Tuesday, 11
April 2000
PRESS
RELEASE
Contact:
Lisa Jacobs, GAVI Secretariat +41 79 447 1935 (mobile) in
Washington, D.C. on 11 April Email:
gavi@unicef.org
GLOBAL ALLIANCE AIMS TO HALVE THE NUMBER OF UNIMMUNIZED CHILDREN IN 5
YEARS
Vaccine fund needs just $200 million more per year to save millions of
lives
A new international vaccine alliance has calculated that within five
years it will be possible to reach nearly half of the 25 million
children born every year in poor countries who are not currently being
immunized, saving millions of lives, at a cost of $350 million per year.
The Global Alliance for Vaccines and Immunization (GAVI), a
public-private coalition that has the long-term goal of ensuring
universal immunization and accelerating the development of new vaccines,
has already received a commitment of $750 million, and is on its way to
securing the $1 billion more that it projects will be needed to reach
its five-year goal.
"More than one-quarter of children born each year in low-income
countries have not been receiving basic immunization, and the time has
come to solve this serious global health problem and reduce the three
million deaths every year from vaccine-preventable diseases," said Dr.
Gro Harlem Brundtland, Director-General of the World Health Organization
(WHO) and Chair of the GAVI Board. "Over the past two decades weve
learned important lessons about immunization strategies - both good and
bad - that we will now use to set a new course for improving health
outcomes for all the worlds children."
After a surge of global efforts in the 1980s, global immunization rates
rose from 5% in 1974 to nearly 80% in 1990. However, since 1990, the
proportion of children being reached has suffered a decline, to just
under 75% -even less in many developing countries. The declining rates
have been due to a number of factors including a reduction in global
funding, conflict and turmoil, and a deterioration of basic health
services in many countries.
Dr. Brundtland will describe how the GAVI partners will reverse this
trend at a Senate hearing in Washington D.C. on April 11th. The
committee is considering a Clinton Administration request of $50 million
in U.S. funding this year for the Vaccine Fund, which has been
established by GAVI to assist developing countries in their vaccination
efforts.
The Bill and Melinda Gates Foundation has provided the initial
commitment to the Vaccine Fund with a grant of $750 million over five
years. In addition to the possible U.S. funding, governments,
corporations and other donors are being approached to provide the
additional resources required to reach the goal of $1.75 billion in five
years.
Since GAVI announced the multimillion-dollar vaccine fund at the World
Economic Forum in Davos, Switzerland in January, more than 50 developing
countries have indicated their interest in becoming involved in the
global vaccine effort. In May, the Alliance will issue an official call
for proposals to 74 low-income countries (defined as those with less
than $1,000 gross national product per capita), with the first grants to
be made in the second half of this year.
In a brand new approach to global health funding, GAVI plans to use
part of the resources from the vaccine fund for a performance-based
system under which governments of countries with low current
immunization coverage will receive financial incentives to strengthen
their health systems to deliver immunization. While the details are
still being negotiated, the basic principle will be to calculate support
based on increases in the number of children immunized in a given
country. It is hoped that if successful, this approach can become a
model for other international health programs.
The vaccine fund will also be used to make bulk purchases of new and
under-used vaccines for low-income countries. Newer vaccines against
hepatitis B, Haemophilus influenzae type b (Hib) and yellow fever have
been available for years, but are not widely incorporated into
immunization programs in many of the poorest countries because of price
and logistical difficulties. The Vaccine Fund will emphasize the use of
safe and simple delivery techniques, such as combination vaccines -
grouping more than one antigen in a single injection - and monodose
delivery devices to reduce wastage and the possibility of unsafe
injections from re-used needles.
"Vaccines provide the single most powerful strategy to improve the
health and extend the lives of the worlds children," said Bill Foege,
Senior Advisor of the Bill & Melinda Gates Foundation. "The world loses
a million children a month because of simple disease problems and a
quarter of them could be saved by the use of vaccines already available.
We need to increase access of these vaccines to children in the poorest
countries. The polio eradication effort has shown us that when the
government and communities mobilize we can reach children even in the
most remote areas. We are excited to be part this global effort."
GAVI partners include: national governments of donor and developing
countries, the Bill and Melinda Gates Childrens Vaccine Program, the
International Federation of Pharmaceutical Manufacturers Associations
(IFPMA), the Rockefeller Foundation, UNICEF, the World Bank Group and
the World Health Organization (WHO). The GAVI strategies to improve
immunization services, and the roles that the different GAVI partners
will play have been outlined in a paper entitled, "Immunize Every
Child".
"This is not pie-in-the-sky. With the commitments we are getting from
partners, its doable. In fact, we may be able to reach even more
children faster than the targets weve set," said Dr Tore Godal,
Executive Secretary of GAVI. "With the increasing recognition that
investing in health will reduce poverty, the scientific and
technological advances in immunization, and the lessons weve learned
about integrating health services without jeopardizing any single
service, this is exactly the type of project we will see more of in the
21st Century."
Other speakers at the Senate hearing will be U.S. Treasury Secretary
Lawrence Summers, Dr. Nils Daulaire of the Global Health Council, and
Dr. Adel Mahmoud of Merck Vaccines. Senators Mitch McConnell (R-KY) and
Patrick Leahy (D-VT) will be presiding at the hearing.
Based on current estimates of vaccine delivery costs, GAVI partners
calculate that $1 billion is currently being spent each year in
low-income countries on immunization services - most of the costs borne
by the governments. An additional $350 million annually is needed to
help those countries reach at least 80 percent coverage with the
traditional and newer vaccines. The Gates commitment will provide $150
million a year; $200 million more per year will be sought.
GAVI officials point to the African country of Uganda to illustrate the
difficulty of complete immunization. One third of the rural districts in
Uganda lack any health center at all, much less an infrastructure to
vaccinate children. One idea is to build a network of mobile services
that do not use cars but rely on animals or motorcycles, which are
better able to reach villages where roads are poor or non-existent.
Health workers can then visit isolated villages to deliver not only
vaccines but a whole range of health services.
The vaccine fund also plans to help countries avoid using expired - and
therefore ineffective - vaccines. Under the old systems, health workers
had no way to judge whether a vaccine was still effective. A new Vaccine
Vial Monitor (VVM) is a container that carries a label that shows
changes in conditions that can affect vaccine quality. As the vaccine
ages or is exposed to undesirable levels of heat, the label changes
color, from a pale white to almost black. VVM was first introduced in
polio vaccine in 1996, and there are plans to broaden its use to all
basic childhood vaccines.
GAVI is the Global Alliance for Vaccines and Immunization, a coalition
of organizations formed in 1999 with the mission of ensuring that every
child is protected against vaccine-preventable diseases. The partners
include: national governments, the Bill and Melinda Gates Childrens
Vaccine Program, the International Federation of Pharmaceutical
Manufacturers Associations (IFPMA), research and technical health
institutions, the Rockefeller Foundation, the United Nations Childrens
Fund (UNICEF), the World Bank Group and the World Health Organization
(WHO).
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