Pneumococcal vaccine support

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Gavi countries rolling out pneumococcal vaccines will potentially avert more than 500,000 future deaths by 2015

Advance Market Commitment plays key role in introduction of sophisticated vaccines

6th May 2013, Kiribati launched pneumococcal vaccine

A vaccination outreach session at a village maneaba. Kiribati is the smallest and most remote country to receive Gavi support. 103,000 people live across its three islands. On 6th May 2013, Kiribati launched the pneumococcal vaccine.
Photo credit: Gavi/2013/Raj Kumar.

Rollout across three continents

The rollout of pneumococcal vaccines in the developing world is underway across three continents: over 25 Gavi-eligible countries have started rolling out pneumococcal vaccines since 2010.

The new pneumococcal vaccines are highly complex and sophisticated vaccines that in the past might otherwise have taken 15 years or more to reach low-income countries. Thanks to the work of Gavi, its donors and partners, the world's poorest children are now receiving the newest pneumococcal vaccines nearly simultaneously with children in developed countries.

Pneumococcal vaccine rollouts

Gavi aims to rollout the pneumococcal vaccine in 45 countries by 2015. Track rollouts country by country from our pneumococcal vaccine support timeline.

More than 50 Gavi-eligible countries approved

More than 50 Gavi-eligible countries have been approved for Gavi support to introduce pneumococcal conjugate vaccine into their national immunisation programmes.

Strong demand means that pneumococcal vaccines will soon be administered in more than half of Gavi eligible countries. This is a ramp up of unprecedented speed. By rapidly scaling up the number of countries and the number of children receiving the vaccines, to date it is estimated that Gavi and its partners have immunised more than 10 million children. 

Advance Market Commitment

The implementation of this AMC is on track ... reducing morbidity and mortality from pneumococcal diseases in developing countries

Source: AMC process and design evaluation

The introduction of these vaccines is largely thanks to the generosity of Italy, the United Kingdom, Canada, the Russian Federation, Norway, and the Bill & Melinda Gates Foundation who together contributed US$ 1.5 billion through an innovative financing mechanism, called the Advance Market Commitment (AMC) for pneumococcal vaccines.

The aim of the AMC is to stimulate the development and manufacture of new vaccines for developing countries.

Two manufacturers have thus far committed to supply 600 million doses over the next 10 years. It is expected that additional manufacturers will have new pneumococcal vaccines ready to participate in the AMC.


Map of countries approved for Gavi's pneumococcal vaccine support


Pneumococcal disease is leading vaccine-preventable cause of death in children under 5 years of age

WHO recommends pneumococcal vaccines are introduced globally

World's biggest child killer

The most common cause of pneumonia – the world’s leading killer of children – is the pneumococcal bacterium, Streptococcus pneumonia.

WHO estimates that more than 500,000 young children die each year from pneumococcal infection, with the vast majority of these deaths occuring in developing countries.

In addition to pneumonia, the pneumococcus is also responsible for an important cause of meningitis, which often leaves survivors with permanent disabilities, including mental retardation, paralysis and seizures.

The bacterium also causes sepsis (blood poisoning), which can lead to death or amputations, and otitis media (infection of the middle ear), which can lead to permanent deafness.

Safe, affordable vaccines

The most effective way to prevent these deaths is to ensure that all children have access to safe, affordable vaccines. This was recognised in the 2007 WHO recommendation - and subsequently reinforced in 2012 - that pneumococcal vaccines be introduced into all national immunisation programmes, particularly in countries with high child mortality.

Map showing global burden of pneumococcal disease. Source: Gavi, June 2010

Pneumococcal global disease burden 

Gavi launches Advance Market Commitment to accelerate production of pneumococcal vaccines targeting needs of developing countries

Pneumococcal AMC

To accelerate the development and production of a new generation of pneumococcal vaccines - better targeted to the epidemiology in developing countries and made more affordable - Gavi, the World Bank and donors launched the pneumococcal Advance Market Commitment (AMC) in 2009.

Thanks to agreements between Gavi and two manufacturers to date, the Vaccine Alliance and developing countries will pay a maximum US$3.50 per dose of pneumococcal vaccines procured in the coming years - less than 10% of the cost of the same vaccines currently being sold in the European Union and United States.1 

Gavi expects additional manufacturers from emerging markets to submit new pneumococcal vaccines for participation in the AMC in the near future.

The AMC was designed to give manufacturers an incentive to invest in:

  • finalising pneumococcal vaccines that include coverage for the additional serotypes which commonly cause disease and death in low-income countries;
  • increasing manufacturing capacity to provide the appropriate pneumococcal vaccines in sufficient quantities to meet demand.

At the same time, developing country governments can budget and plan for their immunisation programmes, knowing that vaccines will be available in sufficient quantity and at a price they can afford in the long-term.


Parallel to the AMC and to help developing countries lay the groundwork for introducing pneumococcal vaccines as soon as they become available, Gavi set-up the Pneumococcal vaccine Accelerated Development and Introduction Plan (PneumoADIP) in 2003. 

The Vaccine Alliance and the Pneumococcal AMC

  • The World Bank: fiduciary support.
  • Industrialised countries: the governments of Italy, the United Kingdom, Canada, Russia, Norway and the Bill & Melinda Gates Foundation committed a total US$1.5 bilion to launch the programme.
  •  Gavi committed to US$ 1.3 billion to support the cost of vaccines from 2010-2015, as well as programmatic and administrative support.
  • WHO established the minimum technical criteria for the vaccines and provides technical assistance as required.
  • UNICEF is responsible for vaccine procurement and distribution.

Based at the John Hopkins Bloomberg School of Public Health in Baltimore, USA, the PneumoADIP worked to increase demand for and access to pneumococcal vaccines by establishing and communicating the evidence base around burden and epidemiology of pneumococcal disease for decision-making in low-income countries, supporting the development of financing mechanisms and ensuring adequate supply to meet demand. More information about the PneumoADIP may be obtained by contacting the International Vaccine Access Center at Johns Hopkins University.

Routine immunisation support

In the same year, following an investment case developed by the PneumoADIP, Gavi decided to offer financial support for the introduction of pneumococcal vaccines through its new and underused vaccine programme.

From 2010-2015, Gavi has endorsed up to US$ 1.3 billion to fund pneumococcal vaccines that are suitable for low-income countries through the AMC.

To be AMC eligible, vaccines must meet specific criteria developed by WHO and be approved by the Independent Assessment Committee (IAC) of the AMC.


 1 For approximately 20% of doses, companies will receive an additional payment of US$3.50 for each dose they provide; donor commitents will cover the extra cost. 

Pneumococcal factsheet

Pneumococcal disease factsheet thumb

Download the Pneumococcal factsheet 


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