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TRANSCRIPT
The PAHO Revolving Fund
Portfolio update
DCVMN Annual Meeting 2013
Hanoi, Vietnam October 7 – 9, 2013
Content
• The Americas: Highlights of the immunization programs
• The PAHO Revolving Fund
• Update on the vaccine portfolio
Population (2012): 953,733,000 Average annual birth rate: 15,547,000 Reported DTP3 Coverage (2012): 93%
2012 Population (in thousands)
5.118 - 1000
1000.01 - 5000
5001.01 - 10000
10000.01 - 100000
100000.01 - 400000
The Americas
PAHO
35 Member States
4 Associated Members
12 Territories
(6UK, 3 French, 3 Netherlands)
0
50,000
100,000
150,000
200,000
250,000
300,000
80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
0
20
40
60
80
100
Cases Coverage
Catch-up campaigns
*1310 confirmed cases in 2011; data as of 13 January 2012.
Follow-up campaigns
Ro
utin
e in
fan
t va
cc
ina
tion
co
ve
rag
e (%
)
Co
nfirm
ed
ca
ses
(th
ou
san
ds)
0
20000
40000
60000
80000
100000
120000
140000
78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10
0
20
40
60
80
100
Pertussis Diphtheria Coverage
Co
ve
rag
e (%
) Nu
mb
er o
f C
ase
s
Measles elimination*
0
1000
2000
3000
4000
5000
6000
7000
70 72 74 76 78 80 82 84 86 88 90 92 94 96 98 00 02 04 06 08 10
0
10
20
30
40
50
60
70
80
90
100
Cases Coverage
Nu
mb
er o
f c
ase
s
Co
ve
rag
e (%
)
Type 1 vaccine derived virus in 2000 and 2001: 21 cases
Polio Eradication
Diphtheria and Pertussis
0
20,000
40,000
60,000
80,000
100,000
120,000
140,000
82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08 09 10 11
0
20
40
60
80
100
Cases Routine coverage
Rubella Elimination*
Acceleration Campaign
Nu
mb
er o
f c
ase
s
Co
ve
rag
e (%
)
*7 confirmed cases in 2011; data as of 13 January 2012.
Ellimination and Eradication in the Americas
"New vaccines" in the Americas, 2012
• 90% of the birth cohort in the Region is in countries that
already include the pneumococcal vaccine in its regular
program (60% of the cohort of LAC)
• 87% of cohort is living in countries that already use
rotavirus vaccine (60% of the cohort of LAC)
• 58% of girls 10 - 14 years old live in countries that have
the HPV vaccine
Vaccines declared as a public good
Pan Americanism and Solidarism
Continuous availability of quality
vaccines
Strong social acceptance
Success of the Program
Immunization Program
in the Americas
The Regional Immunization Program
in Latin America & The Caribbean:
Laws and Source of Funds
0
200
400
600
800
1000
1200
1400
1600
1800
2000
1987-91 1992-96 1997-01 2002-06 2007-08 2009-10
Re
gio
na
l E
PI C
os
t (U
S$
Millio
n)
0
5
10
15
20
25
National Funds External Funds Immunization Laws
79% 92%
99%
94%
90%
99%
2012:
27 countries with
immunization laws
6
WHAT IS PAHO? • The Pan American
Health Organization
(PAHO) is the oldest
international public
health agency in the
world founded in 1902
• It is the specialized,
public health, technical
cooperation agency of
the Inter-American
System
Inter–American System
UN
System
Specialized Agency of the
Organization of American States
PAHO
PAHO’s Comprehensive
Technical Cooperation
Technical Advisory Group
(TAG)
Evidence Based
Decision Making
(PROVAC)
Revolving
Fund
Sustainability, Immunization
Laws
Laboratory Network
Epidemiological
Surveillance
Strengthening NRAs
1977 PAHO Directing Council
Resolution CD25.R27
The Expanded Program on
Immunization (EPI) of the
Americas is created: Regional
Immunization Program
The Revolving Fund for
Vaccine Procurement, launched
in 1979, as part of the EPI,
Supply of essential vaccines,
syringes and other related
products without interruption
The PAHO Revolving Fund
Key Figures 2012
60 products “41 biologicals” / 10 syringes / 9 cold chain”
211 MM doses
41 destinations “35 countries and 6 territories”
1,345 Purchase Orders
US$ 512 MM Procured value US$102 MM Capital Fund
The PAHO Revolving Fund
Processes • Annual planning and reconfirmation of deliveries.
(PAHO-173)
• Informative Session: Status of Immunization Program in the Americas
Demand Planning
• Invitation to Bid (ITB) or Requests for Quotation (RFQ)
• 2014 / single and multi year agreements
• Bid Opening Ceremony with producers that submitted offers Procurement
• Selection Criteria: Price, quarterly availability, performance, technical review, principally.
Selection and award
• PAHO supports on the shipping and claim management
• Shipments delivered to consignee (MOH) / INCO term (DAT) Shipping & Expediting
June - July
August-
September
November
On going
Note: Procurement Process described just for reference.
Criteria, activities and dates could vary.
How vaccines are included in
the portfolio? Recommended by SAGE / PAHO TAG / PAHO IM
technical unit
Included in the National Immunization Program of at
least one country.
Included in the WHO PQ program, if not,
Included in WHO PQ program: licensed by FDA (USA),
EMA (Europe), BGTD (Canada), TGA (Australia) or
KFDA (Korea).
BCG DTP Hib HepB Polio MMR YF Seas. Flu
Rota PCV HPV Pneum
23 Hep A Varicella Meng
Antigua Argentina Bahamas Barbados Belice Bolivia Brazil Canada Chile Colombia Costa Rica Cuba Dominica Dominican Republic Ecuador
El Salvador Grenada Guatemala Guyana Haiti MR
Honduras Jamaica Mexico Nicaragua Panama
Paraguay Peru Saint Kitts Saint Lucia Saint Vincent Suriname Trinidad & Tobago UKOTs Uruguay United States Venezuela
Vaccines used in
the Americas
through the
national
immunization
programs 2013
Source: PAHO/WHO-UNICEF Joint Reporting Forum (JRF)
Use of seasonal influenza vaccine and formulations in the Americas 2012
Source: Country and territory reports to PAHO, MOH websites, WHO survey
Northern
Hemisphere
Southern
Hemisphere
Vaccine not yet
introduced in the
public sector
Belize
Honduras
El Salvador
Nicaragua
Panama
Costa Rica
Brazil
Paraguay
Uruguay
Argentina
Ch
ile
Pe
ru
Ecuador
Colomb
ia
Venezuela
Cuba Bahamas
Turks & Caicos
Jamaica Haiti Dominican
Republic
Anguilla
Barbados
Trinidad & Tobago
Antigua &
Barbuda
St. Lucia
Guatemala
Number of countries with: 2004 2008 2012
- Public policies for influenza vaccination
13 35 40
- Vaccination of children 6 22 25
- Vaccination of elderly 12 33 38
- Vaccination of persons with chronic diseases
9 24 32
- Vaccination of health workers 3 32 37
- Vaccination of pregnant women 3 7 22
Source: Country Reports to PAHO, MOH web pages, PAHO/WHO Surveys
Note: Data was not collected from the French Departments (French Guiana, Guadeloupe, Martinique)
40/45
Pending of introduction:
Haiti, Guyana & St. Kitts & Nevis
Change in JRF Reporting status
Montserrat
St. Vincent
Vaccine introduction: St. Marteen
1
17
4
14
4
0
2
4
6
8
10
12
14
16
18
2006 2007 2008 2009 2010 2011 2012
Cum
ula
tive
nu
mb
er o
f co
un
trie
sw
ith
un
iver
sal v
acci
nat
ion
Year
Pneumococcal conjugate Rotavirus HPV
(3 GAVI)
(4 GAVI)
Introduction of new vaccines
The Americas through PAHO RF 2012
Final considerations
The PAHO Revolving Fund • Vaccine Opportunities
• Benefits for Manufacturers
o A “Single window” to access
40 countries
o Sustainable demand
o Technical support to countries
on demand planning
o 60 days credit line to countries
supports promptly placement
of POs
o Prompt payment
o Post marketing surveillance
• Limited global supply Yellow Fever vaccine
Traditional vaccines
•Vaccines to target wide ranges of target populations (children – pregnant women – elderly)
Seasonal Flu
• High value market (PCV, Rota, HPV)
Priority new vaccines
• Increasing uptake of:
• Varicella, DTaP, Hep A Other
vaccines
