Global Immunization Strategies and Initiatives

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world vaccine congress washington 2013

Day One of the World Vaccine Congress USA 2013 got underway with an introductory speech from Neil Darkes, General Manager of the Life Sciences division at Terrapinn. Neil introduced Dr George Siber, Executive Chairman of Genocea, who welcomed us all to the 13th vaccine congress, and gave us some food for thought by asking the question: which 3 interventions have saved the most lives? The first is clean water, the second is adequate nutrition, and the third is the reason why we have all congregated today – vaccines.

Dr Siber's opening remarks were followed by Aurelia Nguyen's presentation on ‘Investing in immunization through the GAVI Alliance: the evidence base'. Aurelia Nguyen is the Director of Policy & Market Shaping at the GAVI Alliance. Her presentation focused on the work of the GAVI Alliance and the importance building of strong partnerships between the public and private sector to widen the portfolio of vaccines, meet vaccine demand and minimize costs. Aurelia Nguyen highlighted the GAVI Alliance's three market shaping goals – that is, 1) Ensuring sufficient supply of vaccines, 2) Minimising costs, and 3) Ensuring quality and innovation. She discussed levels of vaccine supplies between 2001 and 2012, and also the price evolution of vaccines. She explained the importance of increased competition reducing vaccine prices, and informed us about tiered pricing, giving some examples of the pricing differences between GAVI-eligible countries and the US market. She also spoke about the importance of Advanced Market Commitments for pneumococcal vaccines and how these can help accelerate the manufacture and delivery of vaccines. In the Question & Answer session, topics included Advanced Market Commitments for other vaccines, bridging the gap between education, social mobilization and vaccination, and whether reduced price would reduce quality.

Following on from Aurelia Nguyen's presentation, Kim Bush, Director of Life Sciences Partnerships, Global Health Program at the Bill and Melinda Gates Foundation, delivered a talk entitled ‘Investing in Global Health'. His talk covered the history and work of the Gates Foundation, highlighting some figures regarding the Foundation's investments in global health. He provided a remarkable graph that showed the decline of mortality in the under 5s from 20 million in 1960 to 6.9 million in 2011. Great progress has been made, he said, but more still needs to be done. Thus he continued to highlight the priority diseases and conditions in health, specifying that the Foundation's number 1 global health priority is creating and delivering vaccines for infectious diseases. The Gates Foundation will continue to work closely with expanding donor bases and partnerships. He highlighted the fact that developing countries bear 90% of infectious disease burden, but only 10% of global research and development is geared towards these diseases. Only 3 countries have wild-type polio, but the Gates Foundation hopes that the disease will be eradicated within 8-10 years. He highlighted the importance of industry engagement and successful collaboration models to achieve global health success – and as such a focus of the Foundation is to get partners to invest in global health.

Dr Olivier Raynaud, Senior Director, Head of Healthcare Initiatives & Healthcare at the World Economic Forum, delivered a presentation on ‘Immunization today: a global public health perspective'. He told us about he role of the World Economic Forum in vaccines, stating that the aim of the organisation was to contribute to health and improve the state of the world. To achieve this, the World Economic Forum look at four key factors:

1) Health as an economic issue, and making health make economic sense

2) Collaborative solution and action is critical

3) Engaging with the private sector in global health

4) Involving other [non-healthcare orientated] industries to contribute to health

The motto of the World Economic Forum is entrepreneurship in common public interest, and Dr Raynaud highlights to us importance of data and the aggregation of information. Data, says Dr Raynaud, has no value if it isn't shared. If you wondered what the World Economic Forum has to do with vaccination, the Forum's goal is to ensure access to healthy and productive lives, and quality and affordable care.

Next to the stage was Dr Jesse Goodman, Chief Scientist at the Food and Drug Administration (FDA). Dr Goodman delivered a talk entitled ‘Moving R&D into the future', and spoke about vaccine research and development for the 21stCentury. The science is getting hard, says Dr Goodman, but the opportunity is getting great. Dr Goodman explained to us that the common approach is investigator/sponsor driven, where R&D leads to a plan for use, which leads to purchase and therefore demand. He highlights, however, the importance of a changed demand-driven approach. Demand should lead to a plan for use, which in turn leads to R&D and then purchase. This approach is a very different paradigm, with developers and advocates needing to ask the tough questions upfront of whether the vaccine is a high priority, what needs are required to be met, and whether input from organizations has been sought. These questions need to be asked now, not several years and millions of dollars down the line.  Dr Goodman also highlighted the need to build a bigger pre-competitive space for vaccines. He signaled several opportunities for collaboration, including pre-clinical, product manufacturing, clinical trial design, surveillance, and social and behavioural factors in provider and consumer decisions. He wrapped up his presentation by declaring that there are new ways forward for R&D, but we can make this a "decade of vaccines". Only together we can do this, he said, but we can. Questions from the audience included what steps are we taking regarding H7N9 in China, why the FDA are not pushing more for universal influenza vaccines, and whether Phase III trials can be eliminated.

Dr Guru Madhavan, Senior Program Officer, Institute of Medicine, National Academy of Sciences, concluded the Opening Plenary session with a talk on ‘SMART Vaccines: A decision-support tool for prioritizing new vaccines'. He explained that SMART Vaccines was an innovative product of the Institute of Medicine, and was a decision-support tool but does not make decisions itself. Users are offered a choice of up to 29 attributes drawn from broad categories including health burden considerations, economic considerations, demographic considerations, public concerns, scientific and business considerations, programmatic considerations, and policy considerations. SMART Vaccines integrates computed attributes with qualitative attributes entered by the user to provide a value score that compares one vaccine opportunity against one or more other candidates. SMART Vaccines is expected to be used for facilitating discussions about attributes and values among diverse users, helping them to converge upon mutually beneficial priorities and collaborations. You can read more about SMART vaccines here > Dr Madhavan highlighted three expected benefits of SMART vaccines:

1. Increased transparency

2. Discussion facilitation

3. Decision-making tool

Dr Madhavan concluded by asking for feedback on the Phase II of SMART Vaccines.

Are you at the conference? Do you have any comments about the morning's Opening Plenary presentations? You can leave a comment in the box below, on Twitter with the hashtag #wvcusa, or on our LinkedIn group.

>>Read more>> Day One – Morning Session – Immunization Strategies for the Developing World

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