Abstract
ViPS and Ty21a markets are largely focused on the private sector and travellers markets. Given the product characteristics of TCV, it is anticipated that demand for these markets will decrease and the manufacturers will exit the market in the mid- to long-term. Supply-demand balance is sufficient for ViPS and Ty21a for the foreseeable future. The demand for the TCV market is still evolving and currently there is significant uncertainty in defining local typhoid epidemiology, which affects the vaccination strategies chosen by countries. There is currently only one TCV manufacturer with WHO prequalification (2017), with another manufacturer anticipated to receive WHO prequalification (PQ) by the end of 2020. Four additional manufacturers are domestically marketed or in Phase III development and planning to apply for WHO PQ. If all anticipated manufacturers enter the market in the short- to medium-term and obtain WHO PQ, then the TCV supplier base will become more diverse and stable. Supply-demand balance is sufficient for TCV, assuming all anticipated manufacturers enter the market. There is a potential risk of oversupply in the long-term once all countries have conducted their one-time multi-age campaigns at the time of routine introduction. There is a significant level of uncertainty in whether demand will materialise and at what levels:
» If demand materialises, there is a risk of imbalance due to large countries conducting multi-age campaigns in the mid-term. This risk can be mitigated with appropriate planning and communication from all stakeholders.
» If demand does not materialise, then there is a significant risk of oversupply.