Message from the Chair of the GAVI Alliance Board
Our Alliance is broader and stronger than everImmunisation: a matter of justice
Every 20 seconds a child dies from a vaccine-preventable disease. He or she will most likely be in a developing country. For this still to be happening in the 21st century is unjust and morally unacceptable. Being part of the GAVI Alliance allows me, in some small way, to be part of the solution to this injustice.
My first full year as Board Chair was a pivotal one for GAVI. At the start of the year we faced a funding gap of US$ 3.7 billion in the midst of a global financial crisis and the challenging task of recruiting a new CEO.
The additional funds raised at our pledging conference in June 2011 will help us meet the accelerating demand for vaccines in the years to come. I was equally impressed by the ownership and commitment shown by implementing countries in advancing and co-financing their immunisation programmes. The successful recruitment of a new CEO, Seth Berkley, was another highlight.
Our efforts to engage the private sector also bore fruit in 2011, culminating in the establishment of the GAVI Matching Fund. As part of this initiative, the British Government and the Bill & Melinda Gates Foundation have pledged to match contributions to immunisation from the private sector. This mechanism has the potential to help immunise millions more children, translating the public–private match into the most important match of all – that between the vaccine and the child.
The July Board meeting provided an opportunity to recognise the work of our partners and their unwavering support, especially in the lead-up to the pledging conference. I would also like to thank the Government of Bangladesh for hosting our November Board meeting and providing the venue for the GAVI civil society steering committee meeting. It was a timely reminder of the vital role played by civil society in immunisation delivery and advocacy, at both the national and global levels.
I am certain that 2012 will prove to be an equally exciting year. The Child Survival Call to Action, scheduled for 14–15 June in Washington, DC, will be an opportunity to focus on the importance of immunisation for child health. Later in the year, we will hold our fifth Partners’ Forum in Dar-es-Salaam, bringing together a wide range of Alliance partners to celebrate our achievements, to learn from the past and to see where we can improve.
Our Alliance is broader and stronger than ever. Together we can help to fulfil every child’s right to a healthy, prosperous future.
Message from the Chief Executive Officer of the GAVI Alliance
2011 was a ground-breaking year in the history of the Alliance2011: a milestone year for GAVI
2011 was a ground-breaking year in the history of the Alliance and an exciting year to have joined GAVI as its new CEO. Helen Evans did an excellent job as interim CEO in the first half of the year. One of the highlights was undoubtedly the success of the June pledging conference. The heightened global attention to immunisation contributed to an escalation in the demand for new vaccine support.
The rapid increase in the take-up of the new pneumococcal vaccine was another high point. Sixteen countries had rolled out the new vaccine by the end of 2011 and a further twenty-one have had their applications for support approved. The number of countries wanting to introduce this and other life-saving vaccines is set to accelerate rapidly over the next few years.
I was especially pleased that we took the first steps towards funding rubella vaccines, which will be rolled out together with measles vaccine, and human papillomavirus vaccines which protect against cervical cancer. We also moved towards more customised ways of strengthening health systems to deliver immunisation by developing tailored approaches for fragile countries.
Critical to GAVI’s mission is a healthy vaccine market, characterised by security of supply, low prices and competition between a wide range of manufacturers. As a result of a GAVI call to action in 2011, manufacturers made price reduction offers on several key vaccines.
These price offers are a testament to our increasingly proactive approach to shaping the vaccine market, working closely with our pharmaceutical company partners to make vaccines more affordable for developing countries.
In the years ahead, we will continue to strive to improve our model and to accelerate the introduction of new vaccines to provide all children with the best possible start in life. All the GAVI Alliance partners – UNICEF, WHO, the World Bank, developing and donor countries, civil society organisations, private philanthropists and vaccine manufacturers – have an essential part to play. Casting our net wider, I believe that the Alliance can be a platform for engagement by all stakeholders in immunisation.
The power of vaccines is clear. While the world’s population more than doubled between 1980 and 2009, the number of diphtheria cases fell by 99%, the number of polio cases reduced by 97% and the number of measles and pertussis cases each dropped by 95%.
By further increasing the support for vaccines, we can continue this progress and turn the miracle of vaccines into effective protection for every child everywhere.
Saving lives and protecting health
GAVI’s mission, to save children’s lives and protect people’s health by increasing access to immunisation in poor countries, is underpinned by four strategic goals.
The vaccine goal 1
Accelerate the uptake and use of underused and new vaccines by strengthening country decision-making and introduction.
The health systems goal 2
Contribute to strengthening the capacity of integrated health systems to deliver immunisation.
The financing goal 3
Increase predictability and sustainability
Increase the predictability of global financing and improve the sustainability of national financing for immunisation.
The market shaping goal 4
Shape the market
Shape vaccine markets to ensure adequate supply of appropriate, quality vaccines at low and sustainable prices for developing countries.
By the end of 2011, GAVI had:
- contributed to countries preventing over 5.5 million future deaths otherwise caused by Haemophilus influenzae type b (Hib), hepatitis B, measles, pertussis, pneumococcal disease, polio, rotavirus diarrhoea and yellow fever;
- supported the immunisation of more than 325 million additional children;
- committed US$ 7.2 billion to new and underused vaccines and health system strengthening programmes in developing countries.
These estimates and projections are produced by the WHO Department of Immunization, Vaccines and Biologicals, based on the most up-to-date data and models available as of 30 September 2011.
Delivering on the GAVI mission
GAVI’s 2011–2015 strategy has three indicators, each with specific targets, to measure progress against the overall mission.
Under-five mortality rate in GAVI-eligible countries (per 1,000 live births)
The average under-five mortality rate in GAVI-supported countries fell from 97 deaths per 1,000 live births in 2010 to a projected 95 deaths per 1,000 live births in 2011, in line with GAVI’s target.
Note: Under-five mortality rates are derived from population-weighted estimates of child mortality rates for the 72 countries eligible for GAVI support in 2010.United Nations Child Mortality Estimates
Number of additional future deaths averted (millions)
By the end of 2011, GAVI-funded vaccines had helped developing countries to prevent a projected 5.5 million future deaths. This is an additional 515,000 averted deaths compared with the end of 2010, slightly above the target of 483,000.
Note: The calculation of the number of future deaths averted takes account of nine vaccines funded by GAVI in all 72 countries eligible for GAVI support in 2010.WHO impact estimates
Number of additional children fully immunised with GAVI support (millions)
According to WHO estimates, over 325 million children had received one or more GAVI-supported vaccines by the end of 2011. This is an additional 37.3 million children compared with the end of 2010, ahead of the target of 36 million.
Note: The calculation of the number of children immunised includes the total number of children who have received the full course of any of the GAVI-supported vaccines in all 72 countries eligible for GAVI support in 2010. Country data have been corrected so that children who receive multiple vaccines are not counted more than once.WHO/UNICEF immunisation coverage estimates and United Nations Population Division population estimates
GAVI supports the countries most in need
To ensure its focus on the poorest countries in the world, GAVI applies an eligibility threshold for support that is based on gross national income (GNI).
Interactive map to explore GAVI disbursements and type of support, 2000-2011
Note: Pentavalent, pneumococcal and rotavirus vaccines represent GAVI’s main areas of support. GAVI also provides support for human papillomavirus, measles (second dose), meningitis A, rubella and yellow fever vaccines, as well as for health system strengthening and civil society involvement in immunisation.
GAVI disbursements, 2000–2011 (includes all types of GAVI support):
GAVI support, 2000–2011:
In 2011, 57 countries were eligible for GAVI support as their per capita GNI* was equal to or less than US$ 1,500.**
Since GAVI’s inception, 77 countries have received support for vaccines or health system strengthening programmes.
Not all GAVI-eligible countries qualify for every type of support. For instance, for a country to qualify for new vaccine support its coverage for three doses of diphtheria-tetanus pertussis vaccine (DTP3) has to be at least 70%.*** Meningitis A and yellow fever vaccines are exempt from this requirement.
As GAVI aims to provide additional catalytic investments, vaccine support is not provided to countries that are already self-funding the vaccine.
* Based on World Bank per capita GNI data for 2009, published in July 2010.
** Exceptionally, 16 graduating countries were given a final opportunity to apply for GAVI support in 2011.
*** The filter was temporarily reduced to 50% for the 2011 application round.
Disbursements to countries by type of support,
Every child deserves to be protected against disease with vaccines, no matter whether it is born in Europe, Africa or elsewhere in the world.
For the first time in history, children in developing countries are receiving new life-saving vaccines at virtually the same time as children in high-income countries
Donor contributions to the GAVI Alliance
Cash received by GAVI (in US$ millions) as of 31 December 2011
Click the table heading to reorder items: first-click = low-high second-click = high-low third-click = reset
Donors to the GAVI Alliance 2011 Total 2000–2011 Australia 48.8 77.4 Canada 20.7 172.5 Denmark 8.8 36.8 European Commission (EC) 0 57.9 France 34.5 53.2 Germany 8.5 30.6 Ireland 4.9 34.8 Japan 9.3 9.3 Luxembourg 1.2 7.7 Netherlands 26.3 242.2 Norway 79.2 598.9 Republic of Korea 0.3 0.7 Spain 2.7 43.2 Sweden 92.7 215.2 United Kingdom 85.1 222.5 United States of America 89.8 736.5 Government donors and EC 512.9 2,539.40 Anglo American plc 1 1 Bill & Melinda Gates Foundation 264.1 1,476.90 His Highness Sheikh Mohamed bin Zayed Al Nahyan 14.1 14.1 «la Caixa» Foundation 3.1 18.8 J.P. Morgan 2.4 2.4 Other private 0.8 13.1 Private contributions 285.5 1,526.30 Sub-total 798.4 4,065.70 IFFIm to GFA transfers 300 2,175.70 AMC funds 128.2 171 Total contributions 1,226.50 6,412.40
Donations are recorded on a cash basis.
Note: As GAVI’s financing mechanisms enable the innovative use of donor contributions over time, the amount of donor contributions (as detailed in Annex 2) may differ from the amount of cash received by GAVI (as detailed above) in a given year.
Donor contributions to the GAVI Alliance
Innovative finance mechanisms: AMC and IFFIm
AMC commitments 2009–2020 (US$ millions) Italy 635 United Kingdom 485 Canada 200 Russian Federation 80 Bill & Melinda Gates Foundation 50 Norway 50 Total 1,500
By daring to be imaginative, innovative and bold, we have raised significant capital and ensured the delivery of vaccines to those who need them most.
IFFIm commitments* Length of commitment Amount (in millions) Total (equivalent in US$ millions** United Kingdom 20 years £ 1,380.0 2979.9 20 years £ 250.0 France 15 years € 372.8 1719.6 19 years € 867.2 Italy 20 years € 473.5 635.0 15 years € 25.5 Norway 5 years US$ 27.0 264.5 10 years NOK 1,500.0 Australia 20 years A$ 250.0 256.1 Spain 20 years 189.5 240.4 Netherlands 7 years 80 114.4 Sweden 15 years SEK 276.2 37.7 South Africa 20 years US$ 20.0 20 Total 6267.6
* The UK and Brazil made new pledges to IFFIm in 2011. Negotiations are currently under way to formally sign these grant agreements.
** IFFIm pledges by donors in US$ and US$ equivalent amounts of national currency pledges calculated using prevailing exchange rate around the time of signing of the grant agreement.