With more than half of Gavi-supported countries officially listed as fragile states, Gavi is increasingly working on several fronts to ensure vaccines still reach people living on the frontlines of humanitarian crises.
GLOBAL VACCINE STOCKPILES
The Vaccine Alliance supports
three vaccine stockpiles for emergency responses to yellow fever, meningitis
and cholera epidemics. We have also
invested US$ 10 million annually to fund measles outbreak response and
committed to financing an Ebola vaccine stockpile, once a vaccine is licensed
and WHO recommended.
First use of Gavi Cholera Stockpile - Cameroon 2015
Oral cholera vaccine (OCV): prior to Gavi’s 2013 decision to contribute US$ 115
million towards the cost of maintaining the OCV stockpile over a five-year
period, 2014–2018, supply was struggling to keep pace with the demand caused by
the estimated 1–4 million new cases of cholera that occur each year. Gavi’s support for the OCV stockpile has
helped to mitigate the global shortage. In 2015, the number of vaccine doses
distributed worldwide increased by 60%, with more than two million doses delivered
to six countries, including Bangladesh, Cameroon and Haiti.
Meningitis vaccines: although the meningitis A vaccine has virtually
eliminated epidemics caused by the Neisseria
meningitides serogroup A (NmA), four other meningococcus strains, including
NmC, continue to cause outbreaks of viral meningitis across parts of Africa.Between February and June 2015, an NmC
epidemic claimed 1,000 lives in the Niger and Nigeria. For the first time, Gavi
funds were used to purchase a multivalent (ACWY) meningitis vaccine for use in
the Niger’s emergency response.
Yellow fever vaccine: in the last 20 years, the combination of declining
population immunity, rapid urban migration, climate change and deforestation
have led to a resurgence in the number of yellow fever cases. Current estimates
put the number of cases of yellow fever worldwide in the region of 200,000 per
year, and the number of deaths at around 30,000 per year.
Between 2006 and 2014, and
with support from Gavi, the International Coordination Group (ICG) deployed
over 25 million doses of the yellow fever vaccine worldwide in response to
yellow fever outbreaks. The ICG includes representatives from WHO, UNICEF,
Médecins sans Frontières and the International Federation of Red Cross and Red
prevention campaigns, which started in 2011, have so far protected over 98
million people in 14 countries. According to the Yellow Fever Initiative, mass
campaigns have significantly reduced the risk of yellow fever outbreaks in
Africa, lowering the disease burden by an average 27% among the 12 “high-risk”
However, rapid urbanisation
and environmental changes are shifting the geography of yellow fever such that
the virus is now affecting areas previously considered non-endemic. In
response, Gavi is working with WHO to rework its yellow fever control strategy.
Ebola vaccine: as
the Ebola epidemic swept across West Africa in 2014 and 2015, vaccine
manufacturers stepped up their efforts to develop a safe, effective vaccine not
only to control the existing outbreak but also to prevent future devastating
In late 2014, the Gavi Board
sent a clear signal to manufacturers that there was strong demand by committing
up to US$ 300 million for the production and procurement of up to 12 million doses
of first-generation Ebola vaccines and to create a global stockpile for future
Gavi’s Ebola funding package
also included up to US$45 million to support the roll-out of an Ebola vaccine
and another US$ 45 million to help health and immunisation systems in Sierra
Leone, Liberia and Guinea recover from the devastating 2014-2015 emergency. Gavi is already helping all three countries
ensure children catch up on immunisation they missed during the epidemic.
Once an Ebola vaccine has
been licensed and WHO recommended, it will be supplied to Gavi-supported
countries at a not-for-profit price.
Measles vaccine: since 2013, Gavi has funded measles campaigns in six large countries
considered at high risk of measles outbreaks, reaching a total of 118 million
children in the past three years. In 2015, the Gavi Board approved measles
follow-up campaigns in Chad, the Democratic Republic of the Congo, Ethiopia and
Nigeria to mitigate the risk of outbreaks and further escalation of ongoing
FRAGILITY AND IMMUNISATION POLICY
In 2015, approximately one
third of Gavi funding was invested in fragile states. Our fragility and
immunisation policy, approved in 2012, has allowed us to adapt funding to address
the unique challenges facing countries in short-term emergencies or protracted
- In Yemen,
for example, Gavi reprogrammed its health system strengthening support to
channel funds through UNICEF and WHO and focus on integrated outreach
activities. In 2015, this helped ensure
more than 6,000 immunisation sessions took place across the country, even in
remote villages. Learn more.
- In 2013, Gavi helped the Kenyan government to roll out
pneumococcal vaccine to Somali children sheltering in the Dadaab refugee camp. Chad
will also receive additional Gavi-funded vaccines for refugees.
- HSS support was reprogrammed in the Central African Republic in 2014 to
allow Gavi-supported vaccines to be used for catch-up campaigns.
LOWER PRICES FOR CIVIL SOCIETY ORGANISATIONS (CSO)
CSOs often play a key role in
immunisation in humanitarian crises. In emergency situations, through Gavi,
CSOs are able to get access to lower vaccine prices.
In 2013, for example, we
worked with Médecins sans Frontières to purchase pneumococcal vaccines for
children in South Sudan’s Yida refugee camp.