Haemophilus influenzae type B (Hib) is a bacteria responsible for severe pneumonia, meningitis and other invasive diseases almost exclusively affecting children aged less than five.
Hib vaccine, an essential commodity for child survival, is primarily given as part of the pentavalent combination vaccine, a 5 in 1 vaccine which also protects against diphtheria, pertussis, tetanus and hepatitis B, making administration and logistics of the multiple components easier at the local level.
Since 2001, the Global Alliance for Vaccines and Immunization (GAVI) has provided support to the poorest countries in the world to immunize children against Hib. However, the introduction of Hib vaccine in the pentavalent combination has faced a number of challenges. Prime among these was that the supply market for this vaccine was extremely limited. When GAVI was created in 2000, the pentavalent combination vaccine was available from only one manufacturer and in insufficient quantities. It takes a substantial investment on the part of the manufacturer and usually a minimum of five years to establish WHO prequalified vaccine production.
In addition to limited capacity, many countries were hesitant to introduce the vaccine due to insecurity related to supply availability and concerns about the high price.
In an extensive market shaping exercise, UNICEF and GAVI partners successfully transformed this situation. Substantial efforts were made to improve transparency and helped reduce the demand insecurity felt by manufacturers. This was done by providing detailed forecasting with close to 90 per cent accuracy, long-term funding security through GAVI, and appropriate contracting including firm commitments to back specific production planning. Combined with frequent manufacturer consultations and documented demand increases, these steps have encouraged new manufacturers to enter the market. In 2006, a second manufacturer for pentavalent vaccine became WHO pre-qualified, followed by a third and fourth in 2008. Supply Division expects a minimum of five manufacturers to be WHO pre-qualified for pentavalent during 2010-2012.
By the end of 2008, almost 40 countries have introduced pentavalent vaccine with GAVI support and UNICEF supplies, including Ethiopia and Pakistan. A number of other countries have already been approved to introduce the vaccine in 2009. Demand is expected to reach approximately 200 million doses per year during 2010-2012, with sufficient supply to meet demand, and further price decreases expected during this period.