Immunization, Vaccines and Biologicals

The Middle Income Country Strategy

Enhancing sustainable access to vaccines for populations in Middle Income Countries (MICs)

Over the past decade, access to vaccines in Middle-Income Countries (MICs) has gained global attention. The focus on immunization in MICs has gained momentum from the realization that the majority of the world’s poor and vaccine-preventable deaths now occur in MICs (i.e. countries with a GNI between $1,045 and $12,7361) as well as concern that this group of countries may be missing out on opportunities to introduce new vaccines, given the donor focus on low income countries.

66% of the world’s poor now live in middle-income countries.

2011 Poverty and Inequality World Bank database

At the request of the WHO Strategic Advisory Group of Experts (SAGE) in June 2014, WHO convened a MIC Task Force to develop a coordinated strategy and plan of action to enhance sustainable access to vaccines in MICs.

The MIC Strategy was presented to SAGE in April 2015 and acknowledged as a strong proposal for coordinated and comprehensive approach to issues of sustainable access to vaccines in MICs.

The MIC strategy, aligned with the GVAP time frame (2016–2020), proposes a way forward for non-Gavi countries, through harmonizing existing initiatives targeting MICs and to address important immunization gaps. The strategy coordinates partner action across four main focus areas identified by countries as critical enablers for immunization gains. The solutions put forward by the strategy are also intended to benefit countries as they transition from Gavi support over time, ensuring sustainability of current investments.

The MIC Task Force has started working with a limited number of MICs as part of an initial country engagement phase. So far, the Task Force has started working with Swaziland since November 2015 and is preparing to work with Romania, the Philippines and Tunisia in 2016.


The MIC Task Force also aims to set up focused platforms for peer exchange across the four areas of the MIC Strategy. This includes efforts such as the continuation and strengthening of price information sharing initiatives (the Vaccine Product, Price and Procurement platform), the organisation of regular procurement workshops (such as the Vaccine Procurement Practitioners Forum organized by UNICEF Supply Division), the facilitation of demand and supply information sharing forums and other south-to-south collaborations in areas relevant to the strategy.

For more information about the MIC strategy:

Link to the MIC Strategy leaflet available soon, or contact

1“Country and Lending Groups.” World Bank, 2015..

The following organizations are represented on the MIC Task Force:

Last updated : December 2015