Biomed Analysis: Wanted — cash injection for vaccines
Few causes are more worthy of funding than vaccines, says Priya Shetty, and the developing world relies on GAVI getting the billions it needs.
GAVI, the Global Alliance for Vaccines and Immunisations,will ask donors for US$3.7 billion to fund its work over the next few years at a pledging conference to be held on 13 June in London, United Kingdom.
This is a steep sum. But GAVI has a strong case — after all, few products in global health are as effective at saving lives as vaccines.
Yet it faces threats from the growing anti-vaccination movement and diminishing global aid budgets. This is a big test for funders' commitment. But with GAVI on the brink of radically improving global health, it is vital that it secures the funding it needs.
Strong vaccine portfolio
GAVI is already well-respected in the global heath community. A recent UK government review of multilateral aid agencies, for instance, gave it top marks for being cost effective and critical in reducing child deaths.
This year saw GAVI launch an ambitious rollout of two new vaccines against pneumococcal disease and meningitis, both top killers of children under five years in poor nations — pneumonia alone is behind 18 per cent of child deaths in developing countries. And in February, GAVI began rolling out the pneumococcal vaccine in Kenya, and has plans for about 40 other developing countries.
GAVI also needs US$100 million to vaccinate against meningitis in Africa's 'meningitis belt' of 25 countries that extends across the continent from Senegal to Ethiopia. The new single-dose vaccine, MenAfriVac, is cheap at US$0.50 a dose, and targets group A meningococcal meningitis, which is responsible for more than 85 per cent of cases of the disease in Africa.
Other vaccines that GAVI has added to its portfolio include the rotavirus vaccine, which causes over a third of all diarrhoeal infections severe enough to warrant hospitalisation. The alliance also hopes to vaccinate teenagers with the human papillomavirus (HPV) vaccine to prevent cervical cancer — but that too depends on raising enough funds.
In the past decade alone, GAVI has prevented five million child deaths; fully funded, it could save another four million lives by 2015. "This is a critical point in global health," says Helen Evans, GAVI's interim chief executive. "The science is there, the demand is there. All that is needed is the political will and financial support."
One of the pressures working against GAVI's push for more funding is the growing anti-vaccination movement, especially in the United States.
Some vaccine experts are concerned that the influence of anti-vaccine sentiments could turn public opinion against funding sources such as the US government, which is is a key funder of GAVI.
Last month, the American Academy of Pediatrics spoke out against an anti-vaccine billboard advertisement in New York's Times Square, which was paid for by a non-profit organisation called the National Vaccine Information Center (NVIC) and Mercola.com (a natural health website) — both widely seen by public health experts as spreading anti-vaccine messages.
The alleged link between the measles, mumps and rubella (MMR) vaccine and autism has now been discredited, and Bill Gates, who supports GAVI, has spoken out strongly against groups that fuel fears about vaccines.
"The mothers who heard that lie, many of them didn't have their kids take either pertussis or measles vaccine, and their children are dead today," he told CNN at the World Economic Forum in Davos, Switzerland, in February.
Targeting government funding
Since the effectiveness of vaccines is easy to measure, it is no surprise that the staunchly metrics-driven Bill & Melinda Gates Foundation is behind GAVI, having already given the alliance seed funding of US$750 million.
When the German government said last month that it would increase its funding by €14 million for this year's childhood immunisation drive, the Gates Foundation said it would match this and any further increase in funds that Germany announces before the pledging conference.
But the Gates Foundation is the exception among nongovernmental donors, few of which seem inclined to provide financial support. So governments both in the developed and developing world are likely to step in and become key sources of funding.
GAVI has asked the US government to contribute US$115 million on top of existing contributions towards the pneumococcal vaccine. And the United Kingdom pledged UK£150 million (US$243 million) at the Department for International Development (DFID) annual conference this March. The alliance is also asking recipient countries to contribute to operational costs.
"With increased donor and country support and lower vaccine prices over the long-term, GAVI will be able to deliver these amazing tools to some of the world's most disadvantaged people and by doing so, change the course of global health history," says Seth Berkley, incoming chief executive of the alliance.
GAVI is facing a pivotal point in its mission to stop millions of child deaths in the developing world. It is a rare example of pharmaceutical companies, nongovernmental organisations and developing nations working together efficiently for the greater good. The alliance's optimism — and its record of success — must not go unrewarded.
Journalist Priya Shetty specialises in developing world issues including health, climate change and human rights. She writes a blog, Science Safari, on these issues. She has worked as an editor at New Scientist, The Lancet and SciDev.Net.