As WHO further demonstrated, even something so seemingly simple as a stockpile of vaccines can have an outsized impact on outbreak response while also improving many of the factors that influence access to vaccines.
Managing a stockpile of cholera vaccines, South Sudan
Managing a stockpile of cholera vaccines, South Sudan
WHO/South Sudan
In 2013, WHO created a stockpile of oral cholera vaccines in response to a critical situation. Cholera epidemics were raging, yet the use of vaccines was low and manufacturers had little incentive to increase supplies. In establishing the stockpile, WHO made a commitment to buy and use 2 million doses a year in order to facilitate the availability of vaccine to underserved populations.
Although the cholera vaccine stockpile is essentially a vaccine access, procurement and distribution mechanism, it has generated multiple health benefits well beyond saving lives. It improved reporting. In public health, the promise of assistance is one of the strongest incentives to report epidemic-prone diseases immediately and transparently. As long experience shows, the temptation to cover up a cholera outbreak is great, given the potential impact on trade and tourism.
"The stockpile improved the speed needed for an emergency response, especially in the context of humanitarian crises."
Dr Chan, WHO Director-General
The stockpile improved access to oral cholera vaccine and therefore the capacities of emergency response, especially in the context of humanitarian crises, such as the ones currently being experienced in South Sudan and Somalia. Following receipt of a request by the International Coordinating Group, vaccines are due to arrive in the country within a maximum of 10 days. It also increased supplies. Three producers have now been prequalified by WHO, with vaccine supply set to triple in 2017. These vastly increased supplies have opened the first opportunity for large scale campaigns in “hot spots” with repeated outbreaks.
In addition, the stockpile decreased costs as more producers entered the market, and generated additional data on vaccine safety, effectiveness, and impact, thus strengthening the case for further investment.
In short, a seemingly simple thing, like the setting up of a stockpile, has transformed a vicious cycle of low demand, low production, high price, and inequitable distribution to a virtuous cycle of increased demand, increased production, reduced price, and greater equity of access. WHO regards a stockpile of rabies vaccine as a logical next step to follow.