Bacillus Calmette-Guérin (BCG) vaccine: A global assessment of demand and supply balance

Over the past decade, several countries–representing all regions, income groups, and procurement methods—have been unable to secure sufficient BCG vaccine supply. While the frequency of stock-outs has remained rather stable, their duration increased in 2014–2015 due to manufacturing issues, attracting the attention of national, regional and global immunization stakeholders. This prompted an in-depth analysis of supply and demand dynamics which aimed to characterize supply risks. This analysis is unique, as it provides a global picture where previous analyses have focused only on a portion of the market that procures vaccines through UN entities. Through a literature review, supplier interviews, and the appraisal of shortages, stock-outs, and historical procurement data, as well as through demand forecasting, this analysis shows an important increase in global capacity in 2017: supply is sufficient to meet forecasted BCG vaccine demand and possibly buffer market shocks. Nevertheless, risks remain, mainly due to supply concentration, limited investment in production process improvements, and inflexibility of demand.

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