February 1 2002
Lisa Jacobs +41 79 447 1935 or Heidi Larson +1 212 326 7762/+1 646 207
Business-like approach to funding health programs in poor countries may
save more than two million lives in 5 years
NEW YORK, 1
February Two years after its official launch at the World Economic
Forum annual meeting in Davos, Switzerland, the Global Alliance for
Vaccines and Immunization, or GAVI, reports that its goal-oriented
approach to development aid could raise basic immunization rates in
funded countries by 17 percentage points and increase coverage of
hepatitis B vaccine from 18 to 65 percent by 2007, ultimately saving
more than two million lives, according to new data released at the World
Economic Forum today.
GAVI is a
public-private partnership focused on increasing access to vaccines
among children in poor countries. Partners include national governments,
UNICEF, WHO, The World Bank, the Bill & Melinda Gates Foundation, the
vaccine industry, public health institutions and NGOs.
born out of the growing recognition that the global community must work
harder to reduce the gap between rich and poor countries, and that we
all must work together in new and unconventional ways, said UNICEF
Executive Director Carol Bellamy, current Chair of the GAVI Board.
At the time
of its launch, GAVI also unveiled its financing arm the Vaccine Fund,
created with $750 million from the Bill & Melinda Gates Foundation.
Additional contributions have since increased the total to $1.2 billion.
The fund provides vaccines and financial support to the 74 poorest
countries those with less than $1000 GNP per capita to improve their
health systems and introduce newer vaccines such as hepatitis B.
partners introduced a new idea in international development:
outcome-based grants that give governments responsibility and autonomy
to decide how money is used, but if they dont show results, the funding
stops. To ensure accountability, an initial effort to audit country data
was undertaken in 2001 by an independent consortium that included the
international auditing firm, Deloitte Touche Tomatsu.
not only made remarkable progress in improving the prospects for the
worlds children, in many ways it is the precise embodiment of the
increasing trend of taking a private sector approach to a public
problem, said Professor Klaus Schwab, President of the World Economic
traditional health initiatives often start off by hand-picking countries
to participate in a pilot project thereby slowing down the process
GAVI threw the doors wide open, letting any country apply, as long as it
was one of the poorest in the world. After just two years, 66, or 90% of
eligible countries have applied for Vaccine Fund support, and 53
countries have already been approved including some in the most
difficult situations such as Sierra Leone, Liberia, and Afghanistan.
Proposals from another 13 countries are pending, and most of the
remaining 8 eligible countries are expected to apply this year.
The pace at
which the GAVI partners have designed a program funding process,
solicited and reviewed proposals, and distributed vaccines and resources
to the field is unheard of in the history of international initiatives,
said GAVI Executive Secretary Tore Godal, a public health physician with
years of international health experience.
partners are of course meeting hurdles, such as the weak state of health
infrastrucure in countries, rampant unsafe injection practices and
shortages of the most in-demand vaccines. These challenges have
compelled the alliance to be flexible, creating and adapting policies to
adjust to the realities in countries. For example, to address the
problem of unsterile needles, the GAVI Board approved a new policy for
the Vaccine Fund to provide auto-disable syringes fitted with a
mechanism that prevents re-use for all routine immunizations in
pace and approach have been criticised by some who are concerned that
countries do not have the capacity to comply with GAVIs funding
requirements. While a recent study on the impact of GAVI from a country
perspective concluded that GAVI was generally seen as a positive
development in all four countries visited, countries were concerned
about the overall pace of the application process and some found the
process of collating information difficult.
Acknowledging the dire need for more resources to help overworked health
staff in countries, Dr Godal welcomes the criticism. Most international
health initiatives are condemned for going too slow. It is an incredible
twist of irony to be criticised for going too fast, he said.
officials do accept, however, that in places where resources are
extremely scarce, more support must be found. They stress that the
Vaccine Fund cannot be considered the answer to all resource needs; it
is intended to be a catalyst for other sources of funding including
increases in national governments own health budgets, other bilateral
donor funding and development loans, or through mechanisms such as debt
GAVIs role as a catalyst has been documented. According to the same
study, health officials in Tanzanias Ministry of Health viewed the
initiative as a catalyst to attract a greater proportion of government
budget to the [immunization] program, and further, that donors were
also increasing pledges and expenditure.
data are based on the plans prepared by the countries and partners in
the 53 approved countries. Five-year commitments to these countries
total more than $800 million. GAVI partners estimate that this
investment could result in more than two million lives saved, based on
current data of disease burden and immunization costs. The projected
results are subject to change, both because some countries may not reach
their targets, and others may surpass them.
Alliance for Vaccines and Immunization (GAVI) is a public-private
partnership formed in response to stagnating global immunization rates
and widening disparities in vaccine access among industrialized and
developing countries. The GAVI partners include: national governments,
the vaccine industry, NGOs, foundations, research and public health
institutions, the United Nations Children's Fund (UNICEF), the World
Bank Group and the World Health Organization (WHO). The Vaccine Fund is
a new financing resource created to support the GAVI immunization goals,
providing financial support directly to low-income countries to
strengthen their immunization services and to purchase new and
Products into Old Systems, by the London School of Hygiene and Tropical
Medicine, in press.