The Board of Gavi, the Vaccine Alliance today outlined a set of decisions that will expand the portfolio of vaccine programmes available to lower-income countries in the coming years.
It also committed to providing COVID-19 vaccines to high-risk groups until 2025 and approved an innovative plan to enable pilot investment in reserves of investigational candidate vaccines if appropriate candidate vaccines become available, helping respond more quickly to outbreaks of Marburg and Ebola Sudan viruses.
“Gavi’s record as an innovator and a disrupter in global health has been confirmed today,” said Professor José Manuel Barroso, Chair of Gavi. “Decisions taken by our Board will help countries fight disease more cost-effectively, be better equipped to fight back against emerging threats and continue to protect those most at risk from COVID-19.”
Expanding access to new vaccines
When the Alliance was founded in 2000, it supported vaccines against just three diseases; today it supports vaccines against 19. Continuing this trend, this week’s Board meeting saw the Alliance discuss and approve plans that will see lower-income countries access new vaccines in the coming years.
Hexavalent vaccine: The Board approved Gavi investment in the six-in-one vaccine – a combination of the pentavalent vaccine, which protects against diphtheria, tetanus, pertussis (whooping cough), hepatitis B and Haemophilus influenzae type b, and the inactivated polio vaccine (IPV). A window will now be opened for countries to apply for funding.
The hexavalent vaccine is expected to help countries deliver protection against all these diseases more efficiently and cost-effectively, and to contribute significantly to polio eradication efforts by expanding IPV coverage. Gavi and Alliance partners will also provide support to countries who are currently administering pentavalent vaccine and want to make the switch, and work with manufacturers to ensure the health of both the pentavalent and IPV markets.
COVID-19: The Gavi Board also confirmed that, as part of the transition from COVAX as an emergency response, Gavi will continue to support countries in their efforts to ensure high-risk groups are protected against COVID-19 in 2024-2025.
2018 Vaccine Investment Strategy: Gavi confirmed to the Board today that the Vaccine Alliance will re-start programmes to introduce vaccines that were previously approved but paused either due to the pandemic or product development delays. On this list are hepatitis B birth dose, diphtheria-tetanus-pertussis (DTP) boosters, and rabies post-exposure prophylaxis (PEP).
Also included on the 2018 list were two additional vaccines – the maternal respiratory syncytial virus (RSV) vaccine and multivalent meningococcal conjugate vaccine – which could soon see approved products on the market. The next steps in this process are to continue working with Alliance partners, particularly the World Health Organization (WHO), UNICEF and countries to create timelines, technical guidance for introduction of these new products, and outline the parameters of these new programmes.
2024 Vaccine Investment Strategy: Looking further ahead, the Board also approved a long list of vaccines to be considered for inclusion in Gavi’s next Vaccine Investment Strategy, which will be finalised by 2024. The approved long list includes licensed or pipeline products against hepatitis E, mpox, dengue, COVID-19, tuberculosis, group B streptococcus, chikungunya, and shigella.
Strengthening global health security
The Board acknowledged the critical role that Gavi plays in pandemic prevention, preparedness and response. It encouraged Gavi to bring lessons learned from more than 20 years of increasing levels of immunisation in lower-income countries into the current global discussions concerning the reform of global health architecture.
The Board received an update on Gavi’s work to boost regional vaccine manufacturing, particularly in Africa. They noted progress made on the African Vaccine Manufacturing Accelerator, a financial instrument that is being designed to help support sustainable vaccine manufacturing on the continent, in close consultation with key stakeholders such as the Africa Centres for Disease Control and Prevention (Africa CDC).
Further consultations and technical work on this important instrument will be carried out this year, with the intention of returning to the Board for approval in December 2023. The Secretariat further reported on plans underway to ensure “day zero” financing for future pandemic vaccine response.
The Board also acknowledged the growing threat of climate change and outbreaks with epidemic potential, and that vaccines have played a central role in every Public Health Emergency of International Concern (PHEIC) to-date (with the exception of Zika, when a vaccine wasn’t developed in time). For several of these, vaccines were not yet available at the start of the emergency.
In response to this identified gap, the Board approved a time-limited investment in pilot stockpiles, or “global virtual pooled inventories” (GVPIs), of investigational candidate vaccines against Marburg and Ebola Sudan – if they are recommended by scientific expert groups. The concept of GVPIs is to establish small reserves of investigational vaccine candidates, which would be at the ready for use in the event of an outbreak.
In collaboration with Alliance and key partners, such as WHO and the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi will further progress this GVPI concept for the Board in December, for consideration as a standing program and against a broader range of diseases.
The Board further discussed possible uses for COVAX AMC funding available due to the renegotiation of COVAX manufacturer contracts as well as contingency funding committed to the Pandemic Vaccine Pool. Potential options to be discussed with COVAX AMC donors include – but are not limited to – preparing for and responding to COVID and other health emergencies (including catching-up from the effects of the pandemic and expanding existing immunisation capabilities) and accelerating diversified manufacturing capacity. Following these discussions, concrete options will be brought to the Board in December.
“With more than 1 billion unique children reached, one eighth of humanity has now been protected by the Vaccine Alliance. While it is crucial to acknowledge the achievements of the past, the continued measure of success will be how we build on these experiences to deliver even more impact in the future. This week’s decisions by the Board provide us with a clear path towards an Alliance which is even more effective in protecting lives, addressing the consequences of climate change, and harnessing innovation to support countries,” said Dr Seth Berkley, CEO of Gavi.