on procurement and delivery for COVAX: coordinating the design, implementation and administration of the COVAX Facility and the Gavi COVAX AMC and working with its Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery.

The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. View the full list of donor governments and other leading organisations that fund Gavi’s work here.