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Accelerated Development and Introduction of Priority New Vaccines (ADIPs)

Concepts and implementation

GAVI involvement in global research and development (R&D) efforts

In the Millennium Development Goals the international community defined an ambitious global target for children’s health - to reduce, by 2015, the under-five mortality rate by two thirds. To achieve this goal new ways to combat devastating communicable diseases must be developed.

One of GAVI’s strategic objectives is to accelerate the development and introduction of new vaccines and technologies into developing countries. After a thorough investigation, GAVI identified two priority vaccines, Streptococcus pneumonia and rotavirus, for its initial efforts. These diseases are responsible for the deaths of nearly 2 million children each year (including more than a million deaths in children under five), and both have promising candidate vaccines in advanced stages of development. The rapid introduction of these vaccines into the developing world could have a profound effect on childhood mortality.

ADIP concept

The ADIPs aim to shorten the lag between vaccines being proven safe and effective for use in the industrialized world and their introduction in developing countries. In the past, this gap has been decades long. For example, 15 to 18 years after being made available, Hib and hepatitis B vaccines are routinely given to only 10% of infants in the world’s poorest countries. Clearly, a concentrated public sector effort is needed to accelerate this process for pneumococcal and rotavirus vaccines.

In January 2002, the Gates Foundation and the World Bank commissioned a case study by McKinsey & Company to explore public sector strategies to accelerate the introduction of pneumococcal and rotavirus vaccine into Vaccine Fund eligible countries. (Read the full report (Word - 333K) or view the presentation (PPT - 265).)

The analysis performed by McKinsey suggested that earlier access to these vaccines in the developing world could be achieved through active Public Sector involvement in the preparation of global product launch strategies for countries that historically have not been served by the Private Sector. In addition, the McKinsey analysis recommended that the Public Sector engage the manufacturers of these vaccine candidates as early as possible in order to ensure that activities relevant to the global launch strategies in the developing world (e.g., clinical trials in the developing world) are performed. Finally, it was foreseen that active and early participation in relevant development activities would result not only in extended vaccine access for developing countries, but also in preferential price-volume agreements between national and international vaccine purchasers and product manufactures.

This study identified a “vicious cycle” of demand uncertainty, inadequate supply and high prices as the main cause of inertia in developing countries’ adopting new vaccines.

Vaccine introduction vicious cycle

Breaking this “vicious cycle” and achieving the desired end project, e.g. acess to affordable vaccines for developing countires will require a complex and well-coordinated plan of global activities following this general framework:

1. Establish the value of each vaccine (e.g. disease burden studies, E&GE studies, etc.)

2. Communicate this value to countries, to international public health agencies, and to manufacturers

3. Deliver the promised value by facilitating the procurement and distrubtion of these vaccines in developing countries

ADIP launch

In June 2002, the GAVI Board endorsed the creation of Accelerated Development and Introduction Plans (ADIPs) designed to address the significant challenges involved in making available new vaccines that are used primarily in developing countries.

The Board issued a call for proposals last summer; and two projects were recommended by the Independent Proposal Review Steering Committee (list of members) and endorsed by the GAVI Board:

Rotavirus ADIP proposal (PDF - 360K)
Program for Appropriate Technology in Health (PATH), Dr John Wecker, project leader

Pneumococcal ADIP proposal (PDF - 543K)
Johns Hopkins Bloomberg School of Public Health, Dr Orin Levine, project leader (you may also visit their Pneumococcal project site)

30 million USD grants, to be utilized over the next 3 to 4 years, were awarded to both ADIP projects. Coordination and implementation will be managed by small ADIP teams that are hosted by their respective research institutions.

Having established the case for the investment of public sector funds, the ADIP projects must create transparent, evidence-based plans with clearly defined milestones and objectives that can form a basis for further public health investment decisions.

The ADIP Management Committee is responsible for ensuring that the ADIPs' progress towards their milestones is met, and will offer guidance to the GAVI Board on critical go/no-go decisions.

General activities will include:

1. Assess regional/country specific burden of disease, estimate the effectiveness and cost-effectiveness of the vaccine once it is in use, and to establish the vaccine’s potential impact;

2. Identify and reduce the perceptional and operational barriers for vaccine introduction where needed;

3. Work within public-private partnerships to ensure sufficient supply and distribution for the health benefiting products to children in developing countries

See the resources listed in the right panel of this page to learn more about the ADIP projects and participants.

Job opportunities

Resources

The ADIP Management Committee

...More to come

Contact information

Background information

McKinsey & Company's
ADIP case study (Word - 333K)
Presentation (PPT - 265)

Rotavirus ADIP proposal (PDF - 360K)

Pneumococcal ADIP proposal (PDF - 543K)

Original Request for Proposals

Independent Proposal Review Committee

ADIP Q&A - I (Launch phase)

11 February 2002 - Press release - GAVI and The Vaccine Fund announce $60 million boost to accelerate development of lifesaving vaccines

Related websites

Rotavirus Vaccine Program (RVP) at PATH

Johns Hopkins Pneumococcal ADIP project site

GAVI Board developments

09 May 2003 - Teleconference - Approval of management committee members

28 January 2003 - Teleconference - Selection of host agencies

19 November 2002 - 9th Board Meeting - Discussion of proposals

12 September 2002 - Teleconference - Establishment of ADIP Q&A

8 August 2002 - Teleconference - ADIP Preparatory Activities Staffing

20 June 2002 - 8th Board - Accelerated Development and Introduction of Priority New Vaccines: The case of pneumococcal and rotavirus vaccines

14 June 2000 - 3rd Board - Incentives for Accelerated R&D for Priority Vaccines

From Immunization Focus

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