1. Meningitis Vaccine Procurement

2. Meningitis belt countries in Africa

3. Meningitis AC - Procurement overview Historically limited funding and supply. Only 1 manufacturer for many years. UNICEF has only procured a part of the outbreak supply. Unpredictable demand as outbreak driven In recent years Demand > Supply. Supply has been reserved for outbreak response Additionally 340,000 doses of ACW vaccine has been delivered in 2008

4. Meningitis Investment Case 3 programmatic strategies: –Epidemic response (AC, ACW, A conj) PS (2009-13) AC 30 mil ds, ACW 6 mil ds Men A conjugate (2011-13),9 mil ds –Preventive catch up campaign (Men A) 278 mil ds (2009-2015) –Routine EPI & follow up campaigns (Men A) Routine 77.2 mil ds (2013-15) Follow up 15.7 mil ds (2013-15) ICG is the programmatic body responsible for outbreak assessment and response approval, and UNICEF the procurement agency. To GAVI board in June 2008: Total value of $370 mil through 2009-15. Approved in June 08: Epidemic response 2009-2013 ($55.2M) Approved additionally in October 08 Board: Initial preventive campaign activities ~$32mil

5. Epidemic response stockpile (2009-13) Projected demand for meningitis vaccine for epidemic response in the investment case. Quantities in Million doses

6. UNICEF proceeded with procurement process First focus on poly-saccharide vaccines only (no WHO pre- qualified A-containing conjugate vaccine) Issued RFP covering first 3 years, with quantities confirmed by ICG Demanding product from supply management as fast shipment response is needed to meet outbreaks and no alternative routine or travel demand.

7. Overview of quantities tendered for Tender recommendation currently being presented for final review; results expected communicated shortly to ensure epidemic response capacity

8. Future Meningitis A conjugate vaccine procurement At the GAVI Board in October only a small portion of the non Epidemic activities were approved for funding - due to the effects of the financial market. ~$32 mill For activities associated with preventive campaigns was approved to support the first campaigns. Currently no WHO pre-qualified conjugate A-containing vaccine In the April 2008 market survey during the manufacturers meeting, we were advised of several interested manufacturers interest and/or plans for conjugate A containing Meningitis vaccine. We have provided preliminary feedback to partners, and will make sure this informs our tender process when we commence the procurement process for initial and potential extended quantities.

9. Thank you

11. Mechanism for evaluating and approving country proposals: Epidemic Response