Introduction to ADIPs GAVI Board 910 December 2003

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Introduction to ADIPs GAVI Board9-10 December
2003

• Prof. Jan Holmgren
• Chair, ADIP Management Committee

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ADIP Historical Perspective

• Accelerated Development and Introduction Plan
  (ADIP)
• Proposals solicited in August 2003 for two ADIPs
• Applications reviewed by Technical Expert
  Committee
• Award letters sent January 31, 2003
• US 30 million
• 3-5 year project

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ADIP Organization
GAVI Board
ADIP Management Committee
ADIPs Pneumo JHSPH Rota PATH
Strategic Partners WHO Pneumo, Rota CDC Rota
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Updates on Rotavirus and Pneumococcal ADIPsGAVI
Board9-10 December 2003

• Dr. Orin Levine
• Dr. John Wecker

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Agenda

• ADIP Context
• ADIP Goals and Activities

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Vaccines can play an important part in achieving
Millenium Development Goal 4.
Millions of childhood deaths
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8
6
MDG4 Target
4
2
0
2000
2015
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WHO estimates 2.7M children vaccine preventable illnesses.
Pneumo and Rota account for 44 of vaccine
preventable deaths in children
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Burden of rotavirus mortality is in developing
world.
Source Parashar, et al., 2003
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Pneumococcal and rotavirus vaccines are
low-hanging fruit.

• Pneumococcal vaccines
• 7-valent licensed since 2000
• 9-valent shown to be safe and effective in South
  Africa Other trial results with 9- and 11-valent
  by 2005
• 2 manufacturers expected by 2008 3 possible by
  2011
• Rotavirus vaccines
• Large scale trials ongoing in developing
  countries
• Initial licensure expected for one vaccine in
  2004 second vaccine by 2006
• Additional manufacturers possible by 2010

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15-20 year time-lag between use of hepatitis B
and Hib in developing compared to industrialized
countries.
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The ADIPs will address demand and supply
uncertainties.
ADIP
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Agenda

• ADIP Context
• ADIP Goals and Activities

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ADIPs have two primary strategic goals.
Strategic Goal 1 Provide information that
enables national decision-makers, the GAVI board
and its partners to make an evidence-based
decision regarding the use of vaccine.
Strategic Goal 2 Accelerate the availability of
affordable, new vaccines appropriate for use in
developing countries.
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Strategic Goal 1 Provide information that
enables national decision-makers, the GAVI board
and its partners to make an evidence-based
decision regarding the use of vaccine.
ADIP is successful if it supports efforts of
national governments and GAVI partners to make an
evidence-based decision, even if that decision is
not to invest in vaccine introduction

• Investment trade-offs
• Financial sustainability planning
• Introduction of new vaccines

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Strategic Goal 1 Provide information that
enables national and international
decision-makers to make an evidence-based
decision regarding use of vaccine.
Disease burden (global/country)
Economics (global/country)
Vaccine safety and efficacy (regional
representation)

• Surveillance
• Serotype distribution

• Cost/benefit of illness/death
• Cost-effectiveness of vaccination

• Clinical trials
• Demonstration projects

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Example ADIPs will support regional
surveillance networks.
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Example ADIPs will engage with partners to
conduct clinical trials in developing country
settings.

• Historically, efficacy studies conducted in
  developing countries after licensure
• Sequential testing contributed to delay in
  introduction
• ADIPs seeks to establish vaccine safety and
  efficacy at earliest possible time
• RAPID and ADIP accelerating efficacy testing in
  Bangladesh and South Africa with GSKs vaccine

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Strategic Goal 2 Accelerate the availability of
affordable, new vaccines appropriate for use in
developing countries.

• Address supply conditions with manufacturers
• Address regulatory obstacles

• Support countries in identification of financial
  options
• Identify vaccine infrastructure requirements

• Conduct audience research
• Coordinate demand forecast process
• Develop strategy for country prioritization

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Introduction time-lag can be reduced.
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Saving lives sooner The value of accelerated
introduction.
Deaths pa (1,000s)
700
600
Without GAVI ADIP
500
400
160,000 deaths prevented 20062012 by ADIP
GAVI ADIP
300
1.9 million deaths prevented 20132020 1.6
million more with ADIP than without
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Pneumococcus
100
0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Deaths pa (1,000s)
400
300
343,000 deaths prevented 20062012
Without GAVI ADIP
200
GAVI ADIP
Rotavirus
1.0 million deaths prevented 20132020 800,000
more with ADIP than without
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Rotavirus
0
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2020
2019
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ADIPs are targeted programs.
Does not
Perform RD
Partner
Make policy decisions
Enable
Procure vaccine
Invest
Replace
Compliment
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For more information about ADIPs, visit our
websites

• www.preventpneumo.org
• www.rotavirus.org