Friday, February 1 2002
Contact: Lisa Jacobs +41 79 447 1935 or Heidi Larson
+1 212 326 7762/+1 646 207 5179
FOR IMMEDIATE RELEASE
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
GAVI was 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.
GAVI 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
GAVI has 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 Forum.
While 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
GAVI 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 countries.
GAVIs quick 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.
GAVI 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 relief.
In fact, 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.
The GAVI 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
The Global 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 under-used vaccines.
New Products into Old Systems,
by the London School of Hygiene and Tropical Medicine, in press.