Yellow Fever Stockpile Investment Case Merceline DahlRegis

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Yellow Fever Stockpile Investment Case Merceline
Dahl-Regis
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Objective

• The purpose of this investment is to scale up the
  existing Yellow fever (YF) vaccine stockpile from
  6 million doses to 12 million doses per year, to
  enable the 12 countries most at risk to
  significantly reduce the risk of YF outbreaks for
  the next 20 years.

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Expected Outcome Over the 5-Year Period

• Prevent approximately 687,000 deaths between 2006
  and 2050
• Ensure vaccine security and affordability by
  supporting Yellow fever (YF) vaccine market
• Protect GAVIs current investment in YF vaccine
  provision
• Contribute directly to the achievement of several
  Millennium Development Goals (MDGs), especially
  number 4 (child mortality)

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Countries Most at Risk
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Activities

• Continuation and expansion of Yellow Fever (YF)
  vaccine stockpile
• Comprehensive risk assessment and strengthening
  of surveillance systems
• Use of global YF vaccine stockpile (for outbreak
  response or preventive campaigns)

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Financial Summary (USD 000)
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Critical Risks (5 max 1 min)
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Monitoring and Evaluation

• Process indicators
• Timely response to outbreaks to limit spread of
  the disease
• The building of an immune barrier
• Outcome indicator
• At the end of the project, reduction of virus
  circulation in the 12 countries

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Yellow Fever Stockpile Investment Case Review
Merceline Dahl-Regis
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Investment Case Review

• Clarity, completeness, accuracy and credibility
• Clearly presented, complete and based on credible
  evidence of disease burden and vaccine
  effectiveness
• Major concern
• Prevention campaigns only in 12 of 23 Yellow
  fever (YF) endemic countries in Africa

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Investment Case Review

• Consistency with GAVI principles
• Directly supports achievement of MDGs by reducing
  child mortality
• Promotes use of underutilized affordable vaccine
• Supports innovative model
• Increases equitable access to vaccines
• Coherent with partner responsibilities and
  mandates
• Is catalytic and time-limited
• Is consistent with defined GAVI value added

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Investment Case Review

• Key strengths (1)
• Detailed description of objectives
• Importance of problem to country is clear
• Justification for the investment
• Economic analysis is most convincing
• Recognition of resource constraints
• Potential for rapid impact
• Greater vaccine security with up front investment

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Investment Case Review

• Key strengths (2)
• Availability of stockpile for outbreaks
• Monitoring and evaluation plan well developed
• Responsibilities of various parties well defined
• Countries contribute 67 of campaign operational
  costs

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Investment Case Review

• Key weaknesses (1)
• Timeline ambitious
• Specific strategy to conduct risk assessment in
  large countries with large migrant populations
  not provided
• Cross border transmission a major concern
• Country reporting requirements excessive
• Will present difficulty when there are human
  resource constraints and weak immunization
  infrastructure

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Investment Case Review

• Key weaknesses (2)
• Dependency on co-financing by very poor countries
• Lack of evidence that the mass prevention
  strategy will be successful when only one third
  of a country (e.g. Nigeria)

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Investment Case Review

• Chances of success
• Chances of success in achieving objectives are
  high and dependent on
• National capacity to conduct prevention campaigns
  and effective delivery of vaccines
• Reduction of vaccine price
• Additional resources for prevention campaigns in
  all 23 Yellow fever (YF) risk countries
• Sustained coverage of YF as part of routine
  immunization and future investments in
  strengthening of routine immunization

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Board is Requested to

• decide on Yellow Fever (YF) stockpile support in
  accordance with investment case