Sustaining GAVI-supported vaccine introductions in resource-poor countries

Area of Science:

• Global Health
• Vaccinology
• Health Economics

Background:

• GAVI (formerly the Global Alliance for Vaccines and Immunization) has facilitated a substantial rise in the uptake of vaccines containing Hepatitis B (HepB) and Haemophilus influenzae type b (Hib) in low-resource settings since 2000.
• This expansion was contingent upon time-limited financial aid from international donors, raising questions about long-term sustainability.
• Assessing the long-term viability of these vaccine programs is crucial for global public health.

Purpose of the Study:

• To evaluate the sustainability of expanded access to HepB and Hib vaccines in resource-poor countries following GAVI support.
• To analyze supply chain dynamics, financial resource allocation for vaccine procurement, and national decision-making processes.
• To identify key factors influencing the continued availability and use of these essential vaccines.

Main Methods:

• A review of supply chains, financial data for procurement, and decision-making frameworks in countries that introduced HepB or Hib vaccines with GAVI assistance.
• Analysis of vaccine product types, supplier landscape, and pricing trends over the study period.
• Examination of national program budgets, GAVI's contribution share, and the role of national advisory bodies in vaccine introduction decisions.

Main Results:

• Vaccine product offerings and supplier availability fluctuated significantly during the study period, with an increase in combination vaccines.
• While prices for simpler vaccines decreased, the cost of pentavalent DTwP-HepB-Hib vaccines remained stable.
• National program budgets increased with new vaccine introductions, with GAVI's contribution rising from 25% to 46% of the budget.
• Less than 20% of vaccine introductions were initiated by national advisory bodies, indicating limited national ownership.

Conclusions:

• Strengthening national supply chains is essential for the sustained availability of HepB and Hib vaccines.
• Adjusting financial aid mechanisms and increasing national ownership of vaccine programs are critical for long-term sustainability.
• These strategies will facilitate the continued use of existing vaccines and the potential introduction of other vital vaccines where most needed.