2 March, GENEVA - The first phase of a new global alliance to
increase vaccine coverage among the world’s poorest children is
drawing a surge of interest from developing country health
officials. The Global Alliance for Vaccines and Immunization (GAVI),
which announced a multimillion dollar Global Fund for Children’s
Vaccines at the World Economic Forum in Davos last month, has
already received details on immunization activities and needs from
nearly 50 developing countries.
"We issued a call for expressions of interest and the results
were more encouraging than anyone could have anticipated," said
UNICEF Executive Director Carol Bellamy, a member of the GAVI Board.
"Early and enthusiastic interest on all sides demonstrates the
teamwork and commitment essential to achieving universal child
immunization."
Dr Gro Harlem Brundtland, Director-General of the World Health
Organization (WHO) and Chair of the GAVI Board, concurred. "The
message here is that if the international community can find ways to
make vaccines more affordable to low income countries, the countries
will meet us halfway by investing the necessary resources in people
and systems that will get those vaccines to children. The growing
international momentum in the field of immunization is definitely
being felt on the country level."
On March 2, United States President Bill Clinton is hosting a
meeting of pharmaceutical industry heads and GAVI representatives to
discuss ways to accelerate development and delivery of both current
and new vaccines to the places where they are most needed. The
Clinton Administration has also recently announced a commitment to
securing US$50 million for the GAVI Vaccine Fund, increased funding
for research critical to the development of vaccines for malaria,
tuberculosis, and HIV/AIDS, and to working with the World Bank and
developing nations to improve health care infrastructure.
Every year, nearly three million children die from diseases that
could be prevented with currently available vaccines. The GAVI
Alliance, a coalition of international organizations with the
mission of ensuring that every child is protected against
vaccine-preventable diseases, is seeking to close the growing gap in
the number of vaccines available to children in industrialized and
developing countries.
In late March, the Alliance will issue an official call for
proposals to countries with incomes of less than US$1000 per capita
GNP. Resources from the Fund will primarily be used to purchase
vaccines for hepatitis B, Haemophilus influenzae type b (Hib), and
yellow fever, and safe injection materials. It is envisioned that
GAVI partners at the country level will collaborate with national
governments to help close the other gaps identified in the country
proposals, beyond the provision of vaccines.
Traditionally, new international public health efforts are tested
in a handful of so-called pilot countries, which subsequently
receive extensive external support to evaluate and modify the
programs. By putting the word out to all eligible countries that new
funds and commitments are available, and placing more of the
responsibility for providing the necessary information and
commitment on the countries themselves, the GAVI partners are hoping
that resulting efforts will be more country-driven and therefore
more sustainable.
"In my country, a process of health system reform has highlighted
some gaps in delivery of vaccines," said Dr Chrispus Kiyonga,
Minister of Health in Uganda - one of the countries to send an early
response to the GAVI Alliance. "We are now seeking solutions to
overcome these problems in order to revitalize universal access to
vaccines already in use in the country and to prepare for the
introduction of currently under-utilized and yet necessary vaccines
such as hepatitis B."
The great majority of countries responding currently have or are
developing multiyear immunization plans. In addition, even in
countries with the scarcest resources, the national budgets are
bearing all or nearly all operational costs of immunization systems.
Many of the countries are interested in integrating the hepatitis B
vaccine into their vaccination schedules, with lack of funding being
the only obstacle. Less interest in the Haemophilus influenzae type
b (Hib) vaccine may be due to the reduced perception of need; there
is widespread interest in gaining better understanding of Hib
disease burden through the use of assessment tools such as those
developed by the US Centers for Disease Control (CDC) and the
National Institutes of Health (NIH).
"The Bill & Melinda Gates Foundation is committed to ensuring
that every child has access to lifesaving vaccines, regardless of
where they live," said foundation president Patty Stonesifer. "We
are pleased to support GAVI and its mission of helping to speed the
development and distribution of vaccines, which could help save the
lives of more than three million children annually."
All countries with incomes of less than US$1000 per capita GNP
were invited to submit an "expression of interest" to the Alliance -
74 countries in total, with the majority in Africa. The responses
have been evenly spread, with 26 from Africa, 11 from Eastern
Europe, 6 from Asia, 3 from Latin America, and 1 from the Middle
East.
Updated
list of countries that have submitted expressions of interest
Countries
that have sent Letters of Expression of Interest: view map: 17 March
2000
GAVI is the Global Alliance for Vaccines and Immunization, a
coalition of organizations formed in 1999 with the mission of
ensuring that every child is protected against vaccine-preventable
diseases. The partners include: national governments, the Bill and
Melinda Gates Children’s Vaccine Program, the International
Federation of Pharmaceutical Manufacturers Associations (IFPMA),
research and technical health institutions, the Rockefeller
Foundation, the United Nations Children’s Fund (UNICEF), the World
Bank Group and the World Health Organization (WHO).