GAVI Alliance

Partnership objectives

  1. Vaccine goal: accelerate the uptake and use of medicines.
  2. Health systems goal: strengthen capacity of integrated health systems to deliver immunization.
  3. Financing goal: increase predictability and sustainability of financing for immunization.
  4. Market-shaping goal: shape vaccine markets to provide appropriate and affordable vaccines.

Committed to saving children’s lives and protecting people’s health through the widespread use of vaccines. Committed to saving children’s lives and protecting people’s health through the widespread use of vaccines. Copyright GAVI Alliance

What are the health needs and challenges?

With 20% of the world's children not vaccinated, the GAVI Alliance is seeking to reach more children with life-saving vaccines. Each year, 1.7 million children die from a vaccine-preventable disease. The overwhelming majority of these deaths occur in developing countries. That's one life every 20 seconds. Twenty-three million children in developing countries do not receive life-saving vaccines that parents in wealthy nations take for granted.

Description of partnership activities and how they address needs and challenges

The GAVI Alliance was founded in 2000 by the Bill & Melinda Gates Foundation, the World Bank, the WHO, UNICEF and vaccine manufacturers, including Sanofi Pasteur, Pfizer, MSD, GSK, Novartis, and Janssen Pharmaceutical Companies (previouslly called Crucell) of Johnson & Johnson. Committed to saving children’s lives and protecting people’s health through the widespread use of vaccines, GAVI’s driving objective is to make a critical contribution to global immunization goals by supporting immunization programs and health systems, and accelerating the introduction of new vaccines.

GAVI addresses three critical gaps in the provision of vaccines:

  • between children for whom immunization is a given and the 23.2 million children worldwide with no access to vaccines;
  • between the introduction of a new vaccine in rich countries and the average 10-15 years required for the same vaccine to reach low-income countries;
  • between the need for new vaccines in developing countries and the lack of research and funds to provide them.

GAVI supports new and underused vaccines, health system strengthening, immunization services, injection safety and civil society organizations In total, GAVI has committed USD 7.2 billion since 2000. Eighty (80) percent has been committed towards the purchase of vaccines. The GAVI Fund provides financial support to low-income countries, based upon applications to and recommendations by the GAVI Alliance Board. Besides, industry partners invest in the development of new vaccines and in enhanced global vaccine manufacturing capacity, including facilities in developing countries. They also help to educate healthcare providers and develop technologies to facilitate vaccine distribution.

The GAVI Alliance has also organized a major initiative to contain the risk of yellow fever epidemics. Since 2003, the Group has provided more than six million doses per year of yellow fever vaccines funded by GAVI to go toward emergency stockpiles of vaccines, in order to prevent epidemics in Africa.

Other challenges include: ensuring contributions of all the Board partners; GAVI and Industry constituency governance processes and transparency, management of COI (conflict of interest), improving demand forecast by GAVI to help industry align supply projections, and risk management by GAVI to ensure that funds are properly used in countries. UNICEF policy of supply security and contracts with manufacturers allows for minimal, if any, interruption of immunization programs, Coordination within the Global Vaccine Policy WG (including formal governance procedure related to GAVI work) ensures that all individual companies contribute their knowledge and positions, and all voices are heard and communicated.

GAVI achievements in 2015:

  • Average child mortality in Gavi-supported countries fell from 76 to a projected 63 deaths per 1,000 live births between 2010 and 2015, an unprecedented rate of reduction of 3.6% per year.
  • By helping countries to avert more than 4 million future deaths between the start of 2011 and the end of 2015, Gavi exceeded its target of 3.9 million for the five-year period. In addition, Gavi-funded measles vaccine campaigns conducted between 2013 and 2015 are estimated to have averted more than 300,000 future deaths. Since Gavi was set up in 2000, we have contributed to averting more than 8 million future deaths in developing countries.
  • By the end of 2015, 277 million children had been immunised with Gavi-supported vaccines relative to the end of 2010. This means that the Vaccine Alliance surpassed its target of immunising an additional 243 million children during the 2011–2015 period across all our routine vaccine programmes. Since our inception in 2000, we have supported countries in immunising close to 580 million children.

Industry partners invest in the development of new vaccines and in enhanced global vaccine manufacturing capacity, including facilities in developing countries. They also help to educate healthcare providers and develop technologies to facilitate vaccine distribution.

Janssen activities

Janssen support for GAVI includes supplying large quantities of the first internationally available thiomersal-preservative free, fully liquid pentavalent (5-in-1) vaccine Quinvaxem™, which protects children against 5 diseases (DTP-HepB-Hib) in one single shot. Since 2006, Janssen supplied more than 270 million doses of Quinvaxem™ to the world's poorest countries at discounted prices, including consistent supply when other pentavalent vaccines manufacturers were unable to do so.

From 2011 to 2014 Janssen's CEO represented the Industrialized Countries Vaccine Manufacturers constituency on the GAVI Board. From 2008 to 2011 janssen served on the GAVI Program & Policy Committee.

GlaxoSmithKline activities

GSK is one of the world’s largest manufacturers of vaccines: in 2013, they distributed over 860 million doses of vaccines to some 170 countriesa and 80% of these vaccines were delivered to people low income and middle income countries. For the last decade,GSK  has been the primary supplier of vaccines to UNICEF which purchases vaccines on behalf of GAVI. The GAVI Alliance benefits from GSK’s lowest prices as part of its tiered pricing approach. This approach is designed to support those countries which commit to vaccination for the long term and implement programs aimed at reaching large proportions of the target population. Tiered pricing reflects the fundamental value of immunisation as an investment in health. It also reflects GSK’s desire to enable countries to maintain and expand upon their commitment to immunisation as their economies grow. For the least well-off countries, GSK works closely with GAVI and UNICEF to improve access to vaccines.

In 2016, as a demonstration of GSK’s commitment to increase access to vaccines that can help save children’s lives in the world’s poorest countries, GSK offered a further eduction in the price of its pneumococcal vaccine, Synflorix, to Gavi, the Vaccine Alliance. GSK has a portfolio of more than 30 vaccines; these include vaccines against cervical cancer, rotavirus and pneumococcal disease, each of them highly innovative and each supported by GAVI. 

In 2014, GSK announced that it would freeze the prices of its vaccines for five years for developing countries that graduate from GAVI Alliance support.

In 2013, a 2 dose schedule of GSK’s Cervarix was licensed in Europe and some other countries for girls 9-14 years. Many countries face significant challenges in implementing national immunisation programmes in young adults and so a two-dosing schedule has the potential to be easier to deliver than a three-dose schedule.

Since 2002 GSK has supported the work of the Network for Education and Support in Immunization (NESI) to promote vaccinology training for healthcare workers in sub-Saharan Africa, North Africa and the Middle East. NESI has become a key partner of organizations such as the WHO, UNICEF and GAVI who implement vaccination programs in these regions.   In Sudan, GSK contributed to the introduction of the Rotarix vaccine by supporting social mobilization and training in partnership with the Ministry of Health. In Zambia, GSK supported the Program for the Awareness and Elimination of Diarrhea by donating Rotarix to vaccinate over 84,000 children in the District of Lusaka. This pilot project should be leveraged to develop capacity for national co-introduction of rotavirus and pneumococcal vaccines. GSK has also Cervarix, cervical cancer vaccine, which will be made available in developing countries with help from GAVI. GSK also is developing new vaccines for diseases which are future GAVI targets, including dengue and malaria.

MSD activities

MSD aims to achieve the broadest possible access to our vaccines within a sustainable framework—one that allows ongoing research, development, and distribution of innovative vaccines that address important unmet health needs. We do so through a comprehensive strategy that includes working with governments to build vaccination delivery programs that reliably reach people and also tiered (or differential) pricing–systematically pricing vaccines at differing levels appropriate to the value they create under the economic conditions where they are used–to facilitate broad access.

MSD has supplied over 4 million doses of GARDASIL® [Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant] and over 18 million doses of ROTATEQ® (rotavirus vaccine, live, oral, pentavalent) to Gavi through UNICEF from 2012-2016. 

In low-income countries, MSD offers ROTATEQ and GARDASIL at an access price that is the lowest available price in the world. The access price is exclusive to the public sectors of Gavi-eligible countries meeting the needs of the developing world by facilitating access to these innovative vaccines in the poorest countries, while making sure they remain affordable and sustainable in the long term.  For more developed middle-income countries, MSD practices differential pricing that considers many factors, including countries' ability to pay and others.

MSD is committed to working with partners, including Gavi, to improve access to GARDASIL and ROTATEQ in developing countries.  

In 2015, MSD committed to Gavi to extend its 2015 Gavi prices for GARDASIL and ROTATEQ to Gavi graduated countries. This renewed commitment to Gavi enables these countries to achieve continued access to our vaccines for 10 years (21016-2025).

In 2010, in partnership with the Government of Bhutan, the Australian Cervical Cancer Foundation, MSD began providing GARDASIL to eligible girls in the country.  More than 90% of targeted girls were vaccinated with three doses of the vaccine in the first year of the program.

In 2011, in a partnership with the Government of Rwanda, MSD began providing GARDASIL to , as part of a comprehensive approach to cervical cancer prevention that included both HPV vaccination and HPV DNA testing.  More than 96% of targeted girls were vaccinated with three doses of GARDASIL in 2011 and 2012.  This program has now fully transitioned to Gavi support. In addition, MSD through its partnership with Pink Ribbon Red Ribbon (PRRR) continues to work to address cervical cancer in sub-Saharan Africa through comprehensive approaches to cervical cancer prevention and control, including HPV vaccination.  This effort includes a program launched in coordination with the Zambian government, local NGOs, the US government and PRRR partners, focused on the scale up of breast and cervical cancer education to increase knowledge and awareness and reduce stigma throughout Zambia.  MSD also supported the Zambian Ministry of Health’s plans to conduct an HPV vaccine demonstration project across the province of Lusaka by providing 180,000 doses of GARDASIL to vaccinate 50,000 eligible girls over two years, and provided technical support for the program. Plans are underway by the Zambian government to transition to a national HPV vaccination program with Gavi support.

From 2006-2009, MSD worked with the Nicaraguan Ministry of Health on an innovative partnership to vaccinate all infants born in Nicaragua during this time period against rotavirus.  This program, which was completed in 2009 and transitioned to Gavi funding in 2010, achieved an estimated 94 percent vaccine coverage (with 3 doses) among Nicaraguan infants.  MSD continues to participate in UNICEF tender to supply Gardasil and RotaTeq to developing countries with Gavi support.  MSD’s partnership with Gavi and other Alliance partners is helping to ensure that infants and girls in the poorest countries have sustainable access to these vaccines.

Pfizer activities

In March 2010, Pfizer entered into the first of three 10-year supply agreements under the terms of the AMC to supply 300M doses of PCV 13 for pneumococcal disease (PD). Subsequently, Pfizer entered into two additional agreements with the AMC expanding its commitment with an additional 440 million doses, for a total commitment of 740 million doses of the first 13 valent pneumococcal conjugate vaccine until 2025.

In addition to expanding its commitment, Pfizer further reduced the AMC “tail price” price for Prevenar 13 to $3.40 for 2013 and $3.30 for all subsequent years through 2025. The AMC is a public-private health funding program designed to create a sustainable marketplace, ensure an affordable and stable supply of pneumococcal vaccines at a steeply discounted price and stimulate the development and expansion of manufacturing capacity for vaccines specifically for the world's poorest countries.  Pfizer was proud to introduce its vaccine into the childhood immunization program of a developing country within one year of its launch in the United States and European Union — a historic precedent given the average 10–15 year lag for introducing newer vaccines into developing countries following their introduction in industrialized nations. As of December 2013, Prevenar 13 is now available in 40 GAVI eligible countries.

Nicaragua, the first GAVI country to launch a PCV vaccine, has demonstrated a reduction of infant mortality by 33% just two years after launch.  Pfizer is proud to be a partner in the GAVI Alliance and to contribute to the reduction of infant mortality and to help avert over 500,000 future deaths from pneumococcal disease by 2015.

Sanofi activities

Sanofi Pasteur is a longstanding partner of GAVI in the supply of several  vaccines. In light of GAVI decisions to support implementation of inactivated polio vaccine (IPV) in routine immunization, this partnership has expanded further via the supply of unparalleled quantities of affordable IPV to support rapid & widespread adoption of the vaccine across 73 of the world’s poorest countries, hand-in-hand with the Global Polio Eradication Initiative (GPEI) - another key public-private partnership spearheaded by WHO.

Sanofi Pasteur is a leading supplier of Yellow Fever vaccines, used in ICG (International Coordination Group) funded vaccines stockpile for emergency outbreak response, for mass campaigns and routine use in Africa and Latin America.  Shantha biologics - a Sanofi company - supplies a well adapted fully liquid ready-to-use oral vaccine against cholera, recognised as an important tool in the control of this disease which is estimated to  kill up to 100 000 people every year, around half of whom are in Africa.  The GAVI Alliance financed the supply of vaccine for outbreak situations and campaigns in areas of recurring disease in 2014. Shantha's pentavalent paediatric combination vaccine, DTP-HepB-Hib is added to the list of manufacturers able and ready to supply pre-qualified a key vaccine in GAVI's strategy.

Part of Sanofi Pasteur’s contribution to the GAVI Alliance is its support of the EpiVacPlus program. Implemented by the Agence de Médecine Préventive (AMP), all program activities are implemented in collaboration with governments of partner countries, international health organizations, and African and European universities. In this way, EpiVacPlus constitutes an effective international, public-private partnership, which has demonstrated its effectiveness in improving immunization program performance. The program trains doctors involved in the implementation of immunization programs in eleven Central and West African countries.  By providing medical personnel with crucial training in epidemiology, applied computing, vaccinology, and management of health programs, this diploma course in organization and management of immunization in developing countries will help improve access to vaccines.

GAVI addresses three critical gaps in the provision of vaccines:

  • between children for whom immunization is a given and the 23.2 million children worldwide with no access to vaccines;
  • between the introduction of a new vaccine in rich countries and the average 10-15 years required for the same vaccine to reach low-income countries;
  • between the need for new vaccines in developing countries and the lack of research and funds to provide them. 

GAVI supports new and underused vaccines, health system strengthening, immunization services, injection safety and civil society organizations In total, GAVI has committed USD 7.2 billion since 2000. Eighty (80) percent has been committed towards the purchase of vaccines. The GAVI Fund provides financial support to low-income countries, based upon applications to and recommendations by the GAVI Alliance Board. Besides, industry partners invest in the development of new vaccines and in enhanced global vaccine manufacturing capacity, including facilities in developing countries. They also help to educate healthcare providers and develop technologies to facilitate vaccine distribution.

The GAVI Alliance has also organized a major initiative to contain the risk of yellow fever epidemics. Since 2003, the Group has provided more than six million doses per year of yellow fever vaccines funded by GAVI to go toward emergency stockpiles of vaccines, in order to prevent epidemics in Africa.

Other challenges include: ensuring contributions of all the Board partners; GAVI and Industry constituency governance processes and transparency, management of COI (conflict of interest), improving demand forecast by GAVI to help industry align supply projections, and risk management by GAVI to ensure that funds are properly used in countries. UNICEF policy of supply security and contracts with manufacturers allows for minimal, if any, interruption of immunization programs, Coordination within the Global Vaccine Policy WG (including formal governance procedure related to GAVI work) ensures that all individual companies contribute their knowledge and positions, and all voices are heard and communicated.

Summary of impact and forward looking information 

  • Average child mortality in Gavi-supported countries fell from 76 to a projected 63 deaths per 1,000 live births between 2010 and 2015, an unprecedented rate of reduction of 3.6% per year.
  • By helping countries to avert more than 4 million future deaths between the start of 2011 and the end of 2015, Gavi exceeded its target of 3.9 million for the five-year period. In addition, Gavi-funded measles vaccine campaigns conducted between 2013 and 2015 are estimated to have averted more than 300,000 future deaths. Since Gavi was set up in 2000, we have contributed to averting more than 8 million future deaths in developing countries.
  • By the end of 2015, 277 million children had been immunised with Gavi-supported vaccines relative to the end of 2010. This means that the Vaccine Alliance surpassed its target of immunising an additional 243 million children during the 2011–2015 period across all our routine vaccine programmes. Since our inception in 2000, we have supported countries in immunising close to 580 million children.

 

Videos

Past, Present and Future: The GAVI Alliance

The GAVI Alliance: Private Sector Partnerships

Nicaraguan mother sees hope in new vaccine

Working Together In Achieving The SDGs In Health - Pfizer

Polio Eradication, a unique vaccine story

Partnership information

Company(ies) GlaxoSmithKline , Johnson & Johnson , MSD , Pfizer , Sanofi

Partner(s) Bill and Melinda Gates Foundation, GAVI Alliance, UNICEF, World Bank, World Health Organization (WHO)

Type of Partner(s) IGOs, NGOs, PDPs

Therapeutic Focus Vaccine-Preventable Diseases, Non-Communicable Diseases, Women and Children's Health, Other

Disease(s) Cancer, Cervical Cancer, Children's Health, General Health, Hepatitis, Influenza, Measles, Meningitis C, Mumps, Paratyphoid fever, Pneumonia, Polio, Rotavirus, Rubella, Shigella, Women's Health, Yellow Fever

Program Type(s) Availability of Treatment - Differential Pricing, Availability of Treatment - Financial Support, Availability of Treatment - Patient Safety & Medicines Quality, Availability of Treatment - Product Donations, Health System Infrastructure - Development of Physical Infrastructure, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach, Prevention Programs - Vaccines, Research & Development - Development of Treatments

Targeted Population(s) Children, General population, People with low income, Youth

Region(s) East Asia & Pacific, Europe & Central Asia, Latin America & Caribbean, Middle East & North Africa, South Asia, Sub-Saharan Africa

Number of Countries 66

Country(ies) Afghanistan, Albania, Angola, Armenia, Bangladesh, Bhutan, Bolivia, Bosnia and Herzegovina, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, China, Comoros, Congo, Côte d'Ivoire, Cuba, Democratic Republic of the Congo, Djibouti, Eritrea, Ethiopia, Georgia, Ghana, Guinea, Guinea-Bissau, Haiti, Honduras, India, Indonesia, Kenya, Kiribati, Kyrgyzstan, Lesotho, Madagascar, Malawi, Mali, Mauritania, Moldova, Mongolia, Mozambique, Myanmar, Nepal, Nicaragua, Niger, Nigeria, Pakistan, Papua New Guinea, Rwanda, Senegal, Sierra Leone, Solomon Islands, Somalia, Sri Lanka, Sudan, Tajikistan, Tanzania, The Gambia, Togo, Turkmenistan, Uganda, Ukraine, Uzbekistan, Vietnam, Yemen

Start Date 2000

More information GAVI website

Anticipated completion date Ongoing

« GSK remains fully committed to supporting GAVI to expand and accelerate access to vaccines for children in the countries that still require the support of the Alliance. »

Sir Andrew Witty, CEO, GSK