This article, by DSW’s International Director for Partnership and Communication, was originally published at Devex for the Gavi Replenishment 2015 meeting in Berlin. You can read the original article on their website here.
The great and the good of the international development scene descended on Berlin this week for the Gavi replenishment 2015 conference. This two-day meeting was important for a number of reasons. For the German government, it was the inaugural event of an ambitious agenda for their holding of the rotating G7 Presidency. In particular, global health has been identified as a key issue for their Presidency, which will culminate at the G7 meeting in June.
The Gavi conference was also one of the opening events of what will be a defining year for international development policy and for the fight against extreme poverty around the world. Given the outstanding commitment shown in Berlin this week towards the global betterment of child health, this event will set the stage for upcoming debates on financing for development in July and for the final stages of the negotiations of the post-2015 sustainable development agenda.
Finally, the meeting was an opportunity to take stock of the achievements of Gavi and the global health community in fighting against child mortality in the 15 years since the organisation’s founding. But what were the key issues raised by the replenishment conference, and the work of Gavi both past and future?
Gavi Replenishment 2015: Vaccines work…
One of the recurring themes in the presentations by all the speakers was the impact that immunisation and vaccination programmes have had in the last decade. Since its inception, Gavi has been delivering on its promises of saving lives through immunisation. The organisation has helped over seventy of the world’s poorest counties immunise over 440 million children since the year 2000. This has meant that six million lives have been saved, and economic growth in these countries has increased.
…but there is no room for complacency
However, significant gaps remain in vaccine coverage around the world. An estimated 20 million children in Gavi-supported countries did not receive a full course of even the most basic vaccine in 2012. Access to more powerful vaccines is even worse: over 70 million children not immunised. In addition, only one percent of girls living in low- and middle-income countries received a human papillomavirus vaccine – resulting in an estimated 32 million girls in risk of contracting cervical cancer. The Ebola crisis in West Africa has shown what can happen when there is no readily-available vaccine for a deadly disease and where health systems are unable to cope with the impact. This also comes against the backdrop of the fast-approaching deadline for the MDG target for child mortality (reduction by two thirds by 2015), which is likely to be achieved since between 1990 and 2013 child mortality has been halved.
Gavi Replenishment 2015: Donors have bought into the Gavi model
The headline news coming out of the conference in Berlin was that Gavi had exceeded its target of $7.5bn for donor pledges for the period 2016 to 2020. The final total of $7.54bn reflected significant increases in funding pledges from donor governments including the US, the UK, and the European Commission (who doubled their support to €200m), as well as private philanthropic groups like the Bill and Melinda Gates Foundation. Germany, as the host of the replenishment conference, increased their contribution from 420 million to 600 million euros over the next five years – exceeding their ‘fair share’ and everyone’s expectations. For the first time, donation pledges also came from former Gavi programme countries such as China, as well as from countries in the Middle East. What does this commitment mean for the work of Gavi?
Practically speaking it means that they can lock in the gains already achieved by the roll-out of vaccines by increasing the number of children that will be immunised over the next five years by 300 million. This single action would prevent an estimated five to six million deaths by 2020. Investing in public health is also an investment in economic development – families and communities can become healthier and stronger, more children are able to remain in school and complete their education, and opportunities for girls and mothers are improved. Added together, this could result in a $100 billion economic benefit for the world’s poorest countries – a more than tenfold return on investment.
Gavi Graduates – how will they be affected?
While the amount that Gavi has to spend in the coming five years has increased, the number of programme countries it works with will reduce. An estimated 22 countries will graduate from Gavi support by 2020, and how their immunisation programmes will continue to operate at a sustainable level without Gavi support is one of the key questions facing the organisation in the future. In advance of the conference, several of the industry partners that work with Gavi to produce vaccines committed to price reductions or price freezes on their products for countries graduating from Gavi-supported programmes.
Gavi has made huge progress in supporting and rolling out vaccines for rotavirus, diarrheal diseases and pneumonia that have saved millions of lives. Still, however, there are many diseases which continue to wreak havoc on children and young women for which there is no vaccine in production or on the horizon – diseases such as malaria and HIV & AIDS. A vaccine that would protect against malaria or HIV would make a huge dent in child and maternal mortality figures in the world’s poorest countries. There was little talk, and less urgency, at the meeting in Berlin about how we make this next giant leap in global health.
Chancellor Merkel said “We must invest more in prevention and research”. The response to the Ebola crisis has shown what can be achieved when enough attention and funding is made available. For this to happen though, we need the same donor governments who have upped their support for existing vaccines to commit political and financial capital to global health research efforts to create the next generation of vaccines. For its part, DSW and its partners – through the “Let’s Save Lives” campaign – have been advocating for the European Union and EU member states to invest in research for new prevention, diagnostics and treatment for poverty-related and neglected tropical diseases. If we are ambitious now, and we can make this a central part of the global health agenda, the next Gavi replenishment meeting comes around we could be talking about securing funding for a malaria or a HIV vaccine. It is possible, we only have to aim for it together.