MSF critical of GAVI Alliance supply strategy

The international aid organization Médecins Sans Frontières recently released a brief warning that current childhood vaccine supply and procurement practices are leading to national and international shortages.

The MSF brief uses the experiences of the GAVI Alliance in Nigeria as a case study for how even the most well-prepared organizations can run into significant trouble in their attempts to ensure that they can maintain a consistent and uninterrupted vaccine supply.

The GAVI Alliance, a public-private partnership, finances the introduction of new and needed vaccines in some of the world's poorest countries. The alliance has helped accumulate $7.9 billion for immunization programs around the world and been responsible for vaccinating more than 370 million children.

GAVI hoped to use its vast purchasing power to obtain more favorable rates on vaccines and the ability to procure them in sufficient quantities.

In 2009, Nigeria asked GAVI for the funding needed to introduce a pentavalent vaccine for use against diphtheria, pertussis, tetanus, hepatitis B and haemophilus influenza type B.

Two-and-half years later, after Nigeria had invested in new equipment and secured its cold chain, GAVI said the country would have to alter its plans radically and initially use a lyophilized vaccine instead of a liquid vaccine because of supply problems.

Lyophilized vaccines require more preparation before use because they include a freeze-dried component and must be reconstituted. Liquid vaccines hold other advantages. They take up less space, can be used for up to 28 hours if removed from their vial and are much faster to administer. Using a lyophilized vaccine places an unexpected burden on the Nigerian healthcare system and MSF concluded that the sudden change may have thrown its immunization plans entirely off track.

MSF admitted that it is too early to tell what impact the change may have on immunization rates, but it said that GAVI should have anticipated the problems and hopes the organization will learn lessons from them.