CEECIS Procurement Data

Slide 1: UNICEF Vaccine Procurement in the CEE/CIS Region 1997 - 2007

Slide 2: CEE/CIS – A region with a wide profile of income levels, procurement profiles and immunization schedules Albania, Armenia, Azerbaijan, Belarus, Bosnia-Herzegovina, Bulgaria, Croatia, Georgia, Kazakhstan, Kosovo, Kyrgyzstan, Macedonia, Moldova, Montenegro, Romania, Russian Federation, Serbia, Tajikistan, Turkey, Turkmenistan, Ukraine, Uzbekistan, Yugoslavia FR 2005 Data Country_name No of Countries No of Countries classified as The former Yugoslav Republic of Macedonia No of GAVI countries Serbia and Montenegro (pre-cession) eligible WB Income LDC Bosnia and Herzegovina classification Russian Federation Turkmenistan Grand Total Kazakhstan Kyrgyzstan Uzbekistan Azerbaijan Tajikistan Romania Armenia Bulgaria Moldova Georgia Albania Ukraine Belarus Croatia Turkey Upper middle income 4 Lower middle income 13 5 Low income 3 3 Grand Total 20 8 Vaccine_full BCG 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 20 Dip 1 1 2 DT 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 17 DTaP 1 1 2 DTaPIPV 1 1 DTwP 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 18 DTwPHep 1 1 2 DTwPHib 1 1 DTwPIPV 1 1 Procuring Profiles HepA 1 1 2 HepB 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 20 Hib 1 1 2 •Self Producing Countries Influenza IPV Measles 1 1 1 1 1 1 1 1 1 1 1 1 1 2 4 7 •Self Procuring Countries MenC_conj MM MMR 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 17 •Procurement through MR Mumps OPV 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 5 20 UNICEF Pneumo_ps Pw 1 1 Program, PS, GAVI Rubella 1 1 1 1 1 1 6 Td 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 18 TT 1 1 1 1 1 1 1 1 1 9 Typhoid 1 1 1 1 4 Vitamin A 1 1 2 Yellow fever 1 1 2 Grand Total 8 6 7 9 11 8 9 7 13 8 7 16 15 12 7 9 7 9 11 9 188 Data Source: Immunization Summary 2007 (2005 Data), WHO/UNICEF Joint Publication

Slide 3: UNICEF is forecast to procure for 34% of the Region’s birth cohort in 2008, the majority being within the low income countries within the Region Percentage of Regions Population Within the CEE/CIS region covered by UNICEF Procurement, UNICEF is forecast* to procure by income level all vaccines for: % of Birth Cohort Classification covered by UNICEF Albania and Turkmenistan Procurement and a portion of vaccines for: Upper middle income 0% Armenia, Azerbaijan, Bosnia, Lower middle income 41% Georgia, Kyrgyzstan, Moldova, Low income 87% Tajikistan, Ukraine, Uzbekistan Grand Total 23% * Based on UNICEF Vaccine Forecast 2008 Data Sources: Population Data: ‘The State of the Worlds Children 2008’ Procurement Coverage Data: UNICEF Vaccine Forecast 2008 Income Classification: World Bank

Slide 4: CEE/CIS Vaccine Procurement volumes 1997-2007 140,000,000 120,000,000 100,000,000 80,000,000 60,000,000 40,000,000 20,000,000 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG DT DTP HEPB HIB MEA MMR MR OPV OTHER Td TT

Slide 5: CEE/CIS Vaccine Procurement Value 1997-2007 $16,000,000 $14,000,000 $12,000,000 $10,000,000 $8,000,000 $6,000,000 $4,000,000 $2,000,000 $- 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG DT DTP HEPB HIB MEA MMR MR OPV OTHER Td TT Vaccine 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG $ 364,952 $ 188,682 $ 196,818 $ 110,618 $ 192,446 $ 399,331 $ 76,902 $ 100,946 $ 282,108 $ 56,690 $ 170,035 DT $ 129,037 $ 7,623 $ 51,408 $ 34,522 $ 27,563 $ 10,656 $ 3,513 $ 31,088 $ 33,745 $ 39,687 $ 23,869 DTP $ 820,770 $ 574,942 $ 558,330 $ 502,501 $ 335,877 $ 498,735 $ 770,437 $ 880,581 $ 970,363 $ 735,560 $ 789,737 HEPB $ 20,964 $ 217,340 $ 210,617 $ 930,820 $ 2,729,509 $ 1,992,196 $ 1,105,868 $ 1,597,938 $ 1,295,249 $ 1,529,947 $ 674,650 HIB $ 388,080 MEA $ 603,367 $ 604,758 $ 752,363 $ 479,294 $ 203,993 $ 278,303 $ 299,050 $ 921,880 $ 164,250 $ 92,760 MMR $ 105,627 $ 558,564 $ 313,794 $ 626,075 $ 687,600 $ 429,821 $ 250,865 $ 491,708 $ 981,340 $ 933,974 MR $ 468,050 $ 1,459,766 $ 645,696 $ 488,810 $ 80,520 $ 1,634,130 $ 61,976 $ 10,800,095 OPV $ 3,874,944 $ 4,490,125 $ 2,706,782 $ 2,729,019 $ 2,895,379 $ 3,993,015 $ 527,375 $ 1,037,441 $ 947,652 $ 678,197 $ 794,885 OTHER $ 352,358 $ 14,168 $ 117,959 $ 10,770 $ 793,900 $ 184,231 $ 10,350 $ 1,100 $ 119,213 Td $ 140,357 $ 10,100 $ 54,717 $ 22,268 $ 22,934 $ 18,005 $ 14,243 $ 19,883 $ 16,030 $ 38,080 $ 25,025 TT $ 91,605 $ 2,092 $ 29,109 $ 1,495 $ 21,339 $ 2,570 $ 5,133 $ 21,326 $ 7,504 $ 4,031 $ 11,095 Grand Total $ 6,398,354 $ 6,215,457 $ 5,236,668 $ 5,603,150 $ 9,308,780 $ 8,710,337 $ 3,731,501 $ 4,942,467 $ 5,843,837 $ 4,337,480 $ 14,611,444

Slide 6: Vaccine Procurement CEE/CIS in a Global perspective (US$ value) $700,000,000 $600,000,000 $500,000,000 $400,000,000 $300,000,000 $200,000,000 $100,000,000 $- 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 ROSA WCARO ESARO EAPRO MENA TACRO CEE/CIS USD Value Region Proc Year ROSA WCARO ESARO EAPRO MENA TACRO CEE/CIS Grand Total 1997 $ 23,146,750 $ 14,499,339 $ 18,001,414 $ 11,426,829 $ 9,692,647 $ 556,505 $ 6,398,354 $ 83,721,838 1998 $ 36,106,878 $ 14,870,449 $ 11,055,220 $ 12,779,494 $ 5,420,710 $ 504,598 $ 6,215,457 $ 86,952,806 1999 $ 84,383,759 $ 20,912,869 $ 17,084,510 $ 10,582,900 $ 6,507,163 $ 188,170 $ 5,236,668 $ 144,896,039 2000 $ 77,757,870 $ 25,352,325 $ 14,925,473 $ 6,743,835 $ 7,467,977 $ 895,233 $ 5,603,150 $ 138,745,864 2001 $ 92,380,646 $ 47,115,188 $ 67,593,592 $ 15,599,511 $ 9,795,765 $ 3,992,428 $ 9,308,780 $ 245,785,911 2002 $ 103,094,159 $ 51,172,155 $ 51,204,279 $ 18,445,352 $ 9,553,550 $ 4,635,469 $ 8,710,337 $ 246,815,302 2003 $ 163,842,921 $ 49,218,368 $ 90,171,555 $ 14,390,403 $ 25,019,728 $ 616,395 $ 3,731,501 $ 346,990,870 2004 $ 158,478,808 $ 90,953,011 $ 73,826,061 $ 16,808,986 $ 21,385,538 $ 5,484,391 $ 4,942,467 $ 371,879,261 2005 $ 168,938,666 $ 109,564,797 $ 83,950,693 $ 22,974,046 $ 40,931,542 $ 4,114,880 $ 5,843,837 $ 436,318,461 2006 $ 256,036,096 $ 107,120,500 $ 80,347,168 $ 20,774,421 $ 23,404,505 $ 1,063,764 $ 4,337,480 $ 493,083,935 2007 $ 283,859,149 $ 127,789,438 $ 122,417,692 $ 29,271,774 $ 39,115,118 $ 1,705,178 $ 14,611,444 $ 618,769,792 Grand Total $ 1,448,025,702 $ 658,568,439 $ 630,577,657 $ 179,797,552 $ 198,294,243 $ 23,757,012 $ 74,939,474 $ 3,213,960,078

Slide 7: Unicef Vaccine Procurement by region (in Volume) 3,500,000,000 3,000,000,000 2,500,000,000 Quantity in Doses 2,000,000,000 1,500,000,000 1,000,000,000 500,000,000 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 ROSA WCARO ESARO EAPRO MENA TACRO CEE/CIS

Slide 8: Vaccine Procurement by Country for the period 1997 - 2007 140,000,000 120,000,000 100,000,000 Quantity in Doses 80,000,000 60,000,000 40,000,000 Country Name Quantity in Doses ALBANIA 19,058,730 20,000,000 ARMENIA 16,000,930 AZERBAIJAN 22,159,740 0 BELARUS 373,000 MACEDONIA AZERBAIJAN KYRGYZSTAN ROMANIA TURKEY UKRAINE ARMENIA GEORGIA YUGOSLAVIA FR CROATIA BELARUS KOSOVO ALBANIA BOSNIA-HERZEGOVINA BULGARIA KAZAKHSTAN RUSSIAN FEDERATION UZBEKISTAN MOLDOVA TAJIKISTAN TURKMENISTAN BOSNIA-HERZEGOVINA 10,345,230 BULGARIA 2,426,500 CROATIA 74,600 GEORGIA 14,782,162 KAZAKHSTAN 20,070,000 KOSOVO 3,844,421 KYRGYZSTAN 25,506,050 MACEDONIA 4,076,800 MOLDOVA 9,101,620 Total ROMANIA 2,309,990 RUSSIAN FEDERATION 79,482,550 TAJIKISTAN 50,807,325 TURKEY 131,577,000 TURKMENISTAN 31,253,470 UKRAINE 18,987,880 UZBEKISTAN 122,816,230 YUGOSLAVIA FR 9,054,400 Grand Total 594,108,628

Slide 9: Vaccine Procurement by Country (US$ Value) for the period 1997 - 2007 $18,000,000 $16,000,000 $14,000,000 $12,000,000 US$ Value $10,000,000 $8,000,000 Country Name USD Value ALBANIA $ 3,435,845 $6,000,000 ARMENIA $ 3,076,880 $4,000,000 AZERBAIJAN $ 3,568,734 BELARUS $ 39,588 $2,000,000 BOSNIA-HERZEGOVINA $ 1,520,138 BULGARIA $ 406,142 $- KYRGYZSTAN BOSNIA-HERZEGOVINA BULGARIA UKRAINE RUSSIAN FEDERATION AZERBAIJAN YUGOSLAVIA FR ARMENIA MACEDONIA ROMANIA BELARUS KAZAKHSTAN UZBEKISTAN MOLDOVA ALBANIA GEORGIA KOSOVO TURKMENISTAN TURKEY CROATIA TAJIKISTAN CROATIA $ 20,340 GEORGIA $ 1,954,830 KAZAKHSTAN $ 1,569,477 KOSOVO $ 1,122,822 KYRGYZSTAN $ 5,280,184 MACEDONIA $ 457,676 MOLDOVA $ 2,289,650 ROMANIA $ 278,481 RUSSIAN FEDERATION $ 1,231,743 Total TAJIKISTAN $ 6,334,731 TURKEY $ 11,446,751 TURKMENISTAN $ 5,108,667 UKRAINE $ 6,402,294 UZBEKISTAN $ 16,959,975 YUGOSLAVIA FR $ 2,434,525 Grand Total $ 74,939,474

Slide 10: There has been a steady decline in the overall volume of procurement for the Region through UNICEF although an increased was noted in 2007 140,000,000 120,000,000 100,000,000 Quantity in Doses 80,000,000 60,000,000 7% Funded through GAVI 40,000,000 33 % Funded 20,000,000 through PS 60% Funded 0 through Prog 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 PROG PS GAVI

Slide 11: The procurement profile by value illustrates a gradual decline up until 2007, with the increase of MR procurement for the campaigns undertaken in the Region $16,000,000 $14,000,000 $12,000,000 $10,000,000 US$ Value $8,000,000 $6,000,000 70% Funded by $4,000,000 Prog $2,000,000 $- 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 PROG PS GAVI

Slide 12: Vaccine Arrival Reports are key in ensuring safe vaccine arrival in the country CEE/CIS Regional Vaccine Arrival Report for 2006 Macedonia, TFYR Moldova, Rep of Turkmenistan Bosnia-Herz. Grand Total Kyrgyzstan Uzbekistan Tajikistan Armenia Ukraine Albania 2006 VAR Data Shipments 19 14 10 15 1 1 3 20 7 4 94 VAR received 19 14 10 14 1 1 3 20 7 4 93 VARs received (%) 100% 100% 100% 93% 100% 100% 100% 100% 100% 100% 99% Average of no. of days to receive VAR 6 70 39 15 22 179 10 3 28 24 25 Count of CCM change - Window A 1 6 7 Count of CCM change - Window B 1 6 7 Count of CCM change - Window C Count of CCM change - Window D Goal: 100% of VAR should be returned to SD within 3 days Most countries achieved 100% response rates proving that it is possible – focus still needed on the number of days for VARs to be returned. Delayed VARs put vaccine security at risk

Slide 13: Vaccine Arrival Reports in 2007 in CEE/CIS Region Serbia & Montenegro Moldova, Rep of Turkmenistan Bosnia-Herz. Grand Total Kyrgyzstan Uzbekistan Azerbaijan Tajikistan Georgia Kosovo Ukraine Albania 2007 VAR Data No of Shipments 16 2 10 3 12 17 1 3 17 16 4 8 109 VARs received 16 2 9 2 12 17 1 3 15 16 3 7 103 Percentage of VARs Received 100% 100% 90% 67% 100% 100% 100% 100% 88% 100% 75% 88% 95% Ave No of days to receive VAR 27 17 42 59 13 24 10 7 6 2 13 24 18 Count of CCM change - Window A 2 3 1 6 Count of CCM change - Window B 3 1 4 Count of CCM change - Window C Count of CCM change - Window D For some countries, the number of VAR provided as well as the delays in receiving the VARs still need to improve

Slide 14: Albania 1997-2007 $700,000 $600,000 $500,000 $400,000 US$ Value $300,000 $200,000 $100,000 $- 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG DT DTP HEPB MEA MMR MR OPV OTHER Td TT USD Value Proc Year Vaccine 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG $ 19,725 $ 23,649 $ 17,000 $ 34,918 $ 3,258 $ 5,170 $ 7,380 $ 8,109 $ 5,356 $ 6,367 DT $ 10,640 $ 12,600 $ 7,613 $ 2,220 $ 2,450 $ 4,690 $ 7,353 $ 6,290 $ 6,300 DTP $ 30,794 $ 5,899 $ 64,700 $ 40,581 $ 39,100 $ 11,250 $ 52,722 $ 9,488 $ 44,000 $ 61,824 HEPB $ 116,000 $ 101,026 $ 96,350 $ 43,536 $ 43,833 $ 79,080 $ 4,200 $ 29,635 MEA $ 13,475 $ 16,029 $ 20,800 MMR $ 81,668 $ 218,835 $ 252,400 MR $ 468,050 $ 394,900 $ 46,080 $ 124,970 $ 35,624 $ 488 OPV $ 51,350 $ 70,000 $ 86,200 $ 53,438 $ 17,980 $ 29,906 $ 36,248 $ 36,785 $ 46,512 $ 51,666 OTHER $ 14,362 $ 14,168 $ 54,358 Td $ 11,400 $ 2,200 $ 16,000 $ 6,000 $ 1,800 $ 3,038 $ 5,528 $ 4,935 $ 5,425 $ 6,580 TT $ 17,535 $ 8,970 $ 9,450 $ 2,262 $ 5,133 $ 12,803 $ 4,116 $ 4,031 $ 7,245 Grand Total $ 169,281 $ 131,945 $ 280,628 $ 584,050 $ 647,925 $ 209,050 $ 225,453 $ 198,828 $ 231,533 $ 335,137 $ 422,016 Quantity in Doses roc Year P Vaccine 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG 300,000 420,000 400,000 308,000 72,000 113,000 156,000 159,000 103,000 119,000 DT 180,000 280,000 145,000 40,000 71,500 67,000 86,500 74,000 60,000 DTP 430,000 90,000 980,000 550,000 460,000 125,000 303,000 82,500 137,500 256,000 HEPB 200,000 323,200 205,000 90,700 131,000 300,000 22,700 150,050 MEA 110,000 150,000 200,000 MMR 53,400 162,100 132,280 MR 1,265,000 897,500 96,000 260,800 73,000 1,000 OPV 600,000 1,000,000 1,050,000 636,000 200,000 321,000 394,000 333,000 288,000 316,000 OTHER 0 0 0 Td 180,000 40,000 320,000 125,000 40,000 67,500 100,500 70,500 77,500 70,000 TT 375,000 260,000 270,000 80,000 88,500 118,000 73,500 69,500 103,500 Grand Total 2,175,000 1,700,000 3,490,000 1,465,000 3,254,700 1,193,000 1,138,000 1,342,500 1,158,400 935,300 1,206,830

Slide 15: Armenia 1997-2007 $1,200,000 $1,000,000 $800,000 US$ Value $600,000 $400,000 $200,000 $- 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG DT DTP HEPB MEA MMR MR OPV OTHER Td USD Value Proc Year Vaccine 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG $ 10,695 $ 10,811 $ 9,875 $ 12,000 $ 8,925 $ 4,525 $ 6,863 $ 7,500 $ 9,481 $ 8,883 $ 11,841 DT $ 356 $ 792 $ 450 DTP $ 5,650 $ 34,890 $ 4,869 $ 15,000 $ 16,800 $ 28,488 $ 5,535 $ 19,373 $ 35,673 $ 52,480 $ 79,200 HEPB $ 35,340 $ 91,941 $ 66,700 $ 105,057 $ 61,047 $ 19,065 $ 44,715 $ 39,467 $ 26,469 $ 50,225 MEA $ 19,180 $ 31,567 $ 14,353 $ 31,104 $ 17,280 $ 9,060 $ 4,214 $ 13,500 MMR $ 370,000 $ 76,111 $ 55,675 $ 68,000 $ 67,500 $ 85,200 MR $ 692,288 OPV $ 77,662 $ 94,026 $ 75,914 $ 28,800 $ 23,730 $ 17,280 $ 17,280 $ 36,270 $ 36,108 $ 39,200 $ 39,720 OTHER $ 16,652 Td $ 11,250 $ 7,900 $ 7,900 $ 6,000 $ 8,640 $ 990 $ 4,455 $ 7,975 $ 6,860 $ 6,860 $ 9,400 Grand Total $ 124,793 $ 215,326 $ 221,503 $ 160,054 $ 180,432 $ 491,390 $ 133,522 $ 171,507 $ 209,088 $ 201,392 $ 967,874 Quantity in Doses Proc Year Vaccine 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG 186,000 200,000 190,000 200,000 200,000 100,000 150,000 150,000 185,000 170,000 199,000 DT 8,000 16,000 10,000 DTP 100,000 623,500 100,000 200,000 200,000 316,000 54,000 180,000 181,500 170,500 240,000 HEPB 62,000 161,300 115,000 184,310 107,100 46,500 109,060 96,260 90,900 156,900 MEA 145,000 273,000 130,000 243,000 120,000 60,000 26,500 100,000 MMR 200,000 58,100 42,500 50,000 50,000 60,000 MR 1,492,000 OPV 1,049,000 1,380,000 1,127,000 400,000 300,000 180,000 180,000 400,000 306,000 280,000 300,000 OTHER 0 Td 250,000 200,000 200,000 200,000 180,000 20,000 99,000 145,000 98,000 98,000 100,000 Grand Total 1,738,000 2,754,500 1,908,300 1,368,000 1,184,310 983,100 614,100 1,026,560 1,016,760 859,400 2,547,900

Slide 16: Azerbaijan 1997-2007 $1,800,000 $1,600,000 $1,400,000 $1,200,000 $1,000,000 US$ Value $800,000 $600,000 $400,000 $200,000 $- 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 BCG DT DTP HEPB MEA MR OPV OTHER Td TT USD Value Proc Year Vaccine 1997 1998 1999 2000 2001 2002 2003 2004 2005 BCG $ 31,050 $ 13,986 $ 23,981 $ 15,375 DT $ 43,950 $ 6,300 $ 9,000 $ 9,188 $ 4,995 DTP $ 109,700 $ 41,958 $ 15,968 $ 47,250 $ 40,800 HEPB $ 62,992 $ 188,550 $ 49,950 $ 99,824 $ 81,308 MEA $ 76,305 $ 29,720 $ 41,826 $ 59,896 MR $ 1,575,570 OPV $ 206,745 $ 78,780 $ 117,655 $ 56,670 $ 114,400 OTHER $ 37,490 Td $ 50,450 $ 10,000 TT