The GAVI Alliance's new vaccine strategy

Reproduced by kind permission of Elsevier
First appeared in the Lancet - Vol 372 - July 5, 2008, Editorial

On June 25, the GAVI Alliance launched its 5-year vaccine strategy, announcing plans to focus attention on seven key diseases: cervical cancer, cholera, Japanese encephalitis, meningitis A, rabies, rubella, and typhoid.

This is a huge leap for the Alliance, with a change in both its long-term aims and its strategic approach.

At conception, the GAVI Alliance aimed to support immunisation programmes in 72 poor countries across the world, as a means of reducing the global under- 5 mortality rate.

This new strategy continues here, but also hopes to reduce the overall disease burden in these countries—hence the inclusion of diseases such as cervical cancer, which affects half a million women a year, and rabies, for which vaccination is the only effective option.

This is an excellent time for the Alliance to expand its programme. Immunisation rates are at an all-time high, and scientific achievements have led to a strong vaccine pipeline, with an unprecedented number of new vaccines likely to be available in the near future.

In addition, earlier in June, the GAVI Alliance released its 2007 progress report. Figures show that their work has averted almost 3 million premature deaths since the Alliance started in 2000, and it has increased the number of children in GAVI-eligible countries who were immunised with three doses of diphtheria, tetanus, and polio vaccines by 11% (from 64% to 75% coverage).

The Alliance has also begun to invest in programmes aiming to strengthen health systems, which will be vital for the long-term success of these strategies.

But all these achievements cost money. Despite growing commitments from donor governments, more funds are needed for the Alliance to capitalise on the current environment of exciting new vaccine technologies and recent successful programmes.

Limited resources mean that they are now prioritising within the seven diseases, according to country demand and vaccine availability. The final implementation strategy will be decided in October.

Sufficient funds must be found to ensure that the GAVI Alliance can continue to reduce child mortality rates, and achieve a similar success in easing disease burden, in the poorest countries of the world.