Contribution of the GAVI Alliance to improving health and reducing poverty

Abstract

The Global Alliance for Vaccines and Immunization (GAVI), now 10 years old, was established as a successful and innovative public-private partnership to deal with a fundamental inequity. The poorest children in the poorest parts of the world were being denied access to life-saving vaccines simply on the basis of cost. GAVI has been successful in mobilizing significant funding from donors and through innovative financing instruments, immunizing large numbers of children. GAVI has been less successful, at least in the time frames first envisaged, at quickly reducing the prices of new and under-used vaccines to levels affordable by the poorest countries. Vaccines remain some of the most cost effective of public health interventions. As GAVI seeks to introduce a new set of vaccines to tackle major killers such as pneumonia and diarrhoea, and emerging threats such as cervical cancer, it needs to raise significant additional funds. There is no single solution. Multiple and new instruments will be required to raise finance both globally and at the country level, and also to incentivize industry and others to provide vaccines at affordable prices to the poorest countries.

Figure 1.

Structure of the GAVI Alliance board.

Figure 2.

The impact of the introduction of Haemophilus influenzae type b (Hib) conjugate vaccine on the incidence of Hib meningitis in three sentinel hospitals in Uganda [2].

Figure 3.

The financial commitment of the GAVI Alliance (total US$5.6 billion) by category as of July 2010.

Figure 4.

The GAVI model for making vaccines affordable to poor countries.

Figure 5.

The number of manufacturers and the decline in price of pentavalent (DTP, hepatitis B, Hib) vaccine. Dashed line, expected prequalified manufacturers based in emerging markets; red bars, prequalified manufacturers based in emerging markets; light blue bars, prequalified industrialized country manufacturers; solid red line, weighted average price (WAP).

Figure 6.

The cost of auto-disable (AD) syringes used for vaccination [4].