Nine middle-income countries in Africa have agreed to pool vaccine procurement by sharing vital information on purchases including the prices they pay and their suppliers.
Their commitment on 1 November to improve in-country and cross-border processes was made following a three-day workshop organized by the World Health Organization (WHO) Regional Office for Africa in Mbabane, Eswatini, to address access to safe and affordable vaccines in middle-income countries where immunization coverage is decreasing.
The workshop brought together the countries that, due to their middle-income status, are not eligible for immunization financing support from Gavi, the Vaccine Alliance. These nine countries are Algeria, Botswana, Cabo Verde, Eswatini, Gabon, Mauritius, Namibia, São Tomé and Príncipe and Seychelles.
Participants included officials from the respective health and finance ministries, procurement officials, immunization officers and members of national regulatory authorities for vaccines and medicines.
Despite progress in reducing morbidity and mortality due to vaccine-preventable diseases, around 8.5 million children living in the WHO African Region still do not receive all the basic and necessary vaccines. With many middle-income countries transitioning from donor support to domestically funded immunization programmes, access to vaccines remains a challenge due to limited financial resources and to obstacles in accessing a timely and affordable vaccine supply.
A shift to more strategic approaches to vaccine procurement is critical to improve access to affordable vaccines for middle-income countries in the African Region.
The nine countries agreed on harmonised activities to work to a pooled procurement process in the future. These activities include coordinating joint market research, sharing vaccine supplier information and monitoring vaccine prices. By coordinating the informed buying of vaccines, these countries will have greater stability in their vaccine supply as well as increased bargaining power for lower prices.
Five of the countries, those in the regional organization of Small Island Developing States, have already created a single purchasing bloc, which was highlighted during the workshop as an innovative model due to its ability to leverage a better negotiating position and thus achieve reduced prices. Pooling demand can be particularly beneficial to countries with small populations that combine their orders to improve their negotiation terms with suppliers.
Pooled procurement also contributes towards strengthening existing specialized skills for national vaccine procurement and allows for continuous stability in vaccine supply.
The country representatives agreed on collaborating with different models of group purchasing, with all committing to share information and some agreeing to work towards joint price negotiating.
"Pooling vaccine procurement is a major step to increase immunization coverage in these countries and the African region as a whole," said Dr Matshidiso Moeti, the WHO Regional Director for Africa. "We must work together to improve vaccine delivery so that all children are protected from preventable diseases. I am heartened to see such strong cooperation between countries to make universal immunization coverage a reality."
The workshop followed a consultative meeting organized in April 2018 by the WHO Regional Office for Africa, during which 17 low-, middle- and upper-middle-income African countries called for improved procurement skills and knowledge, harmonized product choice and registration processes and the use of pooled procurement options to enhance vaccine security.