International Coordinating Group (ICG) on Vaccine Provision

The ICG was established in 1997, following major outbreaks of meningitis in Africa, as a mechanism to manage and coordinate the provision of emergency vaccine supplies and antibiotics to countries during major outbreaks. Working closely with vaccine producers, through WHO and UNICEF, and following disease trends, the ICG monitors its vaccine security global stock levels for cholera, meningitis and yellow fever to ensure availability of sufficient supply to respond to disease outbreaks when they occur.

The ICG brings partners together to improve cooperation and coordination of epidemic preparedness and response. The ICG also works on forecasting vaccine stocks, negotiating vaccine prices through its networks or partners, evaluating interventions and standard protocols for managing diseases.

The ICG's mission is to:

• Rapidly deliver vaccines to respond to disease outbreaks;
• Provide equitable vaccine allocation through careful assessment of risk, based on epidemiological and operational criteria;
• Coordinate the use of limited amounts of vaccines and essential medicines;
• Reduce wastage of vaccines and supplies;
• Advocate for readily available, low-cost vaccines and medicines;
• Work with manufacturers through UNICEF and WHO to guarantee the availability of vaccine emergency stock supplies at the global levels;
• Follow standard operating procedures and establish financial mechanisms to purchase emergency vaccine supplies and ensure their sustainability.

The ICG is made up of four member agencies:

International Federation of the Red Cross and Red Crescent Societies (IFRC) - Has strong country presence for community health promotion, local social and resource mobilization and provides support to states during disasters and epidemics.

Médecins sans Frontières (MSF) - An independent, field-based NGO that provides health care to vulnerable populations in emergency settings.

United Nations Children’s Fund (UNICEF) - Conducts wide scale vaccine procurement and shipment, and provides technical support on campaign planning and implementation in country focusing specially on social mobilization and cold chain.

World Health Organization (WHO) - Provides global public health advice and technical support to countries. During outbreaks, WHO focuses on vaccine stockpile management, surveillance, preparedness and response to disease outbreaks.

Additional expertise and technical advice is provided on a case-by- case basis from partners including: Agence de Médecine Preventive in Paris, Epicentre in Paris, GAVI the Vaccine Alliance, WHO Collaborating Centres, the US Centers for Disease Control and the European Community Humanitarian Office (ECHO).

Vaccine manufacturers, vaccine equipment providers and financial donor institutions are also engaged in the ICG operations.

CGs have been established to provide access to vaccines for the following diseases:

Cholera - Since 2013, the ICG for Cholera manages the global stockpile of oral cholera vaccine which was created as an additional tool to help control cholera epidemics. Since July 2013, the ICG has released more than 5 million doses of oral cholera vaccines to affected countries.

Meningitis - The ICG on Vaccine Provision for Epidemic Meningitis Control was established in January 1997, following major outbreaks of meningitis in Africa. Since then, 59 million doses of vaccines were shipped for emergency response in 20 African countries.

Yellow fever - Since 2001, 90 million doses of yellow fever vaccine have been released and shipped to countries facing outbreaks. With vaccine manufacturers as partners in the ICG, a stockpile of 6 million doses has been reserved for outbreak response since May 2016.

Vaccine security stocks can be accessed by ANY country facing an epidemic ANYWHERE in the world, as long as the country’s request fulfills ICG’s criteria for release of vaccine stocks. As a first step, a country must complete and submit a request to the ICG Secretariat using the standard application form

The ICG secretariat at WHO then circulates this request to the partners: UNICEF, Médecins Sans Frontières, the International Federation of the Red Cross, and WHO for review and assessment. Additional requests for information are sent back to the country, if needed. Following a rapid consultation and evaluation process, the decision to release vaccines and other supplies is communicated to the requesting country within 48 hours, once all necessary information has been provided. If approved, UNICEF procures vaccines and injection materials and organizes delivery of vaccines to the country, ideally within 7 days.

Requests are evaluated taking into account the epidemiological situation, vaccination strategy, pre-existing stocks in the country and operational aspects of the epidemic response.