GAVIs PneumoADIP

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GAVIs PneumoADIP Outlook for affordable,
sustainable supply and accelerated introduction

• WHO SAGE
• 11 November 2005

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Overview

• Why do we have a PneumoADIP?
• What is PneumoADIP doing to help build
  evidence-based decision-making?
• What do PneumoADIPs analyses indicate are
  possible for developing countries?
• What will it take to make it happen?

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Why do we have a PneumoADIP?

• Because.
• Pneumococcus is a major cause of deaths worldwide
• 1.6M deaths per year - on par with TB (1.7M) or
  malaria (1.2M)
• Effective pneumococcal vaccines exist
• Gambia trial showed 7 deaths prevented per 1000
  vaccinated children
• Affordable pricing of these vaccines is possible
• Prices beginning at 5 per dose and declining to
  2 per dose over 9 years is possible with GAVI
  commitment now
• Without an ADIP, 15-20 years will pass before
  these vaccines save lives in the poorest countries

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Leading infectious causes of mortality, 2000
estimates
3.5
3.5
gt 5 years old
3.0
2.7
S. pneumoniae 1.6 million deaths, including
800,000 child deaths
2.2
2.5
Deaths (millions)
2.0
1.7
1.5
1.1
0.9
1.0
0.5
0
Pneumonia
AIDS
Diarrhoea
TB
Malaria
Measles
Source WHO
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GAVIs PneumoADIPPotential Deaths Prevented vs.
the Price of Inaction
900,000
800,000
Lives saved with no action
700,000
600,000
Childhood deaths caused by pneumococcal disease
500,000
400,000
3.6 million lives saved by 2025 with accelerated
introduction
300,000
280,000 lives saved by 2015 with accelerated
introduction
200,000
100,000
0
2007
2009
2011
2013
2015
2017
2019
2021
2023
2025
Based on WHO estimates of pneumococcal mortality
in children lt5 years of age
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Case for Pneumococcal VaccinesReducing Poverty
and Achieving MDGs

• Pneumococcal conjugate vaccines can help
  developing countries achieve Millennium
  Development Goals (MDGs) by

Reducing under 5 mortality by 7 deaths per
1000 children vaccinated
Reducing hospitalizations for serious illness by
lt 20 and the long-term costs of caring for
disabled survivors
Preventing meningitis with gt85 efficacy
MDG 4 Child Mortality
MDG 1 - Poverty
Improved Health Outcomes
Poverty Reduction
Immunization
Improved Educational Outcomes
Preventing hearing loss by reducing ear
tube surgeries by 20
MDG 2 Primary Schooling
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Pneumococcal Surveillance and Research Projects
Meningitis, Pneumonia, Sepsis

• 7.8M in ADIP funding committed to 58 countries
• 7 Surveillance networks covering 43 countries in
  Asia, Africa Latin America
• In collaboration with WHO ROs, local Ministries,
  and research units
• gt28,000 blood and CSF specimens have been
  collected
• gt500 pneumococcal isolates and 300 Hib isolates
  identified
• Antibiotic resistance serotyping of isolates
  ongoing
• Some hospitals in our networks have identified S.
  pneumoniae for the first time in recent history
• Some have never had a computer!

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2005 Surveillance Research Activities

Births 82.7 million Under five pneumonia
deaths 1.3M ( 69 of global lt5 pneumonia deaths)
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Next step Communications ToolboxA collection of
support material developed and adapted to local
country level needs

• Reference library
• Data sheets, global, regional country specific
• Health impact calculator, computer model
• Pneumo BAT (Burden Assessment Tool)
• Slide set
• Media outreach tools, guidelines, templates, pre
  written material
• Visual materials, BBC documentary1 2 and short
  promos
• About PneumoADIP and further support and feed back

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Pneumococcal vaccine pipeline
Launched
Clinical trial Phase III
Clinical trial Phase II
Clinical trial Phase I
Pre-clinical stage
Development Stage
Multi-national
9-valent
Prevnar (7-valent)
13-valent
20 vaccines in research/ Pre-clinical
stage (includes conjugate protein-based vaccine
s)
Steptorix1 10-valent
Expected launch 2008
11-valent
7-valent
gt5 mulit-valent conjugate vaccine projects
Emerging suppliers
Discontinued
1Completed first Phase III trial results
announced in Jun05
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From vicious to virtuous cycle
ADIP efforts
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Whats possible for pneumococcal vaccination in
developing countries?

• Cost-effectiveness
• Cost per DALY lt100 at 5 per dose in a
  conservative analysis
• Affordable pricing is possible
• Requires supply strategy, evidence-based demand
  creation, and early commitment to finance the
  vaccine
• Demand forecast
• 50M doses/yr by 2015 and 180M doses/yr by 2025
• Prevents 3.6M child deaths by 2025

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PneumoADIPs Demand ForecastFinding the Solution
Space
Lives saved when we find the solution space
where willingness overlaps
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Whats next?Progress yes, but hurdles still ahead
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• www.preventpneumo.org