Immunization

Securing vaccine and vitamin A supplies

© UNICEF/NYHQ2010-1454/Nesbitt

Measles vaccines for an immunization campaign lay inside a ‘cold box’ that keeps vaccines at a constant low temperature to maintain their potency, here at the Ministry of Health’s Child Health Unit in Lusaka, Zambia.

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

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. 

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. 

The Challenge

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.

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 Solution

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

• In 2010, UNICEF procured around 2.5 billion doses of vaccines for 99 countries to protect children against a handful of killer diseases including polio, measles, tetanus, diphtheria, pertussis (whooping cough) and tuberculosis at a value of US $757 million. UNICEF supported 17 integrated health campaigns and child health days in 17 countries to benefit over 62 million people.
• UNICEF Supply secured vaccine price decreases that will result in savings of US $98 million in 2011-2012.
• Oral polio vaccine (OPV) procurement remained the highest for UNICEF in 2010, with 1.9 billion doses in support of the Global Polio Eradication Initiative (GPEI). Other procurement included 169 million doses of measles vaccines, 106 million doses of BCG, and 130 million doses of tetanus vaccines.
• Among non-EPI health interventions, 633.5 million vitamin A supplements were shipped to 76 countries and 23 million long-lasting insecticide-treated bed nets were shipped to 41 countries.
• 156 million doses of vaccines and 187 million pieces of safe injection supplies (valued at $360 million and $9 million respectively) were procured on behalf of GAVI and delivered to 64 countries.
• UNICEF Supply procured 97.5 million doses of pentavalent vaccine, which combines five vaccines to protect against diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenzae. At US $292 million, pentavalent is UNICEF biggest single expenditure towards reducing child mortality.

For more details see the Immunization related pages on the UNICEF Supplies and Logistics website.