Press
Centre
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.
"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 don't 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.
"GAVI has not only made remarkable progress in improving
the prospects for the world's 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 health experience.
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.
GAVI's quick pace and approach have been criticised by
some who are concerned that countries do not have the
capacity to comply with GAVI's 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, GAVI's role as a catalyst has been documented.
According to the same study, health officials in Tanzania's
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 them.
# # # #
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.
For further information, contact:
Lisa Jacobs +41 79 447 1935
Heidi Larson, UNICEF New York, e-mail hlarson@unicef.org
1 212 326 7762
or +1 646 207 5179
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