Transforming global access to vaccines
Five reasons why UNICEF’s pooled procurement approach is crucial to deliver vaccines affordably and on time.
Every year, UNICEF delivers more than 2 billion life-saving vaccines help to protect children against diseases such as measles, pneumonia and polio. At the heart of this work is ‘pooled procurement’ – a process where UNICEF forecasts and combines vaccine demand from the countries it supports to get better commercial terms from manufacturers than the countries could on their own. It gives suppliers a long-term sense of the doses required, allows for large-scale production of vaccines, and helps UNICEF to get competitive prices by asking manufacturers to submit proposals for supply.
Here are five reasons why this procurement approach is so important.
1. Uninterrupted supply of life-saving vaccines
UNICEF procures childhood vaccines to reach 45 per cent of the world’s children under five years of age, working with countries to estimate expected vaccine requirements for the coming years. This enables UNICEF to plan for supplies to be available with manufacturers who require long-term visibility due to the complexity of vaccine production, which can take up to 24 months.
In the tendering process, manufacturers submit details such as vaccine pricing, cold chain requirements and yearly availability of doses. UNICEF then evaluates the commercial offers while the World Health Organization (WHO) reviews the technical aspects of these proposals. This process kickstarts UNICEF’s negotiations with suppliers before vaccine supply contracts are signed.
The ideal mix of vaccines and suppliers is determined by factors such as the suitability of vaccines for the country context, pricing, delivery times, production capacity and geographical distribution of the suppliers.
2. Driving down the price of vaccines
Pooled procurement offers significant benefits by allowing countries to access vaccines at lower prices than they would typically obtain through individual negotiations with manufacturers. This is accomplished through economies of scale, whereby manufacturers can reduce their costs and streamline production processes by manufacturing larger volumes of vaccines over extended periods. It also means they only need to deal with one buyer, such as UNICEF, and the costs associated with dealing with multiple buyers are reduced. Access to lower pricing is significant for countries that procure smaller volumes and where there are fewer benefits in negotiating individually with manufacturers.
3. Building healthy markets
As the largest single vaccine buyer in the world, UNICEF works with partners to ensure vaccine markets remain healthy now and in the future. This is why UNICEF’s tender process takes into account much more than just pricing and production schedules. For instance, it’s critical that we ensure there is more than one manufacturer of each vaccine to avoid a situation where prices increase and vaccine supply could be compromised. To offset this risk, UNICEF evaluates manufacturers’ proposals against a set of criteria to reduce market barriers for existing and future vaccines. Alongside this, UNICEF works with new suppliers and encourages them to enter the market when appropriate, while incentivizing others to innovate to meet the needs of countries.
4. Partnerships are key to progress
UNICEF does not work alone to procure vaccines. It requires a mix of funding from donors, consultations with the vaccine industry and competitive tenders to secure access. UNICEF works in collaboration with multiple disease prevention partnerships such as the Global Polio Eradication Initiative and the Measles and Rubella Initiative. UNICEF is also a member and the main procurement agency of Gavi, the Vaccine Alliance, which consists of several partners including WHO, the World Bank, the Bill and Melinda Gates Foundation (BMGF), civil society organizations and governments. Only through regular collaboration can UNICEF continue to reach children with the vaccines they need.
5. Success stories
UNICEF’s pooled procurement of vaccines has helped countries make big strides in their routine immunization efforts, and the procurement of the pentavalent vaccine stands out as a success story. The vaccine protects against diphtheria, tetanus, pertussis, hepatitis B and haemophilus influenzae type b – five potentially fatal diseases.
In 2001, only one manufacturer produced the vaccine, meaning there were insufficient doses to protect every child that needed it. Although there were two suppliers by 2007, the price per dose was still high at US$3.50. Through funding from Gavi, the Vaccine Alliance, and UNICEF’s efforts to consolidate the demand on behalf of low-income countries, it helped to create opportunities for manufacturers to enter the market. Today, thanks to ongoing efforts to build a healthy vaccine market, four manufacturers supply the pentavalent vaccine to UNICEF, with the lowest price at US$0.78 cent per dose – a nearly 80 per cent decrease in price since 2007. In 2022, UNICEF delivered pentavalent vaccines to 76 countries.
Pooled procurement, alongside UNICEF’s efforts to shape a healthy market, enables equitable access to life-saving vaccines for every child.