1. Measles Partnership Meeting Update on Vaccine Supply Washington, 27-28th February 2007 UNICEF Supply Division

2. Countries UNICEF procures on behalf of All Vaccines Part of the Vaccines UNICEF procures immunization supplies on behalf of 80-100 countries Vaccines, Injection Devices, Cold Chain (BCG, DTP, TT/Td/DT, Measles, OPV, HepB, YF, DTP-HepB, DTP-HepB+Hib, DTP-Hib, MR, Meningitis, MMR, IPV, Rabies, J.E., etc) - 2006 immunization supply expenditures: USD 550M (including cold chain) - Over 3.0 billion doses of vaccine, over 900 million AD syringes - ~ 1,800 vaccine shipments

3. A significant proportion of low income country vaccine needs are met through UNICEF procurement Data Sources: Population Data: ‘The State of the Worlds Children 2006’ Procurement Coverage Data: UNICEF Vaccine Forecast 2006 Income Classification: World Bank

4. Vaccine Security – Ensuring the uninterrupted sustainable supply of affordable quality vaccines, remains the principle driver of UNICEF Vaccine Supply Vaccine Procurement Principles A healthy industry is vital to ensure an uninterrupted and sustainable supply of vaccines Procurement from multiple suppliers for each vaccine presentation Paying a price that is affordable to Governments and Donors and a price that reasonably covers manufacturers minimum requirements Three Pillars of Vaccine Security Appropriate Contracting Firm Funding Accurate Forecasting

5. Vaccine Security remains a critical issue Positive trends are seen in the new markets DTP-HepB DTP-HepB/Hib Market development- Positive trends lead by HepB market Critical Stage of Introduction of DTP-HepB and DTP-HepB+Hib Principles of Vaccines Security remain valid - to ensure a Healthy Market HepB

6. However in the mature traditional vaccine markets although there has been progress made…. BCG TT Measles DTP

7. Number of manufacturers per vaccine …there is less Vaccine Security - increased dependency on fewer manufacturers for a growing demand = Current Awards

8. Overview of Measles demand Growth in Measles demand 1996 - 2006 Significant growth in the Quantity of Vaccines Procured

9. UNICEF Measles procurement profile Routine Demand relatively stable, Supplementary activities make up majority of demand – largest impact on forecast quantities 2006 peak year, large campaigns undertaken, challenging logistics

10. Looking towards the 2010 Goal Ensuring Supply for 2007 – 2010 Bidding Activities 2006 - Supply Arrangements in place 2007 – 2009 Offered quantities sufficient to meet the forecasted demand requirements Data as at time of Tender Activities

11. High dependence (75% of award) on one supplier for Measles vaccine for 2007 Reduction in the number of suppliers awarded due to reduced number of WHO pre-qualified offers received. However in terms of Vaccine Security the supply is still at risk ….

12. Responses to the RFP for the 2007 – 2009 supply indicated potential new suppliers for measles vaccine Measles containing vaccines are classified as high priority for WHO pre- qualification New suppliers would create a more secure market

13. Awards made for full forecast demand quantity in 2007 Reduced award for 2008 and 2009, awaiting Market developments Additional forecast demand not awarded currently to encourage new entrants

14. Overview of Measles Vaccine Supply 2007 Peak demand period: June – September may require levelling Based on current information, sufficient supply to meet the demand Dynamic situation – large Campaigns have a significant impact

15. Impact of changed schedule of Pakistan Campaign NoDate of CampaignTarget QtyDelivery Date 5 Phases: 1 March 20072,607,785Delivered 2July 20079,066,827June 2007 3Aug/Sep 20076,730,182July 2007 4Nov 200715,880,000Sep/Oct 2007 5Mar 200839,143,000Nov/Dev 2007

16. Overview of MR Vaccine Demand Historically limited quantities procured by UNICEF High variance in demand due to intermittent campaign procurement Current Supply Arrangements covered forecasted demand at time of Tender New Campaign Activities forecast for Q4 2007 Tender issued, closing 5th March 2007 Tight Supply Situation, 2 Suppliers

17. Overview of MMR Vaccine Market UNICEF demand for this vaccine is low. Current Supply Arrangements covered forecasted demand at time of Tender No JL strain available to UNICEF currently Product is difficult to manage due to strain preferences from Countries and limited available pre-qualified products.

18. As a Partnership, what can we do to ensure Improved Vaccine Security? Continue the Partnership Accurate Forecasting –Early/ Long Term Campaign Planning – particularly Large Campaigns –Quantities and Timing of Demand Need to assess the overall market demand – including other Procuring Agencies and India Campaign Activities –In Country Logistics in place Firm Funding –Secure Sufficient Funding to meet program goals 2007 - 2010 –Early Funds Transfer –Support Vaccine Security Appropriate Contracting –Ensure Adequate Contracts in place –Expand the Supply Base

19. Thank You !