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November 2002

GAVI Progress Report

Letter from the GAVI Secretariat

Dear Gavians,

Many who read this report are veterans of the global effort to immunize the world's poorest children against preventable childhood diseases. Some of you are newcomers to the cause. Yet, all of us share a common purpose: to give the world's youngest, most vulnerable population a chance at a better, healthier life.

Three years ago I retired from the World Health Organization after 30 years of service as a physician in the field of public health. Three days later, I was back at work, helping to launch GAVI - the Global Alliance for Vaccines and Immunization. With partners from national governments worldwide, the international community, the pharmaceutical industry, and philanthropy - most notably the Bill & Melinda Gates Foundation, which has provided a startup grant of $750 million to GAVI's Vaccine Fund - we have begun the millennium with new tools, new skills, and a promising business strategy to bring new and underused vaccines to the developing world.

At GAVI today, we take positive lessons from both the private and public sectors to chart our way forward, guided by clearly defined goals, timelines, work-plans, financial controls and a system of checks and balances. Milestones help us to measure our progress.

The end of this year marks the third of our alliance. GAVI immunization programmes are up and running in more than 61 countries around the developing world. By the end of 2002, we projected that 80 percent of the world's poorest countries with adequate delivery systems in place would have introduced the hepatitis B vaccine to their children and, I am pleased to report, they have. Today, with GAVI support, 10 million more children have been vaccinated against the hepatitis B virus. More than 90,000 children who would have died prematurely from this deadly disease will now have a chance for a long, productive life. 1

This is an iterative process. We learn as we push forward, confronting challenges at every turn. During the last two years, broad country demand for the new combination vaccines vastly outstripped supply; monovalent vaccines were shipped instead. To our dismay, only one manufacturer, GlaxoSmith-Kline, was able to fill orders. We hope this situation changes and more vendors enter the market.

We delayed implementation of the performance-based system, because audits conducted in 2001 and 2002 revealed most countries had delapidated information systems or none at all. We will issue first 'reward' payments in 2003.

In some countries, war, political turmoil, failing economies, and natural disaster have impeded the transfer of GAVI/Vaccine Fund assets to local governments.

We must -
for the single and fundamental
reason that
this is the right thing to do.

But everyday, through the hard work of thousands of individuals, progress is steady, though much remains to be done. We must continue to demonstrate to the world the enormous importance of vaccines - including eventually one against AIDS. We must continue to assist countries in strengthening their healthcare delivery systems to ensure rapid delivery of all vaccines - as soon as they become available. As we seek political and financial commitment to our cause, let us show the decision-makers of the world that immunization costs so little and yet can save so many lives. We must - for the single and fundamental reason that this is the right thing to do.

From Senegal, one of the most eloquent tributes to healthcare workers and volunteers comes to us. Serigne Dame Léye, headman in the village of Ngouye Diaraf said: "If we don't have polio or measles or whooping cough in this village anymore it is due to their dedication. They have saved the lives of our children. We used to have epidemics here. We used to bury two or three children every week because of measles. This does not happen anymore because of these people. I include them in my prayers. I trust they will be rewarded in heaven." 2

And to all Gavians who have undertaken this effort as a night job and make our progress possible, I extend my heartfelt appreciation.

Dr Tore Godal
Executive Secretary, GAVI Secretariat

1 Preliminary estimates from the World Health Organization, 2002
2 The Vaccine Trail: A Journey Through Senegal, by Sara Cameron

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In Tanzania, cash from GAVI and The Vaccine Fund provide per diem payments to healthcare workers. In turn, workers use the cash to buy bicycles and petrol -- enabling them to reach more children in remote districts. Here, health care workers travel by velo, transporting vaccine supplies to one such district.

© Thomas Kelly, UNICEF
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