Gavi’s impact 

The vast majority of Gavi-supported countries have introduced the pneumococcal vaccine, reaching more than 183 million children by the end of 2018.

Roll-out across three continents

Gavi aimed to support pneumococcal vaccine introductions in 45 countries by 2015. We reached this target already in November 2014, 13 months ahead of schedule. By the end of 2018, 59 Gavi-supported countries – more than 80% of those eligible to do so – had introduced pneumococcal vaccine into their routine programmes.  In October 2018, Haiti introduced the vaccine into its routine programme, helping to protect children in the poorest and most fragile country in the Americas.

Mongolia, which rolled out the vaccine in June 2016, became the first transitioned country to fully self-fund its pneumococcal vaccine programme, and was followed by Bhutan, which introduced in January 2019, bringing the number of Gavi-supported countries that have introduced pneumococcal vaccines into their routine programmes up to 60.

These vaccines, which protect against the main cause of pneumonia, are complex to develop and produce. In the past, they may have taken up to 15 years to reach low-income countries. Thanks to the Vaccine Alliance, these countries can now access the newest vaccines at the same time as high-income countries.

Advance Market Commitment

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. They have together contributed US$ 1.5 billion to the Advance Market Commitment (AMC) for pneumococcal vaccines.

The AMC aims to stimulate the development and manufacture of new vaccines for low-income countries.

Two manufacturers have thus far committed to supply 1.65 billion doses through 2027. The price of one pneumococcal vaccine was further reduced to US$ 2.90 per dose – less than 10% of the public price in the USA. This latest price drop, the third in three years, represents a US$ 0.40 drop since January 2017. We expect that other manufacturers will have new vaccines ready to take part in the AMC very soon.

More than 183 million children reached

Our support has helped countries immunise more than 183 million children against pneumococcal disease. In 2018, the Gavi Board approved support for catch-up vaccination campaigns in support of future introductions.

Coverage rates for pneumococcal vaccines are now as high in the developing world as they are in the west. Vaccination coverage in the Gavi-supported countries has reached 48% in 2018, up from 37% in 2015 and above the global average of 47%.

We are working with partners to ensure that supply of the vaccine remains stable. We also aim to make sure that countries that have yet to introduce get the support they need to do so. Another important goal is that existing programmes are sustainable over the long term.

The issue 

Leading cause of pneumonia 

Pneumococcal disease is caused by the Streptococcus pneumoniae bacterium. It is the leading cause of pneumonia, which kills more children each year than any other disease. 

Streptococcus pneumoniae can also cause meningitis, which often leaves survivors with permanent disabilities. Another pneumococcal infection is sepsis, which can lead to amputation or death. Pneumococcal otitis media, a middle ear infection, can result in permanent deafness. 

Pneumococcal infection claims the lives of more than 500,000 children every year. The vast majority of these deaths occur in low-income countries.  

Leading cause of pneumonia 

Pneumococcal disease is caused by the Streptococcus pneumoniae bacterium. It is the leading cause of pneumonia, which kills more children each year than any other disease. 

Streptococcus pneumoniae can also cause meningitis, which often leaves survivors with permanent disabilities. Another pneumococcal infection is sepsis, which can lead to amputation or death. Pneumococcal otitis media, a middle ear infection, can result in permanent deafness. 

Pneumococcal infection claims the lives of more than 500,000 children every year. The vast majority of these deaths occur in low-income countries.  

Pneumococcal vaccines

Safe and affordable vaccines are the most effective way to prevent pneumococcal infection.  

WHO recommends that all countries introduce pneumococcal vaccines in their immunisation programmes. This is particularly important in countries with high levels of child mortality. 

Gavi’s response 

Pneumococcal Advance Market Commitment (AMC)  

Gavi, the World Bank and donors launched the pneumococcal Advance Market Commitment (AMC) in 2009. The AMC helps countries access more affordable pneumococcal vaccines adapted to their epidemiology.  

  • The World Bank provides fiduciary support. 

  • Italy, the United Kingdom, Canada, Russia, Norway and the Bill & Melinda Gates Foundation committed US$ 1.5 billion to launch the AMC. 

  • Gavi has committed US$ 4 billion to support the cost of pneumococcal vaccines by the end of 2021. We also provide programmatic and administrative support. 

  • WHO has established specific criteria for the vaccines and provides technical assistance. 

  • UNICEF handles vaccine procurement and distribution. 

Learn more about the AMC

Pneumococcal Advance Market Commitment (AMC)  

Gavi, the World Bank and donors launched the pneumococcal Advance Market Commitment (AMC) in 2009. The AMC helps countries access more affordable pneumococcal vaccines adapted to their epidemiology.  

  • The World Bank provides fiduciary support. 

  • Italy, the United Kingdom, Canada, Russia, Norway and the Bill & Melinda Gates Foundation committed US$ 1.5 billion to launch the AMC. 

  • Gavi has committed US$ 4 billion to support the cost of pneumococcal vaccines by the end of 2021. We also provide programmatic and administrative support. 

  • WHO has established specific criteria for the vaccines and provides technical assistance. 

  • UNICEF handles vaccine procurement and distribution. 

Learn more about the AMC

The AMC gives manufacturers an incentive to invest in:  

  • finalising the development of pneumococcal vaccines that protect against more serotypes. These serotypes often cause disease and death in low-income countries. 
  • increasing their capacity to produce these vaccines in enough quantities to meet demand. 

At the same time, it gives low-income countries the assurance that enough vaccines will be available at a price they can afford over the long term. As a result, they are better able to plan and budget for their immunisation programmes. 

We expect more manufacturers to take part in the AMC in the near future. 

Routine immunisation support 

WHO recommends the use of pneumococcal vaccines in all countries. This is particularly important in countries with high pneumonia and under-five mortality rates. 

Gavi provides support for the pneumococcal conjugate vaccine and injection supplies. Further, countries receive a one-time vaccine introduction grant.   

Vaccines supported through the AMC have to meet specific criteria developed by WHO. They must also receive approval by Gavi’s Independent Assessment Committee (IAC). 

Learn more about the IAC

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