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More About GAVI
Laying the foundation for global health:
A panel session to launch GAVI at the World Economic
Forum meeting in Davos, 31 January 2000
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The organizers of the World Economic
Forum meeting in Davos developed a special panel session,
"Laying the foundation for global health: the GAVI Initiative"
in which the following questions were posed: How can
business play a role in immunization? Who will bear
the cost of not acting now? Can market incentives spur
research into, and action against, diseases which predominantly
affect developing countries?
The GAVI session has been featured
prominently by the WEF organizers - on the WEF website,
during press meetings and a press conference held in
Geneva prior to Davos, and during other panel sessions
in Davos.
The chair of the GAVI Board of
Directors, Gro Harlem Brundtland, Director-General of
the World Health Organization, opened the session. Also
on the panel were, in speaking order: William H. Gates
III, Founder of the Bill and Melinda Gates Foundation;
Joaquim Alberto Chissano, President of Mozambique; Carol
Bellamy, Executive Director of the United Nations Children’s
Fund (UNICEF); Raymond V. Gilmartin, Chairman, President
and CEO of Merck and Co.; and James D. Wolfensohn, President
of the World Bank.
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Summary of remarks by Dr Brundtland:
The fact that 1.3 billion people around the
world live on less than one dollar a day is bad for business;
in a globalized world, one region’s poverty is another
region’s opportunity loss. More than anything, poverty
means bad health, and bad health means low productivity. Malaria
costs at least one percent of GDP in many African countries
through lost productivity. HIV/AIDS is devastating whole economies.
Tuberculosis drives millions of families deeper into poverty
every year through medical expenses and lost income.
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We can turn this around. Improved
health means improved productivity. It can be very simple.
The most cost-effective health intervention of them
all is childhood immunization. For only US $17 per child,
we can provide lifetime protection against the six historical
scourges - polio, diphtheria, tuberculosis, pertussis,
measles and tetanus.
The Global Alliance for Vaccines
and Immunization has been formed to kick-start a campaign
to increase vaccination coverage. GAVI is a true partnership
between public and private sectors. It is one based
on enlightened self-interest, but it is also one that
recognizes the moral responsibility we all have for
a world where all children receive a basic chance of
survival and health.
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Summary of remarks by Mr Gates:
Millions of lives have been saved by
the massive efforts to increase immunization in the 1980s.
But millions of lives are still being lost because the
vaccines that we in the industrialized countries take
for granted are not yet available in many of the poorer
countries. Typically it has taken 15-20 years from the
time a new vaccine is available in the United States and
other industrialized countries before it becomes more
broadly available. After speaking with scientists and
undertaking my own research, it has become clear that
it is more important to help the world secure basic health
rights than to ensure that every person had access to
the Internet. |
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The critical need to get today’s vaccines out to more
children, and developing new vaccines for diseases such
as AIDS, malaria and tuberculosis has had very little
visibility until now. There hasn’t been the will to
take this to the next level. That is why it is so gratifying
to see this issue raised in a number of sessions at
the World Economic Forum, including this session. Also
gratifying is the commitment from President Clinton
to ask Congress to provide GAVI with $50 million for
the Global Children’s Vaccine Fund.
We need cooperation from many groups - governments
in the developed world, governments in which vaccine
coverage is low, and the pharmaceutical industry - in
order to make this happen. We are just getting the critical
mass, and GAVI is galvanizing people to say, yes, we
can do better. It is a privilege to be a part of something
that is going to have a positive impact on the world’s
children.
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Summary of remarks by Mr Chissano:
My country was in war for 16 years
during which time the population was spread, with many
refugees moving into neighboring countries. As a result,
we had a very large period of time when we could not
immunize children and adults alike. During this time,
new health threats were spreading, such as AIDS. AIDS
is such a problem because we have no cure, but in fact
it is malaria that is killing more people in our country
than any other disease. In addition to these two diseases,
there are other major health threats, such as tuberculosis.
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The problem is that we don’t have the means. We had
to rebuild all that was destroyed by war, including
health and education facilities. These two are very
important for vaccination programs. The issue of vaccination
cannot be seen in isolation. It needs to be seen within
the context of all health problems. Resources are so
meagre, that we need to establish the balance between
preventive medicine, and treatments.
Another very important aspect to increasing immunization
rates is the development of research capacity in the
countries. Research cannot only be conducted in the
United States, or Japan and then brought to Mozambique,
or Liberia. The international community, bilateral donors,
and the private sector need to help establish research
centres and pharmaceutical production facilities close
to the people who need the vaccines. In this regard,
the transfer of technology will be very important. A
new ministry of science and technology has been formed,
with the aim of bringing us closer to the technology.
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Summary of
remarks by Ms Bellamy:
As Mr Gates mentioned, in the late
1980s there was huge push for universal vaccination, driven
largely by WHO, UNICEF and Rotary International. These
efforts were very successful; by 1990 global immunization
coverages had reached nearly 80% coverage of all the world’s
children. But we still are seeing millions of children
dying unnecessarily. We have the technology - the vaccines,
the safe injection materials - to reduce disease and death
among all the world’s children. What we need is to work
together, to mobilize political will and the financing
necessary to bring this about. |
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GAVI brings together the very important
different actors into a broad-based strong alliance,
with a strong commitment for financing. But even with
the commitment from the Gates Foundation and President
Clinton, we know that we will need more. In fact, that
is a reason why we have come here to the World Economic
Forum to speak with you.
The success of the Children’s Challenge
will depend on a commitment by private and public sector
leaders to support the right of every child to vaccination.
The same resolve that markets products in poor rural
villages, and sends television programming into the
most remote corners of the world, can surely overcome
all the usually cited barriers to universal immunization.
The use of mass media has been crucial to the success
of immunization programmes so far but we’ve got to explore
all possible means from wind-up radios to hand-held
cameras.
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Summary of remarks by Mr
Gilmartin:
GAVI can serve as a model for corporate
and public cooperation. Merck is committed to developing
new vaccines; we do not have scientific discoveries sitting
on the shelves for lack of a market. The development of
new vaccines is high on Merck’s agenda; Merck is making exciting
advances on the creation of an AIDS vaccine. At the same
time, however, there needs to be more emphasis on developing
better healthcare systems in all countries. The kind of
cooperation that GAVI represents will be essential for
improving access to better health care and medicines and
vaccines more accessible. |
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Merck’s experience with Mectizan,
a medicine that prevents a disease called river blindness,
shows that even the simplest pharmaceutical intervention
faces tremendous challenges in delivery. Even after
Merck decided to donate the medicine free of cost, it
took years of collaboration with international partners
and developing countries to develop the protocols necessary
to deliver the medicine to those who need it. Today,
we are seeing the fruit of that collaboration, with
millions of people receiving Mectizan every year.
Building infrastructure, improving
delivery systems, political will, and sustained commitment
to financing can have a tremendous impact on public
health in develop. Indeed, by improving health infrastructure,
this initiative may further stimulate vaccine research
and development. But the success of any sustainable
health program starts with the political will and commitment
from local governments.
Summary of remarks by Mr Wolfensohn:
Health has emerged as the central issue
in a country’s development. In a survey conducted by the
World Bank among 60 000 people living in poverty, it was
found that health is the single largest contributor to
poverty, and the single most vulnerable aspect. Health
lending is such a good investment because of the direct
links between health and poverty, and immunization is
one of the most cost-effective health interventions.
Increased child survival has been
shown to slow down the rate of population growth, as
well as increasing school enrollment; education rates
are a key determinant of national productivity. In addition,
immunization can reduce production losses caused by
worker illness; permit use of natural resources inaccessible
due to disease e.g. malarious zones of land and safeguard
the gains in life expectancy resulting from years of
development efforts.
The World Bank is making a strong
commitment to reducing poverty through improving health,
by increasing health lending and leveraging our influence
with finance ministers to raising the priority of health
in the broader development context and ensuring a strong
focus on the poor. We will also strive to correct the
market failure resulting in under-investment in priority
new products.
Videocast
of the launch of the GAVI Children’s Challenge at the
World Economic Forum, 31 January 2000 (recorded for later
viewing; you will need the Realplayer
from Real Networks).
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