When a major outbreak of yellow fever hits, countries need to access vaccine supplies urgently for rapid vaccination campaigns to control spread of the disease.
Urban yellow fever can spread rapidly in densely populated cities, causing thousands of deaths and very serious humanitarian consequences. Vaccination is the most important measure for preventing the disease.
If countries do not have sufficient yellow fever vaccine supplies, they can access the global stockpile of emergency vaccines.
In 1997, WHO in partnership with UNICEF, Médecins sans Frontières (MSF) and the International Federation of the Red Cross and Red Crescent Societies (IFRC) created the International Coordinating Group (ICG) for the Provision of Vaccines to manage emergency vaccine stockpiles for future outbreaks and coordinate the distribution of vaccines to the areas of most urgent need. ICGs have been established to provide access to cholera, meningitis and yellow fever vaccines.
The yellow fever vaccine takes a long time to produce – around 12 months – and it is difficult to forecast in advance the quantities that will be needed each year to respond to outbreaks.
The ICG originally planned to stock 2 million doses per year, but, with increasing demands the emergency stockpile was increased to 6 million doses per year in 2003, thanks to financial support from Gavi Alliance.
The response to the Angola outbreak has depleted the global stockpile of 6 million yellow fever vaccine doses twice this year already. This has never happened before. In the past the ICG has never used more than 4 million doses to control an outbreak in 1 country.
In the face of increasing demands this year, the 4 major manufacturers who supply the global stockpile of the yellow fever vaccine have been working around the clock to replenish the stockpile. In early June 2016, it was at 6.2 million doses but this may not be enough if there are simultaneous outbreaks in other densely populated areas.
Yellow fever was first confirmed on 19 January 2016 by laboratories at the National Institute for Communicable Diseases in South Africa. Nine days later on 29 January, the Angolan Ministry of Health requested 1.8 million doses from the global stockpile of emergency vaccine supplies. The ICG approved this request the same day and the vaccine doses were in the country by 3 February ready for a targeted vaccination campaign.
Since then, the country has made several additional requests for vaccines from the emergency stockpile and by 18 May had received 11.7 million doses in total. Ongoing vaccination campaigns due to the further spread of the disease are putting continuous demands on the stockpile.
In addition, outbreaks in Uganda and the Democratic Republic of the Congo have stretched the global supply with demands for more than 700 000 and 2.2 million doses respectively. By mid-June, almost 18 million doses had been distributed for emergency vaccination campaigns in the 3 countries.