2 March, GENEVA - The first phase of a new global alliance to increase vaccine
coverage among the worlds poorest children is drawing a surge
of interest from developing country health officials. The Global
Alliance for Vaccines and Immunization (GAVI), which announced a
multimillion dollar Global Fund for Childrens Vaccines at
the World Economic Forum in Davos last month, has already received
details on immunization activities and needs from nearly 50 developing
"We issued a call for expressions of interest and the results were more encouraging than anyone could have anticipated," said UNICEF Executive Director Carol Bellamy, a member of the GAVI Board. "Early and enthusiastic interest on all sides demonstrates the teamwork and commitment essential to achieving universal child immunization."
Dr Gro Harlem Brundtland, Director-General of the World Health Organization (WHO) and Chair of the GAVI Board, concurred. "The message here is that if the international community can find ways to make vaccines more affordable to low income countries, the countries will meet us halfway by investing the necessary resources in people and systems that will get those vaccines to children. The growing international momentum in the field of immunization is definitely being felt on the country level."
On March 2, United States President Bill Clinton is hosting a meeting of pharmaceutical industry heads and GAVI representatives to discuss ways to accelerate development and delivery of both current and new vaccines to the places where they are most needed. The Clinton Administration has also recently announced a commitment to securing US$50 million for the GAVI Vaccine Fund, increased funding for research critical to the development of vaccines for malaria, tuberculosis, and HIV/AIDS, and to working with the World Bank and developing nations to improve health care infrastructure.
Every year, nearly three million children die from diseases that could be prevented with currently available vaccines. The GAVI Alliance, a coalition of international organizations with the mission of ensuring that every child is protected against vaccine-preventable diseases, is seeking to close the growing gap in the number of vaccines available to children in industrialized and developing countries.
In late March, the Alliance will issue an official call for proposals to countries with incomes of less than US$1000 per capita GNP. Resources from the Vaccine Fund will primarily be used to purchase vaccines for hepatitis B, Haemophilus influenzae type b (Hib), and yellow fever, and safe injection materials. It is envisioned that GAVI partners at the country level will collaborate with national governments to help close the other gaps identified in the country proposals, beyond the provision of vaccines.
Traditionally, new international public health efforts are tested in a handful of so-called pilot countries, which subsequently receive extensive external support to evaluate and modify the programs. By putting the word out to all eligible countries that new funds and commitments are available, and placing more of the responsibility for providing the necessary information and commitment on the countries themselves, the GAVI partners are hoping that resulting efforts will be more country-driven and therefore more sustainable.
"In my country, a process of health system reform has highlighted some gaps in delivery of vaccines," said Dr Chrispus Kiyonga, Minister of Health in Uganda - one of the countries to send an early response to the GAVI Alliance. "We are now seeking solutions to overcome these problems in order to revitalize universal access to vaccines already in use in the country and to prepare for the introduction of currently under-utilized and yet necessary vaccines such as hepatitis B."
The great majority of countries responding currently have or are developing multiyear immunization plans. In addition, even in countries with the scarcest resources, the national budgets are bearing all or nearly all operational costs of immunization systems. Many of the countries are interested in integrating the hepatitis B vaccine into their vaccination schedules, with lack of funding being the only obstacle. Less interest in the Haemophilus influenzae type b (Hib) vaccine may be due to the reduced perception of need; there is widespread interest in gaining better understanding of Hib disease burden through the use of assessment tools such as those developed by the US Centers for Disease Control (CDC) and the National Institutes of Health (NIH).
"The Bill & Melinda Gates Foundation is committed to ensuring that every child has access to lifesaving vaccines, regardless of where they live," said foundation president Patty Stonesifer. "We are pleased to support GAVI and its mission of helping to speed the development and distribution of vaccines, which could help save the lives of more than three million children annually."
All countries with incomes of less than US$1000 per capita GNP were invited to submit an "expression of interest" to the Alliance - 74 countries in total, with the majority in Africa. The responses have been evenly spread, with 26 from Africa, 11 from Eastern Europe, 6 from Asia, 3 from Latin America, and 1 from the Middle East.
Updated list of countries that have submitted expressions of interest
Countries that have sent Letters of Expression of Interest: view map:
17 March 2000
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).