GAVI Alliance develops end-to-end strategy to strengthen supply chains

by Daniel Thornton and Stefano Malvolti, GAVI Alliance The GAVI Alliance will spend $7 billion on lifesaving vaccines from 2011 to 2015, supporting countries to immunize an additional quarter of a billion children. Until now, although members of the Alliance have worked on particular parts of the vaccine supply chain, there has not been an end-to-end approach to the supply chain. And there has tended to be a focus on the flow of goods through the supply chain and less of a focus on the flow of information and money. Yet as powerful new vaccines are being introduced, and as vaccines have gone from costing cents per dose to dollars per dose, the demands on the vaccine supply chain are increasing. For these reasons, the GAVI Secretariat has agreed with its partners to establish a task force that will develop an end-to-end supply-chain strategy. This strategy will look at the entire supply chain from the decision by manufacturers to produce or allocate a vaccine for GAVI-eligible countries to the point where a child is immunized and that immunization is recorded. A consultation on the strategy will be launched later in the year and presented to the GAVI Board meeting in November. As a first step in developing the strategy, a landscape analysis was commissioned to map the players and processes in the current supply chain. The objectives were to: -Map the key players engaged in the vaccine supply chain. -Analyze the end-to-end processes of the vaccine supply chain, highlighting the steps from forecasting to immunization and including the vaccine investment and market-shaping strategies, supply and demand forecasting, applications, approvals, tendering, production, delivery to countries, and delivery to the point of vaccination. -Identify and analyze challenges in the current system. More than 50 global-level supply chain experts, as well as immunization professionals in Ethiopia, Tanzania, and India, were interviewed as part of the analysis. Now that the landscape analysis has been completed, the task force has begun to develop the strategy to: -Establish a common language and agreed set of objectives and indicators for the supply chain. The emerging objectives are related to supporting immunization coverage and cost per dose provided (through maximizing utilization of vaccines) and ensuring that vaccines are viable at the point of use. -Achieve an Alliance-wide consensus on the roles and responsibilities within and beyond the supply chains of GAVI-eligible countries through the recognition of institutional strengths and competencies of partners. -Define a mechanism for the identification and scale-up of promising technologies and pilot projects. It is hoped that the strategy will build and strengthen synergies with partners working on improving vaccine supply chain systems (and including other health commodities) as well as build on existing frameworks for the future of supply chain systems (for example, the 2020 vision of immunization supply and logistics systems developed by a large number of partners with the facilitation of project Optimize, and the work of the UNICEF-coordinated Cold Chain and Logistics group). The strategy will consider what support can be provided through the Alliance to strengthen vaccine supply, either through GAVI’s health systems strengthening support, specific in-country supply chain training, or other mechanisms. It will also consider how the supply chain can be considered more systematically in relation to applications for GAVI support. Finally, it will provide the context for funding supply chain activities under the GAVI Business Plan. For more information on GAVI’s supply-chain strategy, please contact Daniel Thornton ([email protected]) and Stefano Malvolti ([email protected]).