PRESENTATION TO THE MSF VACCINE MEETING YOGAN PILLAY, DEPARTMENT OF HEALTH, SOUTH AFRICA OSLO 15 OCTOBER 2013
EPI Schedule
HPV in 2014
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RSA EPI Vaccine Annual Requirement Annual requirements in doses 3 514 800 2 240 400 4 000 000 2 000 000
Value contribution to EPI budget 1% 1% 34% 10%
Pneumo
3 000 000
36%
Hep B OPV Measles BCG HPV (in 2014)
3 924 520 4 580 500 5 449 000 6 389 000 1 000 000
1% 3% 4% 1% 10%
Doses per annum
36 235 061
Vaccine TT Td DTaP-Hib-IPV Rotavirus
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Annual spend on vaccines • • • • • •
Total: R1.7b EPI: R1.4b Non EPI: R80m Private sector: R250m Total annual public sector exp: R100b Total annual private sector exp: R100b
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Supply issues Vaccine
Supply Issues
No of registered products in SA
Source
TT
Generally ok
Sanofi ( France)
1 (Biovac filing for registration in 2014)
Td
Generally ok
Sanofi ( France)
1
DTaP-Hib-IPV
Had issues in 2012 but 2013 smooth
Sanofi (France)
1
Rotavirus
Had issues in 2011 but 2012+2013 ok
GSK ( Belgium)
2
Pneumo
No issues
Pfizer ( USA & Ireland))
2
Heber ( Cuba)
3
Sanofi (France)
1
Sanofi( France)
1 (Biovac hoping to have a registered one in 2014)
Hep B OPV Measles
Quality issues in 2013 Will hopefully be resolved by end 2013 Worlwide demand and campaigns has affected supply to SA in 2013 Worlwide demand and campaigns has affected supply to SA
BCG
Slight supply issues in early 2013, not major.
SSI ( Denmark)
1
HPV
N/A
GSK
2 5
Differences between comparison of PAHO + UNICEF vs SA SA
PAHO + UNICEF
Decision making
Independent, DoH+ NAGI
General. Supranational organisations: WHO ,SAGE,GAVI ,BMGF play a huge role
volumes
lower
Much larger
Presentation of product
SA specific packs
International pack
Payment
Biovac collects 60days after delivery
Upfront payment before deliveries are made
Price
Public sector prices (Biovac to DoH) c are all inclusive of deliveries to the customer and included in the prices that are in the ‘public’ domain
Prices typically reflect ex-manufacturers prices. Not included in the prices that are in the public domain are extra charges , see below: UNICEF: procurement services handling fee of 4.5%, requirement for a 10% buffer until the transaction has been completed, and freight and insurance costs PAHO: 3.5% of the net cost of the goods (excluding freight and insurance). The 3% goes to the common capital fund to be used by PAHO as working capital to provide a line of credit to participating Member States, and a 0.5% contributes towards the administrative and purchasing activity costs.
Products
• SA uses acellular pertussis penta • IPV already introduced through the pentavalent • Pneumo= SA uses a 2+1 schedule • HPV= unique 2 dose schedule will be implemented
• Mainly whole cell pertussis penta being used • IPV is only being introduced through the polio eradication plan from 2016 • The traditional 3+o schedule is used • HPV= 3 dose schedules to be adopted 6
African Human Vaccine Manufacturers
Egypt Senegal
South Africa)
Source: World vaccines, 2007
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Developing Regions birth cohort and the proportion of vaccine manufacturers
Region
Birth cohort
No of Vaccine manufacturers
Africa
47m
3
Asia
61m
>20
Latin America
10,7m
7
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Thank you for your attention!
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