UPDATE ON IMPLEMENTATION OF GAVIS STRATEGY Seth Berkley, MD 29 - PowerPoint PPT Presentation

UPDATE ON IMPLEMENTATION OF GAVI’S STRATEGY Seth Berkley, MD 29 November 2017, Vientiane, Lao PDR www.gavi.org

5 ON TRACK 2016 – 2020 INDICATORS † Baseline value reset to “0” at the 0 MODERATE DELAYS / CHALLENGES start of the strategy period. Targets MISSION PROGRESS for 2020 represent anticipated 0 SIGNIFICANT DELAYS / CHALLENGES cumulative achievement over the Gavi Board duration of the strategy period. UPDATED: 11 October 2017 1 MA UNDER-5 MORTALITY 62 per 1,000 The Vaccine Alliance tracks five key targets to help 2015 BASELINE 2020 TARGET achieve our mission: to save children's lives and 65 per 1,000 59 per 1,000 protect people's health by increasing equitable use MA 2 FUTURE DEATHS AVERTED of vaccines in lower-income countries. 1.2m 2015 BASELINE † 2020 TARGET 0 5-6 million 3 FUTURE DISABILITY-ADJUSTED LIFE YEARS (DALYS) AVERTED MA 56m 2015 BASELINE † 2020 TARGET 0 250 million CHILDREN IMMUNISED WITH GAVI SUPPORT MA 4 62m 2015 BASELINE † 2020 TARGET 0 300 million MA 5 VACCINES SUSTAINED AFTER GAVI SUPPORT ENDS 100% 2015 BASELINE 2020 TARGET 100% 100% GAVI BOARD 29-30 NOVEMBER 2017

8 ON TRACK Progress has been updated for indicators 2016 – 2020 INDICATORS 4 MODERATE DELAYS / CHALLENGES where data is currently available. 2 SIGNIFICANT DELAYS / CHALLENGES Updates are color-coded to reflect the status STRATEGY PROGRESS 3 TRACKING TREND ONLY / DATA INCONCLUSIVE and trend of each indicator. Grey bars indicate target not set. Gavi Board UPDATED: 8 November 2017 1 Accelerate vaccines 2 Strengthen capacity 3 Improve sustainability 4 Market shaping ROUTINE IMMUNISATION COVERAGE EFFECTIVE VACCINE MANAGEMENT CO-FINANCING COMMITMENTS SUPPLY SECURITY 1 1 1 1 PENTA: 80% MCV1: 78% PENTA: 80% MCV1: 78% 15% 100% 9/11 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET PENTA3: 80% PENTA3 85% 16% 43% 85% 100% 7/11 11/11 MCV1: 78% MCV1: 83% 2 2 2 2 BREADTH OF PROTECTION DATA QUALITY COUNTRY INVESTMENT IN VACCINES VACCINE PRICE REDUCTION 37% 49% $19 54% 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 30% 62% 45% 53% N/A 100% $20 N/A 1 3 3 EQUITY: GEOGRAPHIC DISTRIBUTION PENTA1 COVERAGE & DROP-OUT 3 COUNTRIES ON TRACK TO TRANSITION 3 VACCINE INNOVATION 16% 7 PP PENTA1: 87% 75% 3 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2020 TARGET 2015 BASELINE PENTA1: 87% PENTA1: 91% 16% 26% 63% 75% 10 0 DROP-OUT: 7 PP DROP-OUT: 4 PP 4 EQUITY: WEALTH 4 INTEGRATED HEALTH SERVICE DEL. 4 INSTITUTIONAL CAPACITY 4 HEALTHY MARKET DYNAMICS 36% 26% 4% 2/11 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 26% 36% N/A ** 1/11 6/11 39% 49% EQUITY: MATERNAL EDUCATION 5 5 CIVIL SOCIETY ENGAGEMENT ** Currently insufficient data to MCV1 Measles-containing vaccine 1 st dose define target; targets to be 30% 40% defined after provision of one full PP Percentage point year of PCA version 3.0 reports 2015 BASELINE 2015 BASELINE 2020 TARGET Pentavalent 1 st dose 2020 TARGET Penta1 1 Not published due to ** 34% N/A 44% Pentavalent 3 rd dose Penta3 commercial sensitivity GAVI BOARD 29-30 NOVEMBER 2017

8 ON TRACK Progress has been updated for indicators 2016 – 2020 INDICATORS 4 MODERATE DELAYS / CHALLENGES where data is currently available. 2 SIGNIFICANT DELAYS / CHALLENGES Updates are color-coded to reflect the status STRATEGY PROGRESS 3 TRACKING TREND ONLY / DATA INCONCLUSIVE and trend of each indicator. Grey bars indicate target not set. Gavi Board UPDATED: 8 November 2017 1 Accelerate vaccines 2 2 Strengthen capacity 3 Improve sustainability 4 Market shaping Strengthen capacity 2015 to 2016 changes: ROUTINE IMMUNISATION COVERAGE EFFECTIVE VACCINE MANAGEMENT CO-FINANCING COMMITMENTS SUPPLY SECURITY 1 1 1 1 • PENTA: 80% MCV1: 78% PENTA: 80% MCV1: 78% 15% 20 countries: decreased dropout 100% 9/11 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET • PENTA3: 80% PENTA3 85% 36 countries: unchanged 16% 43% 85% 100% 7/11 11/11 MCV1: 78% MCV1: 83% • 12 countries: increased dropout 2 2 2 2 BREADTH OF PROTECTION DATA QUALITY COUNTRY INVESTMENT IN VACCINES VACCINE PRICE REDUCTION 37% 49% $19 54% 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 30% 62% 45% 53% N/A 100% $20 N/A 1 3 3 EQUITY: GEOGRAPHIC DISTRIBUTION PENTA1 COVERAGE & DROP-OUT 3 COUNTRIES ON TRACK TO TRANSITION 3 VACCINE INNOVATION 16% 7 PP PENTA1: 87% 75% 3 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2020 TARGET 2015 BASELINE PENTA1: 87% PENTA1: 91% 16% 26% 63% 75% 10 0 DROP-OUT: 7 PP DROP-OUT: 4 PP 4 EQUITY: WEALTH 4 INTEGRATED HEALTH SERVICE DEL. 4 INSTITUTIONAL CAPACITY 4 HEALTHY MARKET DYNAMICS 36% 26% 4% 2/11 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 2015 BASELINE 2020 TARGET 26% 36% N/A ** 1/11 6/11 39% 49% EQUITY: MATERNAL EDUCATION 5 5 CIVIL SOCIETY ENGAGEMENT ** Currently insufficient data to MCV1 Measles-containing vaccine 1 st dose define target; targets to be 30% 40% defined after provision of one full PP Percentage point year of PCA version 3.0 reports 2015 BASELINE 2015 BASELINE 2020 TARGET Pentavalent 1 st dose 2020 TARGET Penta1 1 Not published due to ** 34% N/A 44% Pentavalent 3 rd dose Penta3 commercial sensitivity 4 GAVI BOARD 29-30 NOVEMBER 2017

Above trend to immunise 300M children this period, but challenges in reaching the fifth child 1 Accelerate vaccines Children immunised with DTP3/PENTA3 (Gavi68) DTP3/PENTA3 (Gavi68) MCV1 (Gavi68) 78% 78% 78% 78% 80% 80% 80% 78% 68% 68% 60% 60% 63.9M 63.1M 62.4M 60.4M 60.6M 60.3M 59.5M 2010 2011 2012 2013 2014 2015 2016 2001 2005 2010 2014 2015 2016 2001 2005 2010 2014 2015 2016 GAVI BOARD 29-30 NOVEMBER 2017

Breadth of protection tracking above trend 1 Accelerate vaccines 70% 62% protection (%) 60% Breadth of 50% 37% 40% 30% 30% 23% 20% 20% 2013 2014 2015 2016 2017 2018 2019 2020 Year GAVI BOARD 29-30 NOVEMBER 2017

No increase in countries meeting geographic equity target – ~40% are close to target 1 Accelerate vaccines 3 more countries within 20% of target 2016 2015 Countries 100 100 meeting target % of districts with >80% % of districts with >80% Countries 80 80 Penta3 coverage Penta3 coverage 1-20% off target 60 60 Countries >20% off target 40 40 More countries excluded 20 20 by data quality criterion 0 0 Countries Countries Note: N=30 countries, 38 countries excluded by data GAVI BOARD quality criterion, 2 countries without data 29-30 NOVEMBER 2017

Wealth equity indicator: few surveys limit the power of the indicator • Wealth equity 8 countries with new surveys for 2016 • indicator 6 countries improving • 2 countries worsening (Senegal now 50% below threshold) 39% • Lowers indicator value 40% 36% 30% • 6 countries with first data point 20% • 1 of 6 meets target 10% • Lowers indicator value 0% 2015 2016 • 36 countries without new data • 18 countries without data in last 5 years GAVI BOARD 29-30 NOVEMBER 2017

Gavi countries currently 7 of 10 countries with most under-immunised children 1 Accelerate vaccines Top 10 countries under-immunised, DTP3, 2016 3.44M 2.91M 1.43M 1.02M 0.72M 0.65M 0.44M 0.41M 0.41M 0.39M Nigeria India Pakistan Indonesia Ethiopia DRC Iraq Angola Brazil South Africa Other Transitioned Gavi Angola (end 2017), India (2021) and Nigeria (2021) transitioning from Gavi support GAVI BOARD 29-30 NOVEMBER 2017

1 Accelerate vaccines 29 introductions so far in 2017 – majority are campaigns Since January 2017: India Pakistan Pneumococcal 13 routine introductions Rotavirus Measles-rubella Niger Mali 16 campaigns/demos Lao PDR Meningitis A Chad Meningitis A Measles-rubella Meningitis A Meningitis A Senegal Cambodia Ethiopia Myanmar Guyana Measles-rubella HPV Measles JE HPV Nigeria Measles-rubella Liberia Measles Uganda IPV Burkina Faso Meningitis A Sri Lanka Meningitis A HPV Rwanda CAR Côte d’Ivoire Measles-rubella Meningitis A Rotavirus Meningitis A Burundi Indonesia Measles-rubella HPV Measles-rubella Bolivia Malawi HPV Measles-rubella Lesotho Measles-rubella Board meeting 29-30 November 2017

Target of 50 introductions in 2017, HPV the main driver of gap to projection 1 Accelerate vaccines 139 Gap to projection Forthcoming/ 68 projected ~80 72 Completed 59 27 50 10 ~41 ~36 14 71 7 49 45 29 2014 2015 2016 2017 2018 2019 2020 GAVI BOARD 29-30 NOVEMBER 2017

Improving Knowledge Management tools to monitor progress of introductions proactively 1 Accelerate vaccines GAVI BOARD 29-30 NOVEMBER 2017