Haemophilus influenzae type b (Hib) is a bacterium which can lead to serious, often life-threatening illness in young children. Hib causes meningitis and severe pneumonia, leading to an estimated 8 million cases of serious illness and nearly 400,000 deaths each year in children under 5 years of age.
There is a highly safe and effective vaccine routinely used in the industrialized world for almost 20 years. More than 100 countries, including Canada, the United States, Australia, New Zealand, and many countries in Western Europe routinely use Hib vaccines in childhood immunization programs and have documented virtual elimination of Hib disease.
WHO recommends that Hib vaccine be included in all countries’ routine infant immunization programs and funding from the GAVI Alliance is available to introduce the vaccine into resource-constrained countries. By 2010, 61 of 72 countries eligible for GAVI funding have introduced Hib vaccine into their routine immunization program.
Hib Vaccine Supply and Financing
The GAVI Alliance supports the combination pentavalent vaccine which offers protection from diphtheria, tetanus, pertussis (DTP), Hib and hepatitis B (hepB). Supply is currently available in sufficient quantities to meet the needs of both low and middle income countries. New, pre-qualified products from emerging country manufacturers are also expected soon.
GAVI phase 2 financing allows GAVI-elligible countries to purchase the vaccine for a small co-payment through 2015. GAVI's subsidizatio of pentavalent has encouraged additional suppliers to enter the market, leading to a decline in vaccine prices. However, others, particularly lower middle-income countries, are struggling to find affordable solutions for Hib vaccine use.
Global vaccine supply and demand
Uptake for Hib-containing vaccines has increased rapidly since 2007-2008. Long-term predictions indicate that demand in lower and middle income markets will peak at nearly 350 million doses in the timeframe of 2015 to 2017.
Hib-containing Vaccines: Products Currently Available and In Development
Currently, there are a large number of vaccine manufacturers producing and developing Hib-containing vaccines. For GAVI-eligible countries, suppliers produce pentavalent, monovalent and tetravalent Hib-containing vaccines. The UNICEF supply division maintains current lists of available UNICEF-procured vaccines on their website.
Qualifying and distributing vaccines
The global community is working to ensure a sustainable and affordable supply of Hib vaccines. Increased competition among manufacturers and additional demand for the easy-to-use combination vaccines promise an adequate supply of the vaccine in the years to come.
The UNICEF Supply Division is responsible for procuring vaccines and devices for countries on behalf of the GAVI Alliance. The World Health Organization provides a “pre-qualification” service to UNICEF and other UN agencies by assessing the quality, safety and efficacy of vaccines from a variety of different sources.
A list of WHO pre-qualified vaccines is available here.
Financing Hib Vaccines through the GAVI Alliance
The GAVI Fund enables eligible* countries to purchase Hib containing vaccine for a small co-pay of 15 to 30 cents per dose. Additional vaccines can also be adopted for a co-payment of 15 cents per dose. GAVI pays for the remainder of the vaccine cost, which is often procured through UNICEF. Countries are eligible for funding through 2015, provided that the vaccine is included in their Comprehensive Multi-Year Plan (cMYP).
GAVI Phase 2 has extended funding to allow more countries to provide children with lifesaving vaccines. The increase in predictable demand is already drawing more manufacturers. Prices of pentavalent combinations are expected to decline, making vaccines increasingly more affordable.