Milestones in vaccine procurement, delivery and market shaping

A year of progress towards achieving equitable access to childhood vaccines.

A girl is smiling into the camera after receiving her polio vaccination.
20 April 2022

In 2021, UNICEF procured 2.299 billion doses of vaccines that protect children against diarrhoea, measles, pneumonia, polio, tetanus, tuberculosis and other potentially deadly preventable diseases.  

Thanks to the procurement principle of having multiple vaccine suppliers in place and ensuring buffer capacity in each market, UNICEF was able to place multiple orders with a range of suppliers even if one or more faced constraints during the COVID-19 pandemic.  

With its expertise in forecasting and anticipating demand trends and a strong knowledge of market dynamics and the vaccine industry, UNICEF was able to take into consideration the challenges of production and supply chain. As a result, UNICEF planning helped minimise risks to countries and ensured timely access to vaccines, despite difficult supply and logistical challenges. 

Complex logistics key to Pakistan’s mass MR vaccine introduction campaign 

One highlight in 2021 was UNICEF’s procurement of over 113 million doses of measles-rubella (MR) vaccine targeting every child between nine months and 15 years in Pakistan. 

Transporting such a massive quantity of vaccines – the second-largest MR vaccine procurement in UNICEF’s history – necessitated lengthy and complex logistical arrangements. The delivery of MR vaccines was undertaken in 41 commercial air shipments over five months without a single delay. The volume of auto-disable syringes required for the campaign could fill more than 180 40-foot containers.  

Careful planning was needed to ensure Pakistan’s health system could complete the campaign in just two weeks. More than 386,000 health professionals, including 76,000 vaccinators and more than 143,000 social mobilisers, were involved.  

A boy receives a vaccination against measles and rubella in his arm.
UNICEF/Pakistan2021/Asad Zaidi
Zafar Khan, a government vaccinator administers measles and rubella vaccination injection to a boy.

Towards a diverse and resilient supplier base in Africa 

2021 saw significant progress towards shaping the vaccine market in Africa.  

In April, UNICEF welcomed the African Union (AU) and Africa Centres for Disease Control and Prevention (Africa CDC) commitment to increase the share of vaccines produced in Africa from one per cent to 60 per cent by 2040.  

In line with its efforts to support a more diverse and resilient supplier base across the continent, UNICEF introduced an additional positive weighting in vaccine tender evaluations for prospective manufacturers who could contribute to strengthening the public health systems in African countries. 

A baby receives a vaccine dose in the arms of the mother.
A baby is being vaccinated in Boulpore, the central plateau region of Burkina Faso. UNICEF supports the center for the acquisition and supply of vaccines, therapeutic milks and nutritional foods that allow children to be treated and cured.

Malaria vaccine – a study in market shaping  

One early potential dividend of UNICEF’s work to encourage vaccine manufacturers to engage with the nascent African vaccine industry came in December 2021. 

Malaria is a leading cause of child mortality, and a preventative vaccine has been decades in the making.  

In 2019, a pilot rollout of the malaria vaccine RTS,S1/AS01e was launched in Ghana, Kenya, and Malawi. UNICEF provided demand forecasting, supplier coordination, and vaccine delivery for the Malaria Vaccine Implementation Programme (MVIP).  

By 2021, 1 million children had received the malaria vaccine in the three pilot countries. Evidence showed it reduced deaths by almost a third. 

As optimism grew around these results, UNICEF joined an advisory group for a WHO-commissioned malaria vaccine market study. In March, UNICEF began consulting with manufacturers and partners to design a procurement strategy to shape the first tender with the aim of accessing the largest quantity of the available malaria vaccine supply as quickly as possible. 

Based on data generated by the pilot, WHO recommended the widespread use of the malaria vaccine for children in sub-Saharan Africa and other regions with moderate to high P. falciparum malaria transmission.    

In December, UNICEF issued its first malaria vaccine tender. Through the use of firm procurement commitments, flexible pricing, readiness to maximise dose procurement and other special contracting tools, UNICEF underlined its readiness to incentivise vaccine manufacturers and developers and mitigate supplier risk.