Dramatic progress in GAVI's first five years shapes next steps in plan to boost vaccinations

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GAVI Alliance gathers with WHO, UNICEF and other partners in New Delhi as global immunization effort enters critical phase

9 December 2005 - NEW DELHI-Rapid progress in vaccine development, funding, and purchasing power suggests that immunization will play an unprecedented role in global poverty reduction over the next ten years. But this will take place only if governments provide sustained support for proven solutions such as vaccines, said the head of the GAVI Alliance at today's conclusion of the 3rd GAVI Partners' Meeting.

"We now have the evidence that it is possible to rapidly scale up access to vaccines and that even poor countries with few resources can obtain brilliant outcomes if given the opportunity," said GAVI Executive Secretary Julian Lob-Levyt. "As we go forward, we will need to take some risks and explore new ways of working to see how we can better reach the most vulnerable and excluded children. It is crucial that donors recognize the need to disproportionately finance human development now, with predictable funding over the long term."

Since its launch in 2000, GAVI has demonstrated that development assistance can be effective, if the funds are targeted and if flexibility is built into the process. Countries eligible for GAVI support have seen improved immunization coverage rates and have successfully introduced new vaccines. Key to this success has been GAVI's approach, said Lob-Levyt. It rewards results, but allows recipient nations to develop their own plans for reaching their immunization goals. Their success has in turn attracted the attention of donors.

"These increases in funding for immunization through GAVI have been possible only because countries have delivered results," Lob-Levyt said. "Contrary to popular misunderstanding, immunization systems in many of the poorest nations, even those just emerging from conflict, demonstrate considerable resilience. This suggests that we have underestimated the ability of some countries to absorb funds-the lack of which is often used as an excuse by donors to hold off investment."

In the last five years, the GAVI Alliance has supported the immunization of 100 million additional children with new generation vaccines. The number of children reached with these vaccines-against deadly diseases such as hepatitis B and yellow fever-is expected to climb to 225 million by 2008, according to the WHO. The impact of the Alliance also has been felt in the vaccine industry. As a large buyer of vaccines, GAVI has stimulated new and unprecedented market interest in producing vaccines. While a few years ago there was only one manufacturer of the combined Diphtheria-Tetanus-Pertussis-Hepatitis B vaccine, for example, 11 companies have submitted bids to begin supplying the vaccine in 2006.

The GAVI Alliance is preparing to begin a new stage (Phase II). Armed with the potential doubling of the amount of money it has to spend, the Alliance will be influenced by some lessons learned regarding the need for collaboration and "harmonization" and the importance of working with partners under the direction of the target countries. GAVI is making a commitment, for example, to work with partners and other donors to strengthen health systems throughout the world's poorest regions. Lob-Levyt notes that members of the international community can work with developing countries to implement a coherent plan of action, "a radical change in the way development assistance is delivered and received."

At the Partners' Meeting in New Delhi, experts are also reporting on GAVI-funded efforts to accelerate the introduction into developing countries of several new generation vaccines that target diseases such as rotavirus and pneumococcal disease-killers of more than 1.5 million children every year.

Lob-Levyt argues that "a big push" is needed in order to accomplish the goals of immunizing millions more children, but current progress will not be sustained and the goal of saving millions of poor children's lives will not be met without a dramatic increase in donations.

A report released today by WHO and UNICEF during a press briefing at the GAVI Partners Meeting anticipated that the price of saving an additional 10 million lives between 2006 and 2015 would include the costs of reaching more children with basic vaccines, improving health care systems, and introducing new vaccines, such as those for pneumococcus, rotavirus, meningitis, and Japanese encephalitis. The report estimated the total cost at US$35 billion and calculated a shortfall of US$10-15 billion.

"For the first time we have a costed global picture, a global strategy and a process for tracking needs against the available resources," said Lob-Levyt. "This information was a great achievement by WHO, UNICEF, and other partners. It places the GAVI Alliance in a great position to respond to the challenge posed by the partners' Global Immunization Vision and Strategies (GIVS) program."

Most recently, six European nations agreed to support the new International Finance Facility for Immunization (IFFIm), which will launch in 2006 and is expected to provide $400 million annually. GAVI is also working with other GLOBAL HEALTH partnerships, the World Bank, and the G-7 finance ministers on Advance Market Commitments that would spur the development of new vaccines and drugs.

Meeting the financing goals outlined by WHO will require "additional and innovative sources of finance," said Lob-Levyt, but he noted he is optimistic, given the response of donors to GAVI's successes. By the end of 2005, the GAVI Alliance will have raised almost US$3 billion from traditional donor and private sources. (US$1.7 billion has been received). At least US$3 billion more is expected from the International Financing Facility for Immunization (IFFIm), which will operate with the backing of six European nations to obtain the funds through the sale of bonds on capital markets.

"GAVI will continue to work with its partners to provide the advocacy and ideas required to secure funding for immunizations," Lob-Levyt said.

In calling for more donors to view immunization as a cornerstone of their development programs, Lob-Levyt noted that a new study published recently in the journal World Economics suggests that success in boosting immunization rates may someday be measured as much in economic terms as in health benefits.

"The authors-researchers from Harvard University School of Public Health-found that the rate of return on GAVI's prospective investments are estimated to be 12.4 percent in 2005, rising to 18 percent in 2020, as coverage increases and vaccine costs decline," said Lob-Levyt. "Remarkably, this is a similar or better rate of return as for primary education-long known to have direct effects on economic growth."

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