World Health Assembly 66; Agenda item 66/19: Global Vaccine Action Plan
Intervention by Kate Elder, Médecins Sans Frontières
Médecins Sans Frontières welcomes the focus on immunisation brought by the Decade of Vaccines.
MSF works with Ministries of Health to deliver vaccination services in many of the countries with the weakest health systems. Our experience shows that significant challenges remain in reaching infants with even the basic package of vaccines. Last year we vaccinated almost 700,000 people against measles in outbreak response campaigns; these outbreaks are testament to the high numbers of children falling through the service delivery net. More than 22 million children are not fully vaccinated – 20 % of all children born each year.
MSF is concerned that the Global Vaccine Action Plan’s monitoring and evaluation framework omits two essential targets.
First, the framework is not ambitious enough in bringing new vaccine delivery technologies to immunisation programmes. Current tools are inadequate: they require refrigeration, are difficult to transport, and need trained health staff. To extend vaccination services to these 22 million children, we need better adapted tools; innovative technologies more suited to the places where vaccines are most needed – needle-free, oral, heat-stable vaccines. The monitoring and evaluation framework aims for only one “new platform delivery technology” by 2020. This is not ambitious enough, especially considering many delivery technologies are well under development. We urge Member States to call for increasing this target to five new platform delivery technologies by 2020.
Second, the Action Plan presents a critical opportunity to start tracking vaccine prices. The cost of fully vaccinating a child has increased by 2,700% since 2001, and promises to increase further. High vaccine prices threaten the sustainability of immunisation programmes.
At last year’s WHA many Member States voiced concern about rising vaccine prices and called for the Decade of Vaccines to work towards greater affordability. The disproportionately higher cost of the newest vaccines also directly impacts MSF. GAVI policy does not allow MSF access to GAVI-negotiated prices; MSF in fact is quoted a price for the vaccine against pneumonia which is quadruple the GAVI price. There are no policies in place which extend price negotiations to MSF and other non-governmental actors. This prevents MSF from meeting medical needs, and from fulfilling Ministry of Health requests to help you reach your most vulnerable children.
We are compelled as a global community to start tracking prices, particularly for a Decade of Vaccines that is estimated to cost more than $57 billion dollars, with half of the costs on vaccines alone. The monitoring and evaluation framework of the Action Plan does not yet include indicators to track vaccine prices. The Secretariat has initiated work to develop indicators for proposal to the next Strategic Advisory Group of Experts in November. We encourage Member States to voice their support for this work and insist that price indicators be included in the Action Plan M&E framework.