International Coordinating Group for vaccine provision · Work with manufacturers to ensure...

Emergency Vaccine Stockpiles

International Coordinating Group

for vaccine provision

International Coordinating Group

for vaccine provision

2

Existing Vaccine Stockpiles

Vaccine Year Use Qty million doses

Storage Mechanism Funding

Smallpox 1980 Epidemic response 35 WHO/ countries

WHO Donations

Meningococcal 1997 Epidemic response 5 Producers ICG GAVI/ revolving fund

Yellow Fever 2001 Epidemic response 6 Producers ICG GAVI/ revolving fund

Influenza 2007 Epidemic response 10 % of prod

capacity

Virtual WHO/PIP PIP

Cholera 2013 Epidemic response and humanitarian emergencies

2 Producers ICG GAVI/ revolving fund

mOPV2 2015 Epidemic response 500 Producers SAGE WG GPEI

Ebola (under discussion)

2016 Epidemic response ? Producers ICG-like GAVI

Control of Epidemic Diseases

ICG - History and MissionICG - History and Mission

� In 1996, Africa experienced the largest recorded outbreak of epidemic meningitis in history, with more than 200,000 cases and 20,000 deaths

� The emergency response fully exhausted international vaccine reserves

� IFRC, MSF, UNICEF and WHO established the ICG in 1997.

“to assure a well-coordinated and equitable distribution of meningococcal vaccines and related material during meningitisepidemics”


ICG ObjectivesICG Objectives

To ensure rapid access to

vaccines bundled with injection materials for

countries experiencing

epidemics

To promote the optimal use of

these resources (especially when

stocks are limited)

To coordinate international

efforts in preparing for, and

responding to epidemics


ICG Basic principlesICG Basic principles

1. Timely arrival of vaccine for an effective outbreak response where is most needed

2. Fairest distribution of the vaccine. Careful assessment of risks and benefits. Global stock is managed by an international partnership

3. Work with manufacturers to ensure availability of an emergency stock of supplies at global level

4. Use and promotion of epidemiological and operational criteria for vaccine release

5. Standard operating procedures

6. Established financial mechanism to purchase emergency supplies and ensure sustainability


The ICG partnershipThe ICG partnership

� An extended partnership with technical partners and

vaccine producers:− WHO CCs (CDC, NIPH-Oslo, IP Paris/Dakar) and other partners (AMP,

CERMES, Epicentre, LSHTM, MVP, etc)

− Manufacturers: vaccines and antibiotics

− Donors: GAVI, ECHO, CERF…

� The ICG executive sub-group:

– A core group of public health organizations acting at global level:

IFRC, MSF, UNICEF, WHO (secretariat)

– Decision-making body


� International Federation of the Red Cross and Red Crescent Societies (IFRC):

− Strong country presence: community health promotion, local social and resource mobilization,

− Support to states during disasters and epidemics

� Médecins Sans Frontières (MSF)

− An independent field-based NGO providing health care to populations in precarious and emergency situations (epidemiology, case management, vaccination, training, and evaluation)

� United Nations Children's Fund (UNICEF)

− Vaccination campaign planning and implementation

− Vaccine procurement and shippment

� World Health Organization (WHO) – ICG Secretariat (Coordination)

− Advisory normative role; global public health;

− Stockpile management

− Technical support to countries: surveillance, preparedness and response to outbreaks

ICG Executive Sub-GroupICG Executive Sub-Group


Criteria for membership in the ICG Executive Group

Criteria for membership in the ICG Executive Group

o International public health agency or international non-governmental organization

support to countries on health matters irrespective of race, religion, gender or political

affiliation.

o Active role in response: agencies and organizations must participate in response and

control interventions.

o Commitment and daily availability: be available for emergency consultation at any time

o Respect of data ownership and confidentiality: agencies must commit to respect the

confidentiality of country data

o Lack of conflict of interest: any involvement with the vaccine industry e.g. perform

consultancies for and/or receive funding from such manufacturers.


ICG mechanism - componentsICG mechanism - components


ICG stock management: ForecastingICG stock management: Forecasting

� Carefull assessment of vaccine supply and production

capacity

� Composition and size of the emergency stockpile of

vaccines is estimated on a yearly basis by the ICG

executive sub-group

� Work with manufacturers.

� Supply for preventive campaigns


ICG stock management: StorageICG stock management: Storage

� The stockpiles are kept at the manufacturer warehouses

�at least 2 sites

� Quicker delivery (air connections)

� Shelflive optimization, rotating stocks

� Dubai – Geneva warehouses

� Copenhagen (injection materials)


ICG - ApplicationsICG - Applications

� ICG standard forms

� ICG partners work with countries

� Training, workshops in regional meetings


ICG - Decision-makingICG - Decision-making

� 48 hours decision-making

� One organization = one vote

� Consensual decisions

� When disagreement: teleconferences convened to reach

consensus

� ICG Decision: approval, partial approval, more information

needed, disapproval


ICG - Criteria for ReleaseICG - Criteria for Release

� Evidence of an ongoing outbreak

� Laboratory confirmation of the responsible pathogen

� Feasibility of conducting a vaccination campaign (security,

partners in the field)

� Adequate storage conditions and resources

� A plan of action for mass vaccination


ICG – Procurement and shipmentICG – Procurement and shipment

� Target: 7 days, vaccine ready in 48h + 5 days shipping

� UNICEF SD in Copenhagen

� MSF Bordeaux - Brussels

� WHO Kuala Lumpur


ICG - Financial managementICG - Financial management

� 1997 - 2003 fund-raising appeals:

– limited success

– Unsustainable strategy

� 2003 – started requesting reimbursement of costs to countries:

– Not a pre-requirement for request approval

– Promoted and implemented by the secretariat, but with little

administrative resources

– Less than 50% reimbursement obtained?

� 2009 – Vaccine stockpiles funded by GAVI including operational support for vaccination campaigns

� 2010 - Establishment of a revolving fund in WHO (CERF, ECHO, UNICEF,

MSF)


ICG processVaccine stockpile

ICG processVaccine stockpile

1- Submission

2- Circulation

3- Decision in 48h

4- Approval

5- Procurement

6- Packing and shipment

7- Arrival

8 - Reimbursement

IFRC, MSF, UNICEF, WHO

WHO ICG secretariat

ICG

Country request

UNICEF SD

Manufacturers

Vaccines in country

Request more

information

10 days max


ICG - monitoring and performanceICG - monitoring and performance

� ICG performance

– Lead times for ICG submission, decision making, procurement, shipping, vaccination.

– Forecasting

– Led to work with country: improved quality of requests ICG workshops, improved forms and guidelines, direct support to countries (including evaluations of epidemic detection and response)

� The ICG mechanism has contributed to reinforced surveillance and laboratory confirmation

� Impact of vaccination and response


The ICG value: why it works The ICG value: why it works

� The ICG is an operational, solution-driven and creative partnership

� Grounded on pragmatism while adhering to strict epidemiological criteria and principles

� ICG members: Commitment and availability; Collaboration; Complementarity (global action and field presence)

� Real partnership

� Extended partnership with key technical organizations, manufacturers and donors

� ICG Mechanism: standardized, transparent, adapting

� ICG revolving fund: development of an autonomous financial system


Extra slides


� Managed by the International Coordinating Group (ICG):

established in 1997

� Revolving stock: Men AC + ACW + ACWY + Men A conj.

– 70 million doses of vaccine have been channelled since 1997

� Emergency stockpile 2009-2015: 45 million doses

– Financed by GAVI

– Revolving Fund mechanism to ensure sustainability beyond 2013

Meningococcal vaccine stockpileMeningococcal vaccine stockpile


Yellow fever stockpileYellow fever stockpile


established in 2001

� Revolving stock of YFV for outbreak and preventive

campaigns

– 90 million doses of vaccine have been shipped since 2001



– Revolving Fund mechanism

– Unused vaccine used for preventive campaigns


Cholera stockpileCholera stockpile


established in 2013

� Revolving stock of OCV for outbreak and preventive

campaigns

– 3 million doses OCV



– Revolving Fund mechanism

– Unused vaccine used for preventive campaigns

International Coordinating Group for vaccine provision · Work with manufacturers to ensure...

Documents

Transcript of International Coordinating Group for vaccine provision · Work with manufacturers to ensure...