GAVI exceeds US$7·5 billion fundraising target

Abstract

Donors responded overwhelmingly at the recent GAVI replenishment meeting, pledging slightly more than the US$7·5 billion fundraising target for 2016–20. Ann Danaiya Usher reports. GAVI CEO, Seth Berkley, referred to the US$7·5 billion ask as “ambitious, but necessary”. According to GAVI's investment plan for 2016–20, 300 million children will be immunised against diseases such as pneumonia, rotavirus, measles, and cervical cancer, which is expected to save up to 6 million lives. Although non-governmental organisations and UN agencies are struggling with cuts in public funding, donors met GAVI's ask in full at the replenishment meeting in Berlin last week (Jan 27), and actually pledged slightly over. The vaccine alliance's top three donors—the UK, the Bill & Melinda Gates Foundation, and Norway, which provided 60% of total funding during 2011–15—all increased their contributions. Yet these donors' share of total resources dropped because several other donors promised hefty increases in their levels of support for the next 5 years as well. The USA doubled its support. Germany almost tripled its level of funding. Canada, the European Commission, and the Netherlands all gave substantially more compared with the last round. The chair of GAVI, secretary general of the Nordic Council, and a former Norwegian Minister of Health, Dagfinn Høybråten, described the result as a “record-breaking commitment”. “I think GAVI's case is compelling, both morally and economically. There is an imperative to act for anyone who has the capacity to donate. But it is also a smart investment. It will give returns in saved health costs on the national and family level, as well as in terms of increased productivity. We have estimated $80–100 billion in savings on this investment of $7·5 billion”, he said. The spectre of the Ebola crisis hung heavily over the meeting in Berlin, with most speakers referring to the need to learn from the epidemic and stressing the importance of strengthening health systems. GAVI plans to spend almost $1 billion on health systems during 2016–20 (table).TableGAVI planned expenditures 2016–20 (US$ billion), by main areas of spendingUS$ billionAll 11 vaccines6·5 of which, pneumonia vaccine2·8Cash support for vaccine introduction0·6Health systems strengthening0·9Provision for strategic investments0·5Programme implementation0·8Total spending 2016–209·5 Open table in a new tab The Swedish Development Minister Isabella Lövin went farthest in warning against an “isolated and vertical” approach to immunisation. Although she praised GAVI for being “very effective”, she pointed out that vaccines are not sufficient. She pledged SEK1·5 billion for the 5 year period, SEK300 million per year, or $206 million. This is about the same level as Sweden's contribution for 2011–15. Still, Lövin underlined that Sweden remains GAVI's third largest donor on a per-head basis. Since the Ebola outbreak, the GAVI board has approved plans to purchase an Ebola vaccine to support large-scale immunisation efforts, as soon as a safe, effective vaccine is recommended for use by WHO. However, GAVI's funding requirements for 2016–20 were formulated back in May, 2014, and do not include a provision for Ebola. As a result, funding related to Ebola will have to come on top of the $7·5 billion promised in Berlin. GAVI estimates that an additional $390 million will be required to roll out an Ebola vaccine. Of the total $9·5 billion in available resources in the coming 5 years, GAVI plans to spend $6·5 billion on 11 different vaccines. Almost half of this money will be used to pay for the pneumonia vaccine. Médecins Sans Frontières (MSF)has argued that the price of pneumonia vaccine remains too high. Berkley acknowledged the problem in his opening remarks at the replenishment meeting, saying that he hoped that once new suppliers enter the market, the prices will come down. However, new companies are not likely to enter the market before 2019, observers note. The day before the Berlin meeting, Pfizer, one of the two current suppliers of pneumonia vaccine, announced it will reduce its price per dose from $3·30 to $3·10. Kate Elder, vaccines policy adviser in MSF's Access Campaign, said: “MSF is pleased that donor countries and private foundations have pledged additional funds to buy vaccines for children in poor countries. However…GAVI and [donors] need to make better use of taxpayer money and push pharmaceutical companies to reduce their vaccine prices much further.” Dafinn Høybråten says the critique reflects a “partial” perspective. “If you look at the full package, there has been an overall drop in the price of vaccines purchased by GAVI of almost 40% since the last replenishment. The market effect of growing the GAVI portfolio has helped our dollars go further”, he said. ADU writes on aid politics for Development Today ADU writes on aid politics for Development Today