Leveraging the power of business relationships to curb a measles outbreak

Vaccine procurement is a continuous balancing act. It requires observation of a disease’s trajectory, data-driven forecasting and decisive action when needed. Essential to this is vaccine availability, enhanced by strong relationships with manufacturers.

UNICEF Supply Division
Child gets vaccinated

22 July 2019

UNICEF supplies vaccines to reach nearly half of the world’s children under five years old. Over the last five decades the measles vaccine has become widely available. Global deaths from the disease fell by 80 per cent during the period 2000–2017 alone.

But the threat from the disease has not gone away. In 2017, there were approximately 110,000 measles-related deaths globally, even though the disease is preventable through vaccination. Most of these victims were children: on average, 300 die from measles-related illnesses every day.

In 2018, an outbreak of measles in Georgia caused more than 2,200 men, women and children to be infected over the course of the year. Insufficient levels of immunization against the disease contributed to the outbreak.

Consequently, there was a sudden increased demand for the vaccine, which Georgia’s routine immunization stock was insufficient to meet. UNICEF was then able to support the Government by procuring emergency doses on its behalf. The terms of an existing long-term arrangement with a vaccine manufacturer meant that UNICEF could secure access to 100,000 doses to meet the unforeseen demand. The strong relationship with the manufacturer was instrumental in ensuring a rapid response.


As countries strengthen their health systems and implement routine immunization, the risk of the disease is lowered. However, when immunization coverage rates are not as high as they should be, populations can become vulnerable to outbreaks. As a result of lower coverage rates, even populations in some middle- and high-income countries with developed health systems have recently become vulnerable to a measles resurgence.

Because measles is highly contagious, vaccination coverage within a population should be at least 95 per cent and involve two doses of measles-containing vaccine. But as populations benefit from immunization, the incidence of a disease becomes rarer and people may forget that it remains a threat. The subsequent uncertainty in demand can be challenging for countries trying to forecast necessary stock levels for their programmes.

Uncertainty in demand can also impact the planning of production capacity for manufacturers. If a manufacturer overproduces, there is a risk of waste and increased costs. If it underproduces, sufficient doses of vaccine may not be available to respond to an outbreak such as the one in Georgia.

Good forecasting accuracy can also contribute to the sustainable reductions in vaccine prices. When manufacturers are confident of the accuracy of expected vaccine needs, they can achieve efficiencies in their production lines and reduce costs.

UNICEF works with vaccine suppliers continuously as part of its vaccine security strategy, so that surges in demand can be prepared for and responded to quickly. By continuing to work closely with businesses on the supply side and support governments to deliver their immunization programmes on the demand side, UNICEF and partners are leading efforts to protect children from this preventable disease.