UNITE FOR CHILDREN

Immunization

Securing vaccine and vitamin A supplies

GOAL: UNICEF will ensure global vaccine and vitamin A supplies. Specifically, UNICEF will sustain an uninterrupted, long-term supply to low-income countries through reliable forecasting and secure, stable funding.

“We are extraordinarily concerned about the future of vaccine supply.  UNICEF meets around 40 per cent of the global demand for children’s vaccines. We have already had several temporary vaccine shortages and it seems to be becoming a global problem.” — UNICEF Deputy Director, Supply Division, Stephen Jarrett.

The Challenge

For more than 50 years UNICEF has been supplying vaccines to the world’s children as part of global immunization and disease-control campaigns, beginning with BCG for childhood tuberculosis in the late 1940s. In 2003, UNICEF procured 2.5 billion doses of vaccine for nearly 100 developing countries to protect children against a handful of killer diseases, including polio, measles, tetanus, diphtheria, pertussis (whooping cough) and tuberculosis.

UNICEF is a major supplier of vaccines for the campaigns to eradicate polio, eliminate maternal and neonatal tetanus and to control measles. UNICEF also supplies vaccines for the Global Alliance for Vaccines and Immunization (GAVI), which is focussed on delivering new and underused vaccines to the poorest countries.  Under the GAVI safe injection programme, UNICEF shipped more than 54 million auto-disable syringes to 18 countries.

UNICEF Vaccine Supply:

  • 1.9 billion doses oral polio vaccine (OPV) through 2003
  • 185 million doses of measles vaccine per year by 2003
  • 180 million doses of tetanus toxoid per year to eliminate maternal and neonatal tetanus (MNT)
  • 350 million doses of hepatitis B and Hib vaccines through 2003

In recent years, UNICEF has found it increasingly difficult to meet the demand for vaccines – both in terms of quantities and timing – and vaccine shortages are threatening to jeopardize immunization programmes. Changes in the market – mergers between large pharmaceutical companies and diverging vaccine usage among industrial and developing countries – have reduced the number of manufacturers that are producing traditional childhood vaccines. Many have stopped, or dramatically reduced, production of the older, inexpensive vaccines in order to produce newer, more profitable pharmaceuticals.

“The major wakeup call for us was the polio vaccine. In 1999, the decision was made to dramatically increase immunization activities in 20 endemic countries. This meant that the demand for oral polio vaccine (OPV) tripled overnight. We had large contracts for the polio vaccine, but nowhere near the amount required.  For the first time, the availability of vaccines was determining the eradication activities.” —  UNICEF Deputy Director, Supply Division Stephen Jarrett.

The Solution

Most vaccines require one or two years to produce. To guarantee a steady supply of vaccines, it is critical that manufacturers have sufficient advance orders and assurances that there will be demand for their products. UNICEF has not been able to make long-term commitments to manufacturers in the past because funding from donor countries has been set year by year. Without such commitments, manufacturers can’t guarantee that production lines for inexpensive childhood vaccines will remain available.

As the largest buyer of vaccines for the world’s poorest countries, UNICEF is taking several steps to avert a crisis and ensure the reliability of vaccine supply. First, UNICEF is trying to enter into more guaranteed procurement with major suppliers so they can plan ahead, confident that UNICEF will buy their vaccines. Secondly, UNICEF is appealing to donors to make long-term financial commitments for multi-year periods. Lastly, UNICEF is working with the World Health Organization (WHO) to improve the planning, forecasting and management of vaccines once they reach their destinations.

Progress

  • UNICEF shipped 1.9 billion doses of oral polio vaccine (OPV) in 2003. Globally, the OPV was used for National Immunization Days and smaller
    ‘sub-national’ immunization days.
  • Other Expanded Programme on Immunization (EPI) vaccines: UNICEF shipped 132 million doses of diphtheria, pertussis and tetanus (DPT), 117 million doses of Bacille Calmette-Guérin (BCG), 110 million doses tetanus toxoid (TT), and 95 million doses of measles vaccine in 2000.
  • Non-EPI vaccines: UNICEF purchased 3.9 million doses of yellow fever vaccine, 5.1 million doses of hepatitis B, 2 million doses of measles, mumps and rubella (MMR), and shipped 100,000 doses of Haemophilus influenzae type b (Hib) vaccine that were provided by the manufacturer, in 2000.
  • UNICEF’s Supply Division distributed some US$5.5.million worth of donated vitamin A capsules and iron folate supplements in 2000.
  • UNICEF shipped 144 million auto-disable syringes and over one million safety boxes in 2000.
  • In 2000, UNICEF Supply Division purchased US$11 million worth of cold-chain equipment, including vaccine carriers, cold boxes and freezers.
  • UNICEF’s Pretoria Procurement Centre in South Africa purchased US$4.5 million in malaria-related commodities such as bed nets, for the Roll Back Malaria initiative in 2000.

 

 

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