The PAHO Revolving Fund, a strategic mechanism that pools and organizes immunization demand plans and facilitates timely access to quality vaccines at lower prices for the countries of Latin America and the Caribbean, was presented as an innovative model for meeting investment demands and addressing public health needs during the Workshop on Business Modeling for Sustainable Influenza Vaccine Manufacturing held at PAHO January 14-16, 2013.

“For countries, the Revolving Fund represents a permanent mechanism that not only promotes continuous access to safe and effective vaccines, but also that lowers and stabilizes prices, facilitates budget planning and contributes to the financial self-sustainability of the immunization programs,” said Mr. Daniel Rodriguez, Advisor for the PAHO Revolving Fund.

Through the Revolving Fund, PAHO manages key processes ranging from supporting countries in the region in preparing vaccine demand plans, procurement on their behalf and  coordinating  supply logistics with manufacturers.
 
During the workshop, Mr. Rodriguez spoke about how the Revolving Fund has helped the countries of the Americas achieve common immunization goals despite cultural and socio-economic differences.

“The region has a remarkable amount of financial self-sustainability as it is, with more than 99% of the costs of vaccination programs - including the procurement of vaccines - funded by national budgets,” said Mr. Rodriguez. “The PAHO Revolving Fund helps to increase sustainability even more, which has played an important part in some of the greatest vaccination achievements in the Americas: the eradication of polio, the elimination of measles and rubella, and a reduction of morbidity from other vaccine-preventable diseases.”

The seasonal influenza vaccine has supply challenges. The strains in this vaccine can change from year to year according to WHO recommendations for northern and southern hemispheres. Once strains are selected, manufacturers have a very tight timeline to complete the manufacturing processes and to deliver the vaccine to countries, before the influenza season begins. The PAHO Revolving Fund focuses on consolidating seasonal influenza vaccine demands based on country plans and on the procurement activities with manufacturers which follow a defined schedule, in order to facilitate the timely delivery of vaccine to countries.

The Revolving Fund also facilitates access to influenza vaccines during pandemic outbreaks – such as the H1N1 pandemic in 2009. As the pandemic broke, PAHO’s Immunization Project developed a regional plan to provide technical cooperation in vaccination to the countries of the Region. One of the three main pillars of the plan was to support H1N1 vaccination acquisition through the Revolving Fund. As a result, during the pandemic, 23 countries purchased vaccines through the Revolving fund, which was enough to cover 5% of their population.

Launched in 1979, the PAHO Revolving Fund offers 60 different products to participating Member States. It was founded based on the same principles of PAHO: equitable access (participant countries will have access to the same vaccines, same quality and conditions, regardless of the size of the territory, the doses required and economic development), Panamericanism (as a principle of solidarity, all participating countries will share their requirements within an economy of scale  and will contribute to the capital fund), and transparency (PAHO practices transparency in the procurement and relationships with manufacturers and countries, and all vaccines and supplies follow international quality standards to ensure that they are safe and effective for the populations).  

Links:

• Experts discuss business models for sustainable production of influenza vaccines
•  Global Action Plan for Influenza Vaccines