Vaccines, inspiring innovation in health

Abstract

This report covers the topics of pandemics, epidemics and partnerships, including regulatory convergence initiatives, new technologies and novel vaccines, discussed by leading public and private sector stakeholders at the 18th Annual General Meeting (AGM) of the Developing Countries Vaccine Manufacturers' Network (DCVMN). Contributions of Gavi and the vaccine industry from emerging countries to the growing global vaccine market, by improving the supply base from manufacturers in developing countries and contributing to 58% of doses, were highlighted. The Coalition for Epidemic Preparedness Innovations (CEPI), the International Vaccine Institute (IVI) and others reported on new strategies to ensure speedy progress in preclinical and clinical development of innovative vaccines for future MERS, Zika or other outbreak response. Priorities for vaccine stockpiling, to assure readiness during emergencies and to prevent outbreaks due to re-emerging diseases such as yellow fever, cholera and poliomyelitis, were outlined. The role of partnerships in improving global vaccine access, procurement and immunization coverage, and shared concerns were reviewed. The World Health Organization (WHO) and other international collaborating partners provided updates on the Product, Price and Procurement database, the prequalification of vaccines, the control of neglected tropical diseases, particularly the new rabies elimination initiative, and regulatory convergence proposals to accelerate vaccine registration in developing countries. Updates on supply chain innovations and novel vaccine platforms were presented. The discussions enabled members and partners to reflect on efficiency of research & development, supply chain tools and trends in packaging technologies improving delivery of existing vaccines, and allowing a deeper understanding of the current public-health objectives, industry financing, and global policies, required to ensure optimal investments, alignment and stability of vaccine supply in developing countries.

Keywords: Developing countries; Epidemic; Procurement; Stockpiling; Technology; Vaccine manufacturing.

Fig. 1

DCVMN contribution to Gavi market. The critical role of DCVMN in ensuring high proportion of vaccine availability in number of doses (pie chart) to Gavi countries. The growing number of manufactures supplying Gavi (columns chart) from emerging countries is illustrated by yellow bars, as compared to vaccine manufacturers from industrialized countries, light blue bars, and other regions, dark blue bars. Courtesy of S. Berkley, Gavi. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

Fig. 2

Overview of global vaccines’ markets by income and by vaccine family. Graphic illustration of the proportion of global vaccine market volume and value by countries income groups (left chart) and among 11 vaccine families (right chart). Note that non-Gavi Middle Income Countries represent about 63% of global vaccine market by volume and about 16% by value. USA = United States of America; HICs = high income countries; UMICs = upper middle-income countries; LMICs = low middle-income countries; LICs = low income countries. BCG = Bacillus Calmette–Guérin; DTP = diphtheria-tetanus-pertussis; Flu = influenza; HPV = human papillomavirus; MCV = measles containing vaccines; Men = meningitis; PCV = pneumococcal conjugated vaccines; Polio = poliomyelitis virus; PPSV = pneumococcal polysaccharide vaccine; Rota = rotavirus, TDs = tetanus-diphtheria. Source: V3P&, Global Vaccine Market Model (GVMM), Linksbridge, SPC, Bill & Melinda Gates Foundation funded project, September 2017. Courtesy of T. Cernuschi, WHO.

Fig. 3

UNICEF responses to humanitarian situation from 2005 to 2016 showing resources (blue line/blue circles) and number of UNICEF emergency global responses (red line/red circles), and number of countries served (grey line/grey circles) annually, over the last decade. In 2016, 108 country offices responded to 344 humanitarian situations, the most since UNICEF began tracking in 2005. Since 2010, UNICEF has responded to an average of over 300 humanitarian situations in nearly 90 countries each year. Number of country offices in 2016 in responding to emergencies is 37% higher than five years ago (79 in 2012). Courtesy of S. Rautio, UNICEF. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

Fig. 4

Confirmed number of cases of MERS globally reported to WHO, since 2012 in Saudi Arabia (dark blue columns), in Republic of Korea (red columns) and other countries (light blue colums). Courtesy of J. Kim, IVI, and WHO. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)

Fig. 5

HEATmarker® VVM and VVM+ color evolution when exposed to a single heat excursion. The HEATmarker VVM+ indicator includes a peak temperature threshold indicator in addition to the VVM in the same device, reacting as a VVM at temperatures up to 37 °C, but reaching the endpoint rapidly after exposure to a defined peak temperature, in this case 40 °C. VVM+ reacts like a VVM up to 37 °C. At 40°, VVM+ reaches the endpoint rapidly to show exposure to critical peak temperature. Courtesy of M. Rush, Temptime.