From Atlanta to Accra, today is a day to celebrate.
In Atlanta, Shot@Life is launching its national campaign to engage Americans in the critical effort to reduce the number of preventable deaths of children around the world.
In Accra, where I’ll be today, that work is happening on the ground. Ghana is first of the countries GAVI supports, the 73 poorest countries in the world, to simultaneously roll out pneumococcal and rotavirus vaccines. These two vaccines protect children against the biggest vaccine-preventable killers of children, diarrhoea and pneumonia, which together kill nearly one million children every year. Both of these efforts are critically important if we’re going to reach millions more children with life-saving vaccines.
Last September I had the pleasure of joining Shot@Life in New York when the campaign was first introduced. I’m inspired by what I’ve seen since then. Champions ranging from mom bloggers to an eighth grader who led a fundraising effort at his school have turned Shot@Life into a movement.
How can you add your voice to this movement? By supporting the launch, where parents and children can learn about the campaign through interactive exhibits, participating in one of the grassroots events being held around the country, and giving your ongoing support to the campaign.
Shot@Life’s national launch and the rollout in Ghana fall during World Immunization Week, a WHO-led celebration from April 21 to 28. Many countries will be launching immunisation campaigns, hosting public education events, or even introducing new vaccines. This year’s theme is: “Protect your world. Get immunized.”
Shot@Life delivers that message powerfully by linking Americans with worldwide efforts to provide vaccines and expand immunisation. In most countries where GAVI works, families hardly need to be convinced of the benefits of immunisation, which now reaches more children than ever before.
For the first time, we’re supporting countries to apply for vaccines against human papillomavirus (HPV) and measles-rubella, which join our existing portfolio of yellow fever, meningitis A, measles second dose, pentavalent, pneumococcal and rotavirus vaccines.
When one out of five children still don’t receive the routine vaccines they need, we at GAVI spend plenty of time thinking about how best to reach this fifth child. We’re exploring new ways to reward countries for increased immunisation coverage, and looking at strategies for countries in conflict.
After one year without a new case of polio, India has shown the world that immunisation can reach every child. In a country where 26.5 million children were born last year, some of them nomadic and some not even registered, vaccinators travelled up and down the country looking to reach them all with two drops of polio vaccine. It is an extraordinary success.
Take a moment this week, no matter where you are, and help ensure that children all over the world have a Shot@Life.
From Albania to Yemen and Fiji to Nigeria, many countries will launch immunisation campaigns, host public education events or even introduce new vaccines. This year’s theme is: “Protect your world. Get immunised.”
In most low income countries supported by GAVI, parents hardly need to be persuaded of the benefits of immunisation, which now reaches more of their children than ever before and is saving millions of lives each year.
Delivered from factory to village health posts in mountains, valleys, deserts, and tropical jungles, these vaccines are transforming the lives of millions. Children stay healthy, go to school, and grow up fitter and stronger. And without the need to care for sick or disabled children, parents can also lead more productive lives as well as invest more into their children. A 2005 Harvard School of Public Health study found that GAVI’s support for immunisation could yield as much as an 18 percent return on investment to countries by 2020.
For this year’s World Immunization Week, my first as GAVI’s CEO, I will travel to Ghana for the simultaneous launch of both the pneumococcal and rotavirus vaccines on 26 April. These two vaccines will protect Ghanaian children against the leading causes of pneumonia and severe diarrhoea, which together account for about 20 % of Ghana’s child mortality.
The introduction of just one vaccine alone would imply an immense workload of financial planning, medical training, and upgrading a complex logistical system. So with this double launch, Ghana’s health officials are feeling twice the heat as our terrific video shows. But their ambition is based on a cool and calm calculation.
Ghana wants to achieve Millennium Development Goal 4, a two thirds reduction in child mortality by 2015, and immunisation is an effective way to reduce unnecessary deaths.
Meanwhile, the GAVI Alliance’s Board Chair, Dagfinn Høybråten, will travel to Haiti, still recovering from a catastrophic earthquake in 2010 but just about to introduce the pentavalent vaccine with GAVI’s support.
By protecting against five deadly diseases, this vaccine reduces the number of injections needed and is popular with health ministries around the world because it saves on time, money, and even trauma for the infants on the receiving end of the needles. It is a very powerful weapon in the battle against vaccine-preventable death.
Africa’s most populous country Nigeria will also introduce the pentavalent vaccine, when it begins a three-year roll-out later this month. Coming so soon after India’s pentavalent introduction, I’m excited about the prospects for child health in these two countries, which together account for the largest numbers of unimmunised children and some of the world’s highest child mortality.
With more than a year passed without a single new case of polio, India has shown the world what can be achieved with immunisation. In a country where 26.5 million children are born every year, this is an impressive success built on the hard work of all those individuals who travelled the length and breadth of the country to reach every child—often multiple times—with just two drops each of polio vaccine.
But successes in India, Nigeria, and Ghana are just the tip of the needle.
Since June last year, when donors gathered in London to commit an extra US$ 4.3 billion for GAVI’s immunisation programmes, the political momentum has been growing.
The same day as the Ghana vaccine event, the UN Foundation will launch shot@life, their advocacy campaign for global immunisation and we’re also looking forward to a US-led global summit on child survival in June.
Thanks to the support of our many donors, GAVI can continue to provide developing countries with the vaccines to save another four million lives between 2011 and 2015. That of course is the most important thing to celebrate.
As 2011 draws to a close, it’s a good time to reflect on what an extraordinary year it’s been for GAVI and for this Alliance’s mission to ensure life-saving vaccines reach all the world’s children regardless of whether they are born in a poor country. Those of you who know me from my time as CEO of the International AIDS Vaccine Initiative will be familiar with my end of year letters and it’s a tradition I would like to introduce at GAVI.
Over the past five months, I have enjoyed getting to know better how the Alliance works: its members, its mechanisms and, most of all, the magical formula that ensures our partners deliver more together than alone. This learning process culminated in the recent GAVI Alliance Board meeting in Bangladesh, where it was great to see Geeta Rao Gupta, Deputy Executive Director at UNICEF and a leading champion of immunisation, appointed vice-Chair of the GAVI Board.
Without a doubt, the high point of the year was the June pledging conference in London when donor governments pledged funding which the Alliance will use to immunise close to a quarter of a billion children against life-threatening diseases by 2015. At a time when the economic outlook is uncertain, that represented an exceptional vote of confidence – not just in our Alliance but also the cost-effectiveness of vaccines and their ability to make a difference.
The level of political commitment was extraordinary. The Prime Ministers of the UK and of Norway, the President of Liberia, and Bill Gates and many many other leaders together brought the focus on immunisation to a whole new level. That political commitment came from implementing countries too, with the countries reaffirming their commitment to co-finance vaccines, which they continue to do. And in the approach to the conference, vaccine manufacturers made offers of significant price reductions for key vaccines.
As the chair of the GAVI Board, Dagfinn Høybråten, said recently, it was a great GAVI moment; and we need more moments like that.
Prior to the conference, pneumococcal vaccines were already reaching developing countries in record time thanks to GAVI support; in February, Kenya’s President, Mwai Kbaki, marked the introduction of pneumococcal vaccines into the national immunisation programme with a special event to celebrate the global rollout. Now, the pledging conference has given us an enormous opportunity to accelerate the rollout of both pneumococcal and rotavirus vaccines against the leading causes of pneumonia and diarrhoea deaths respectively. By 2015, some 40 countries are expected to gain access to these vaccines through GAVI funding and the work of countries and our other partners in countries.
We recognise that a number of countries eligible for GAVI support do not have the immunisation infrastructure in place to deliver all of the new antigens. Funding the introduction of new vaccines is only part of GAVI’s vision. Immunisation programmes also need to be sustainable so vaccines do not protect only one birth cohort. Working with our partners on the ground to build countries’ systems and figure out their needs will be a critical part of what we have to do in the immediate future.
As an innovative Alliance, GAVI never stands still and, last month, we were pleased that our Board meeting in Bangladesh took the first steps to opening windows of support for the introduction of vaccines against human papillomavirus (HPV) - the second human cancer vaccine - and rubella virus in developing countries. Both have a huge potential impact. If negotiations to secure a sustainable price for the vaccine from manufacturers are successful and countries can demonstrate their ability to deliver them, up to two million women and girls in nine countries could be protected from cervical cancer by 2015. Over the same period, the rubella vaccine has the potential to reach 588 million children.
Opening an HPV window does bring its own set of new challenges. While we will be able to build on the same cold chain used for other vaccines, the vaccine needs to be provided to adolescent girls, which is a new age group for GAVI.
However, our Alliance allows us to bring together an enormous number of talented people to accomplish more than our individual capacities alone. In 2012, we will be looking to build new partnerships with reproductive health groups, family planning groups, ministries of education, nutrition and maternal child health and others, and these will help to provide opportunities to link the introduction of HPV vaccine with other additional steps to improve girls’ and families’ health.
If we lift our eyes to the horizon, there are many new opportunities in prospect. The research and development effort on vaccines is currently very rich. In 2011, phase three trials of a malaria vaccine delivered exciting early data. And in addition to the traditional multinational pharmaceutical companies, there is the R&D work being done by Public-Private Product Development Partnerships as well as the beginnings of work being done by developing country manufacturers.
The Alliance needs to be a big tent where all of the major players in immunisation can meet. So we need to rethink our links to the polio eradication campaign, which is continuing to have success and is beginning to think about the end game for this terrible scourge of mankind. Similarly we need to look at how we can strengthen our connection with those working on measles elimination. Our work here is aligned with and part of the Decade of Vaccines and our goal of ensuring vaccines are a higher public health priority.
As I noted above, we received significant new commitments from vaccine manufacturers on prices in the approach to the pledging conference. We need to continue to work to create a healthy vaccine market, with secure supply, as much competition as possible, assurance of high quality and sustainable prices. Under our new supply and procurement strategy, approved at the November Board meeting, we will look at each vaccine market in turn and take a tailored approach to each.
With these challenges ahead, and the success of the June replenishment notwithstanding, it is critical that GAVI constantly thinks about how to renew resources and diversify its funding base, especially in the current economic climate. We were delighted this year to have two donor governments, Brazil and Japan, make their first grants to GAVI. The Matching Fund initiative, launched by the UK and the Gates Foundation, is also attracting new private sector champions to our cause.
Such generosity puts the emphasis on being accountable to our donors. Last month’s Aid Effectiveness conference, which I attended in Busan, South Korea, emphasised the importance of data transparency. In 2011, GAVI published all its key performance indicators on www.gavialliance.org. In 2012, we will strive to improve immunisation impact data by working with our partners and also give access to more timely information on vaccine rollouts.
Finally, I take inspiration from the memory of a Dhaka schoolgirl Saleha Akhter, presentor of a video shown to the GAVI Board last November and a reminder of why GAVI exists.
In six significant minutes, Saleha describes the vital role of governments, UN agencies, civil society organisations, vaccine manufacturers and donors in delivering vaccines to her fellow Bangladeshi schoolchildren. All are critical members of our extended family. Without these combined talents, neither Saleha nor 90% of her fellow Bangladeshi schoolchildren might ever have had the chance to fulfill their life’s potential.
As always, we thank you for your interest in GAVI’s work and look forward to working with you next year to continue to increase our impact on the lives of so many. If there are any questions, please let us know.
With best wishes for you and yours for the holiday season.
My British friends sometimes refer to pneumonia as “old man’s friend”, because it can bring swift and painless death to elderly patients who become unconscious and slip away in their sleep.
But 98.5 percent of pneumonia deaths actually happen in the developing world and pneumonia is not a friend.
In fact pneumonia is the world’s biggest killer of children, filling their little lungs until breathing becomes difficult and painful. It kills 1.5 million children under five every year.
But as we observed World Pneumonia Day this year on Saturday 12 November, we celebrated the fact that vaccines against pneumococcal disease, the biggest cause of pneumonia, are finally reaching the children that need them most.
Almost a year ago, in December 2010, Nicaragua became the first of 15 developing countries so far to have introduced the pneumococcal vaccine. By the end of next year, 13.6 million children in developing countries will have been immunised against the leading cause of pneumonia.
The idea that vaccines can save lives is not a new idea, of course. In the last 30 years or so, immunisation has brought profound drops in the incidence of many diseases, including measles, polio, and tetanus. It has also eradicated smallpox.
As the CEO of the GAVI Alliance, a public-private partnership focused on saving children’s lives by increasing access to immunisation in poor countries, I’m proud to say that – with magnificent support from the British government – we have made available these pneumococcal vaccines to children in the world’s poorest countries.
By concluding long-term supply agreements, our Advance Market Commitment (AMC) has reduced market uncertainty, encouraging manufacturers to develop adequate production capacity and to supply at drastically lower prices.
By some estimates these vaccines are now reaching developing countries about 10 to 15 years earlier than they would otherwise have done.
Breast-feeding, better nutrition, and antibiotics are also key to reducing the burden of pneumonia deaths in the developing world.
But when isolation and lack of resources mean medical care is hard to access, immunisation becomes even more important. GAVI also supports vaccines against Hib, measles, and whooping cough, which help reduce the pneumonia burden.
The pneumococcal vaccines alone could save as many as 7 million child lives by 2030.
Like the other vaccines that we support, pneumococcal vaccines help save lives and protect the health of communities. And by protecting families from disease and disability, we are also saving them the costs of expensive medical care and treatment, preventing many of them from sliding deeper into poverty.
In our first decade of work, GAVI has helped countries immunise nearly 300 million children so far. And the British government’s US$ 2.5 billion contributions to GAVI equal about a third of our total income.
My British friends and I agree: no child should die of a disease we can prevent.
The power of vaccines is evident around the world, nowhere will it be more so than in the over 30 developing countries that will begin – for the first time – to immunise their children with new rotavirus and pneumococcal vaccines over the next year and a half—vaccines against the most common forms of severe diarrhoea and pneumonia, the largest killers of children in these countries.
In large part thanks to widespread immunisation, the number of young children dying each year has significantly declined from approximately 14 million in 1979 to slightly less than eight million in 2010. This number could drop even further – to about five million by 2020 – if donors, the global health community and developing countries themselves stay focused on immunisation.
This, of course, is a tough challenge for donor governments who are facing very real and very serious budget deficits. Yet all that is being asked is that we provide children who happen to have been born in poverty access to life saving vaccines that all of our children routinely receive.
Republicans and Democrats have an unprecedented opportunity to demonstrate their continued cooperation on cost-effective health solutions for poorer nations that yield real results. Leaders on both sides of the congressional aisle have carried the torch. The United States’ support for global health has leveraged not only other public donor support, but private support from the Gates Foundation, United Nations Foundation, corporate partners and others.
Congressional leadership can continue the decade-long, bipartisan collaboration by championing global immunisation. Literally millions of people are alive and healthy today thanks to vaccines.
And so much more can be done. In addition to the new vaccines against pneumococcal disease and rotavirus, there are existing vaccines which have enormous impact. Polio can be eradicated. Measles is under attack, particularly in sub-Saharan Africa. New meningitis A vaccines are highly effective and affordable and a future malaria vaccine is showing promise.
The return on investment in global health is tremendous, and the biggest bang for the buck comes from vaccines. Vaccines are among the most successful and cost-effective health investments in history. For just a few dollars a dose, vaccines save lives and help reduce poverty. Unlike medical treatment, they provide a lifetime of protection from deadly and debilitating disease. They are safe and effective. They cut healthcare and treatment costs, reduce the number of hospital visits and ensure healthier children, families and communities. Investments in immunisation yield a rate of return on a par with educating our children – and higher than nearly any other development intervention.
For just a small percentage of the total foreign assistance program, which in itself makes up just one percent of the federal budget, the U.S. can lead a transformation in child health and survival around the world.