PRESENTATION TO THE MSF VACCINE MEETING

YOGAN PILLAY, DEPARTMENT OF HEALTH, SOUTH AFRICA

OSLO 15 OCTOBER 2013

EPI Schedule

HPV in 2014 2

RSA EPI Vaccine Annual Requirement

Vaccine Annual requirements in doses

Value contribution to EPI budget

TT 3 514 800 1% Td 2 240 400 1% DTaP-Hib-IPV 4 000 000 34% Rotavirus 2 000 000 10% Pneumo 3 000 000 36% Hep B 3 924 520 1% OPV 4 580 500 3% Measles 5 449 000 4% BCG 6 389 000 1% HPV (in 2014) 1 000 000 10%

Doses per annum 36 235 061

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Annual spend on vaccines

• Total: R1.7b • EPI: R1.4b • Non EPI: R80m • Private sector: R250m • Total annual public sector exp: R100b • Total annual private sector exp: R100b

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Supply issues

Vaccine Supply Issues Source No of registered products in SA

TT Generally ok Sanofi ( France) 1

(Biovac filing for registration in 2014)

Td Generally ok Sanofi ( France) 1

DTaP-Hib-IPV Had issues in 2012 but 2013 smooth Sanofi (France) 1

Rotavirus Had issues in 2011 but 2012+2013 ok GSK ( Belgium) 2

Pneumo No issues Pfizer ( USA & Ireland)) 2

Hep B Quality issues in 2013 Will hopefully be resolved by end 2013

Heber ( Cuba) 3

OPV Worlwide demand and campaigns has affected supply to SA in 2013

Sanofi (France) 1

Measles Worlwide demand and campaigns has

affected supply to SA

Sanofi( France) 1

(Biovac hoping to have a registered one in 2014)

BCG Slight supply issues in early 2013, not major.

SSI ( Denmark) 1

HPV N/A GSK 2

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Differences between comparison of PAHO + UNICEF vs SA SA PAHO + UNICEF

Decision making Independent, DoH+ NAGI General. Supranational organisations: WHO ,SAGE,GAVI ,BMGF play a huge role

volumes lower Much larger

Presentation of product SA specific packs International pack

Payment Biovac collects 60days after delivery Upfront payment before deliveries are made

Price Public sector prices (Biovac to DoH) c are all inclusive of deliveries to the customer and included in the prices that are in the ‘public’ domain

Prices typically reflect ex-manufacturers prices. Not included in the prices that are in the public domain are extra charges , see below: UNICEF: procurement services handling fee of 4.5%, requirement for a 10% buffer until the transaction has been completed, and freight and insurance costs PAHO: 3.5% of the net cost of the goods (excluding freight and insurance). The 3% goes to the common capital fund to be used by PAHO as working capital to provide a line of credit to participating Member States, and a 0.5% contributes towards the administrative and purchasing activity costs.

Products • SA uses acellular pertussis penta • IPV already introduced through the

pentavalent • Pneumo= SA uses a 2+1 schedule • HPV= unique 2 dose schedule will

be implemented

• Mainly whole cell pertussis penta being used • IPV is only being introduced through the polio eradication

plan from 2016 • The traditional 3+o schedule is used • HPV= 3 dose schedules to be adopted

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Source: World vaccines, 2007

Egypt

Senegal

African Human Vaccine Manufacturers

South Africa)

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Developing Regions birth cohort and the proportion of vaccine manufacturers

Region Birth cohort

No of Vaccine manufacturers

Africa 47m 3

Asia 61m >20

Latin America 10,7m 7

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Thank you for your attention!

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