Gavi, the Vaccine Alliance

Combining five different vaccines in a single vial, pentavalent vaccine brings cost savings in terms of equipment, delivery and disposal programmes. When Gavi set out to catalyse the adoption of new vaccines in low-income countries in 2000, Hib was top of its priority list. The vaccine had existed since the early 1990s, but by 2000, only one low-income country had introduced the vaccine into its national immunisation programme. As a result, support for routine immunisation against Hib was immediately made available through Gavi. Initially, Gavi-eligible countries were slow to take up the offer of support for Hib vaccine, both because of limited awareness of Hib's disease burden and concerns about the cost of the vaccine. By 2004, four years after the Hib vaccine had become part of Gavi's vaccine portfolio, only 15 countries out of the 74 eligible countries had been approved for Hib vaccine support. Initially, Gavi provided support for hepatitis B (hepB) monovalent vaccine. However, in December 2005, the Gavi Board decided only to accept new applications for hepB vaccine support through combination vaccines (tetravalent and pentavalent).

GAVI’s support for new vaccines presents an opportunity for countries to not only implement vaccines that protect against diseases causing substantial morbidity and/or mortality, but also to build upon the vaccine investments in order to increase immunisation coverage rates, and strengthen routine immunisation services and primary health care systems. Rotavirus vaccine protects children against rotavirus disease and the severe and deadly diarrhoea that it causes in children. WHO recommends that rotavirus vaccination be included in all national immunization programmes, and the use of rotavirus vaccines should be part of a comprehensive strategy to control diarrhoeal diseases. Two oral rotavirus vaccines are currently available for routine infant immunisation with GAVI support: a two-dose schedule and the three-dose schedule vaccine.

GAVI’s support for new vaccines presents an opportunity for countries to not only implement vaccines that protect against diseases causing substantial morbidity and/or mortality, but also to build upon the vaccine investments in order to increase immunisation coverage rates, and strengthen routine immunisation services and primary health care systems. The pentavalent vaccine, administered in a three-dose schedule, offers protection against five diseases: diphtheria-tetanus-pertussis (DTP), heptatitis B and Haemophilius influenzae type b. Until 2013, GAVI has helped to introduce the pentavalent in 70 of the 73 GAVI-eligible countries, with the aim of reaching all 73 by the end of 2014. GAVI support for pentavalent vaccine is in line with WHO recommendations, for routine infant immunisation and primarily targeting children under one year of age.

Gavi prioritised typhoid conjugate vaccines in 2008, as part of the vaccine investment strategy, but did not make a financial commitment due to the absence of a suitable vaccine. Following the WHO prequalification of a newly available typhoid conjugate vaccine at the end of 2017, and the release of SAGE guidance on the use of typhoid conjugate vaccines, Gavi opened a funding window for the vaccine.

GAVI’s support for new vaccines presents an opportunity for countries to not only implement vaccines that protect against diseases causing substantial morbidity and/or mortality, but also to build upon the vaccine investments in order to increase immunisation coverage rates, and strengthen routine immunisation services and primary health care systems. Pneumococcal vaccines can protect children from Streptococcus pneumoniae, which is the most common cause of severe pneumonia among children living in the developing world, and can also causes meningitis and sepsis. In line with WHO recommendations, GAVI support for pneumococcal vaccines is for routine infant immunisation. Two pneumococcal conjugate vaccines are currently available with GAVI support: a 10-valent (PCV10) and a 13-valent (PCV13).

Gavi has supported the global oral cholera vaccine stockpile since 2014 Oral cholera vaccine stockpile The global oral cholera vaccine (OCV) stockpile was founded in mid-2013 by five donors. In 2013, the Gavi Board approved support for the stockpile as part of our Vaccine Investment Strategy. Our contribution of over US$ 110 million for the 2014–2018 period aims to increase access to OCV during emergencies and in countries that regularly experience cholera outbreaks.