Towards a Vision and Strategy for Vaccines and Immunization for the Decade Ahead 2021-2030
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WORKING DRAFT
Last Modified 8/22/2018 2:01 AM India Standard Time
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Towards a Vision and Strategy for Vaccines
and Immunization for the Decade Ahead
2021-2030
March 2019
Executive summary
Why do we need a new,
2021-2030 plan for vaccines What will the new, 2021-2030 How is the 2021-2030 plan
and immunization? plan include? being co-created?
A compelling vision and strategy Overall, the 2021-2030 plan will include The 2021-2030 plan is being
for vaccines and immunization four elements developed through a highly
2021-2030 is needed, so that all • Global vision and strategy collaborative process, which
countries, regions and partners • Local, regional and global started 18+ months ago with
can define their own strategies implementation plans country consultations that have
and operational plans in a • Revised M&E guidelines already fed into regional business
coordinated way • Advocacy plan and call to action cases, and global strategies
The vision and strategy is the first of As the journey continues, a next
the four elements. It will build from milestone is an Forum in Geneva
and advance existing strategies, and from March 18-21, 2019 to
enable operationalization "Co-Create the Future of
Immunization"
Why do we need a new, 2021-2030 plan for vaccines and immunization?
With the GVAP coming to an end in 2020,
a new plan is needed to set a compelling,
country-centric vision and direction for
the coming decade;
Address new and emerging issues, and
harness new solutions in vaccines and
immunization;
And re-ignite the importance of
immunization for broader health agendas
4
The Decade of Vaccines has achieved
significant progress for immunization
Infants received recommended DTP3 worldwide in 2017,
116M the most ever
4.6M Additional infants vaccinated in 2017 compared to 2010
1.8M Fewer children went under-vaccinated in 2017 than in 2010
Additional countries achieved maternal and neonatal tetanus
3 elimination in 2017 (Ethiopia, Haiti and the Philippines)
113 Countries introduced new vaccines since 2010
+140% Increase in the number of functional NITAGs since 2010
Source: 2018 assessment report of the GVAP (WHO)
Non-exhaustive
However most GVAP goals will not be met by 2020, with
existing/emerging realities further inhibiting progress
Most GVAP goals will not be met by … with several current and emerging
2020 (select figures) … realities standing in the way of progress
3 Polio-endemic countries remain (Afghanistan, Pakistan, Political & Economic dynamics – e.g., volatile and uncertain
Nigeria); global polio eradication by 2018 not achieved yet geopolitical dynamics generate more fragile, at-risk contexts;
No Region has sustained verification of measles elimination status persisting economic and capacity inequalities in-country and
between-countries are reflected in coverage disparities
Only 1 Region became rubella-free in 2018 (the Americas)
Demographic dynamics—e.g., population growth, mass
14 Countries yet to achieve MNT elimination urbanization and migration pose major challenges for
~85% Coverage level stagnation level for MCV1 between 2010 and immunization systems; 'hard to reach' populations become
2017 (below the 90%+ target) more multi-faceted
< 30% Of countries have achieved DTP3 coverage of 90% nationally Technological trends – e.g., social media, a potential means
and 80% in every district for spreading information and educating consumers, is also
contributing to increased 'vaccine hesitancy' in some
19.9M Children still under-vaccinated in 2017
countries
25 Low- and middle-income countries have not introduced any Source: 2018 assessment report of the GVAP (WHO);
new/ under-utilized vaccine between 2010 and 2016 GVAP—Secretariat annual report 2018
Non-exhaustive
Immunization will continue to evolve from a focus on infants and children to
vaccinating along the life course
Country-focus will be key to ownership, political commitment and sustainability of
the immunization agenda
The next decade Approaches to reach un-immunized populations will target increasingly fine and
precise areas, thanks to higher-quality data
will need to also
address new and Focus will be on driving coverage and equity for existing vaccines, leveraging
innovations in delivery products and practices
emerging issues,
Developing and securing healthy vaccines markets (adequate, continuous supply;
and harness new affordable prices; etc.) will continue to be a key priority
solutions in Thoughtful integration with Maternal, Child and Adolescent health programs and
vaccines and PHC, and collaboration across the ecosystem will be key to deliver at-scale impact
immunization … Immunization demand and acceptance will also be essential to drive coverage
Disease surveillance will be a driving component of high functioning vaccine and
immunization systems
The role of vaccines in preventing or responding to health emergencies, even more
so in fragile contexts, will become ever more important in the next decade
7
… while at the
same time
contributing to
the broader
global health and
development
agendas Sustainable Primary Universal Health 13th General
Development Health Coverage Programme of
Goals Care Work
8
What will the new, 2021-2030 plan include?
Under development
The 2021-2030 plan will include four key elements
1 2
Global, regional and local implementation plans,
aligned with overall strategy, tailored to context to
ensure implementation
A new global vision and strategy for
vaccines and immunization for the
entire health community up to 2030,
3
Revised M&E guidelines—streamlined, linked to
that reflects the collective inputs of other frameworks—to reduce the reporting burden
all partners and stakeholders, and improve data quality
and provides a scaffolding for
partner’ efforts
4
Advocacy for the 2021-2030 strategy to create a movement and build
To be endorsed by Ministers of Health momentum for the new vaccines and immunization agenda
of all countries during WHA 73 (2020)
Focus between now and WHA 73Non-exhaustive
Plan being co-created bottom-up: Countries, existing strategies
are the sources shaping the unified vision and strategy for 2030
Extensive country inputs
have been the basis for
new global and regional,
health immunization and
disease-specific strategies.
They will constitute
building blocks of the
2021-2030 plan
Unified, global
2021-2030 vision and
strategy for vaccines
and immunizationNon-exhaustive
2021-2030 plan will link to recent health agendas for the
decade —all of which have had substantial country input
“Health” scope Health and SDG 3
Wellbeing Plan 2030
GPW 13
2023
Universal and UHC Vision
Primary Health 2030
PHC Vision
2030
Maternal and
Child Health UNICEF Health
strategy 2030
Immunization Regional Gavi 5.0 UNICEF Immun. 2021-2030 2021-2030 plan will
roadmaps 2030 2025 RM 2030 plan serve as global umbrella
ADI 2020 for immunization
Disease-specific Meningitis M&RI 2020
RM 2030
Polio Endgame MNTE Plan
(2023), PCS 2020
Geography
Global covered
Country Region LICs MICs
(incl. HICs)
Ending before 2030
Color key: (to be updated in light of 2021-2030 plan) Covering until 2030 RM: roadmap… while recognizing differences between
the two documents
Equity, Security and Prosperity
2021-2030 Gavi 5.0 2021-2030
Focused scope Broader scope
process will • Priority countries • All countries
• Priority vaccines • All recommended Vaccines
also leverage • Focused interventions • Broader set of interventions
ongoing Gavi • Five years • 10 years
5.0 process and Platforms for investments that
contribute to 2021-2030 objectives
Platform for aligning on a new global
vision and strategy for the entire
consultations … (funding mechanism) health community
Target audience is the Gavi Board Target audience are countries and
Ministers of Health/WHA
13Non-exhaustive
2021-2030 plan will provide unified vision and approach for
vaccines and immunization, and support for country impact
Country impact Example priorities to be explored
• Lifecourse and integrated
delivery platforms
Strategic priorities • Products/delivery innovations
To achieve the vision • Demand and acceptance
• Surveillance and data
• Management of transitions
Operational enablers • Etc.
For the vision and strategy
Strategy “operationalization” will be key
2021-2030 vaccines focus for 2021-2030, with regional/ local
and immunization vision plans to be developed beyond WH73
(Vision for in-country and levering existent partnerships and new
global impact, and for contribution models of coordination/ collaboration
to health and development agenda)How is the 2021-2030 plan being co-created?
Six principles are guiding development of 2021-2030 plan
Think in novel ways; Be collaborative, while
Focus on countries
Engage broadly focused and practical
Country impact at center of plan Think creatively; engage more broadly: Collaborate with partners throughout
development: focus on country involve non-immunization partners in process; generate lean, prioritized,
ownership, implementability, and impact building plan focused, practical plan
Advance broader
Learn from the past Build on the existing health agendas
Learn lessons from GVAP 2011-20, Integrate with existing global health, Lay out how next-generation
especially on how to manage partner, immunization and disease-specific immunization systems will contribute
accountabilities and build strategies (UNICEF, Gavi, WHO, GPEI, to and align with broad health agendas
effective partnerships M&RI, MNTE, etc.) (SDG, UHC, PHC)Under development
A holistic, representative and collaborative working structure
propels the 2021-2030 plan
Engagement of Ministers Engagement of Chairs of RITAGs Involvement and consultation Engagement of broad
of Health and NITAGs of countries immunization community
• WHO Regional Committees • Regional Immunization Technical • Dedicated consultations e.g., • Dedicated engagements e.g.,
(Summer/Fall 2019) Advisory Groups (RITAG) Gavi 5.0 country consultations, Gavi 5.0 country consultations,
Country and • WHO Executive Board • National Immunization Technical 2021-2030 March consultation 2021-2030 March Forum
stakeholder • WHA72 (May 2019) and Advisory Groups (NITAG) • Additional involvement • Additional involvement
engagement WHA73 (2020) channels—to be defined channels—to be defined
Leadership Council1 Leadership Team1 Partner Task Team1
(coordinated by WHO) • Advises on directions and • Develops content for and drafts
• Broadly endorses the priorities for 2021-2030 the new strategy
2021-2030 plan • Ensure countries/regions • Establishes mechanism
• Advocates immunization as are engaged for broad-based, multi-
Global foundation of PHC • Steers work of Task Team stakeholder consultations
alignment • Engage Ministers of Health to • Endorses new strategy for • Gathers country inputs
champion 2021-2030 plan submission to SAGE throughout development
endorsement at WHA73 in • Provides update to the
May 2020 Leadership Council
Secretariat
• Coordinates process
1. With initial representatives from CDC, CSO, BMGF, Gavi, GFF, NIH-NIAID, RITAG+, UNICEF, WHO, World Bank, others as neededNon-exhaustive
Deep and broad stakeholder engagement will enable
co-creation of 2021-2030 vision and strategy ahead of WHA73
2018–Mar. 2019 Apr. 2019 May–Sept. 2019 Oct. 2019–May 2020
Initial co-creation “Draft zero” Broad engagement to Continued engagement
co-develop and refine to refine and socialize
AFRO EPI Mgrs EMRO RWG ASVAC AFRO EPI Mgrs
Key regional Mar 18-20 June 9-10 Sep 13-15 Q3
and country
meetings TAGs (PAHO/ SEARO/ WPRO) Regional Committees EURO TAG
June-July Mid Aug- Mid Oct Oct-Nov (TBD)
Scheduled Post-2020 Gavi Board UNICEF CDC Gavi Board DOV WG Task Team Gavi Board
Partner Forum Retreat MENA Retreat Meeting Meeting Meeting Meeting
consultations Mar 19-21 Mar 27-29 Apr 29-30 June 3-14 June 26-27 Aug 20 Sep (TBD) Dec 4-5
Submission SAGE Paper EB Paper WHA Paper
deadlines Sep 16 Sep 30 Feb 20
Key review and SAGE SAGE WHO EB SAGE
decision points Apr 2-4 Oct 8-10 Jan 20 Apr 4
Key events World Imm. Week WHA AU meeting UNGA - UHC WHA73
Apr 24-30 May 20-28 June 27-28 Sep 17-30 MayThe next key milestone
March Forum
March 18-21, 2019
19The “draft zero” of the 2021-2030
vision and strategy will be put
together and broadly circulated for
open input, comments, revisions,
Following additions over several months
the March Forum Country leadership will be identified
for involvement in the WHA process
Advocacy and “political will”
strategy will be developed
20We look forward to working together
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