Immunisation: not just a lifesaver

What could be more important than saving the life of a child? Saving not just one child, but hundreds of millions of the poorest and most vulnerable children in the world. In January, German Chancellor Angela Merkel invited global leaders to Berlin, where they rose to this challenge, making a record-breaking financial commitment of more than $7.5 billion in additional funds to protect millions of children in developing countries with vaccines.

Gavi’s replenishment, held as part of Germany’s G7 presidency, saw pledges made by world leaders that will now help improve access to immunisation worldwide. Their generous support, combined with theleadership of implementing countries, the private sector and all of our partners, will enable Gavi, the Vaccine Alliance, to help developing countries immunise an additional 300 million children between 2016 and 2020, thereby preventing between five and six million deaths. In addition to saving lives, this investment is expected to lead to economic benefits of between $80-100 billion, through productivity gains and savings in treatment and transportation. This is just one reason why immunisation is such a crucial building block for prosperity and eradicating extreme poverty.

Chancellor Merkel was joined at this historic event by President Jakaya Kikwete of the United Republic of Tanzania, President Ibrahim Boubacar Keïta of the Republic of Mali, and Prime Minister Erna Solberg of Norway, as well as Donald Kaberuka, President of the African Development Bank, and Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation. They were also joined by ministers from more than 20 implementing and donor countries; chief executive officers of civil society organisations and vaccine manufacturing companies; the World Health Organization (WHO); Unicef; and others who came together to secure the multi-year financial commitments.

Gavi’s case for supporting its replenishment was clear-cut. With the deadline for the Millennium Development Goals now in sight, it is clear that reducing childhood mortality will remain a priority for us all beyond 2015. One of the most efficient and cost-effective ways of achieving this is through increasing coverage of childhood immunisation. Gavi has already demonstrated the huge impact that vaccines can have on reducing infant mortality and morbidity, and on restoring global equity by making new vaccines available to the world’s poorest countries.

Since 2000, Gavi has used its public-private partnership model to help immunise 500 million additional children, preventing an estimated seven million deaths in the process. And now Gavi is looking to build upon this progress and scale up its activities in a bid to reach every child. The challenge in doing so is to provide countries with the support they need, not only to introduce vaccines, but also to strengthen health systems in order to increase their national coverage levels, making them available to all children, no matter where they live.

Wider impacts of immunisation
But equity is just one motivation. There are strong economic grounds for investing in vaccines, too. There is a growing body of evidence to suggest that the true value of vaccines extends beyond saving individual lives and reaches well into a child’s life, through adulthood and into the wider economy. Children who are healthier do not require medical treatment or care, both of which cost time and money. So, by avoiding illness, infants have a greater chance of growing into healthier children who are able to attend school and become more productive members of society. Meanwhile, instead of caring for a sick child, parents can go out to work, thereby increasing their ability to earn. So, rather than spending money on medical bills, they are boosting their income and spending capacity, both of which can help the economy grow.

All of this is more than just common sense; there is a growing body of scientific evidence to back it up. It has been shown, for example, that vaccinated children do not just do better at school; through the prevention of damage that can be caused by infectious diseases, they also benefit in terms of cognitive development. Similarly, vaccination has also been shown to lead to wage gains across populations, while improvements in child survival lead to people having fewer children. And, in terms of the wider gains, one study found that a five-year improvement in life expectancy can translate into a 0.5 percentage point increase in annual growth of income per capita.

What’s more, this investment is about sustainability. Through its business model, Gavi’s financing needs should decrease after 2020 as countries pay an increasing share towards the cost of their vaccines until eventually they transition out of Gavi support and cover the full cost. Through the Vaccine Alliance’s co-financing policy, between 2016 and 2020 implementing countries are forecast to allocate a combined total of around $1.2 billion towards their Gavi-supported programmes. This is over and above the billions raised from donor countries.

Country co-financing encourages national ownership of new vaccine investments and is one key to assuring long-term sustainability. The other key in the Gavi model is our focus on market-shaping. Gavi diligently uses the force of its purchasing power and its partnership with industry to transform the global vaccine marketplace, securing lower prices and assured supply of more appropriate products. This ensures that children in developing countries will ever continue to have access to the benefits of vaccine science.

World leaders and global health champions recognise all this, which is why in Berlin we saw unprecedented engagement from donors, with many deciding to double or even triple their commitments to support Gavi, thus ensuring that its replenishment is fully funded. The new commitments came from a mix of pledges from 22 sovereign donors, and, for the first time, almost all donors have made pledges for the full five-year funding period. China, Oman, Qatar and Saudi Arabia also made pledges to Gavi for the first time. China’s pledge means that all BRICS countries have now committed to contributing towards childhood immunisation through Gavi.

Additionally, in Berlin Gavi announced that the Gavi Matching Fund, a fund that doubles private-sector contributions and impact, will be renewed for the 2016-20 period with the support of the Bill & Melinda Gates Foundation, the Netherlands and other sponsors.

With all 73 of Gavi-supported countries now offering the five-in-one pentavalent vaccine – which combines diphtheria-tetanus-pertussis (DTP) vaccines with those that protect against hepatitis B and Haemophilus influenzae type B (Hib) – the focus will be on the increase of overall coverage of this life-saving vaccine to 80 per cent of newborns and at a record low price. In addition to this, we are looking to increase coverage of other vital vaccines, such as pneumococcal conjugate vaccine (PCV) and rotavirus, which protect against pneumonia and diarrhoea, the two biggest childhood killers among infectious diseases.

The Ebola epidemic in West Africa has demonstrated the central role that immunisation plays in the health of a nation. Indeed, today, no other health invention reaches so many lives, with 30 vaccine doses administered every second across the globe. Yet, with one in five of the world’s children still not receiving a full course of even the most basic vaccines, and with developing countries not yet fully accessing new vaccines, we need to do more. With the assistance of donors, Gavi is now helping to change that, increasing the number of children receiving all 11 WHO-recommended vaccines from less than five per cent to more than 50 per cent by 2020. By working together, we can reach every child.

This year, the G7 has shown global leadership in securing Gavi’s funding. We look forward to the continuing commitment of the world’s richest countries to ensuring that one of the greatest benefits of modern science, vaccines, are accessible to all children, including in the world’s poorest countries. As the first chair of the Gavi Board, Nelson Mandela, once said: “History will judge us by the difference we make in the everyday lives of children.”