Opinion: I fail to see the rationale for not supporting Gavi

Pneumonia killed a child in Africa every minute when I became president of Tanzania in 2005. That’s over 1,000 children every day, despite there being a safe, effective vaccine to prevent it. Most African countries could not afford it. Nearly 15 years ago, that started to change thanks to Gavi, the Vaccine Alliance. The alliance, which includes implementing countries, the World Health Organization, UNICEF, civil society, and many other partners, reduced the cost of the pneumonia vaccine, enabling Tanzania and other African countries to roll it out. Since that time, the number of African children who die from pneumonia each year has fallen by more than 60%. At a global pledging summit in June, Gavi raised more than $9 billion to help countries protect millions of children from deadly, preventable diseases over the next five years. Unfortunately, it still fell short of the nearly $12 billion it needs. To someone who has witnessed firsthand the impact of Gavi on my country and my continent, the outcome is more than disappointing — it is dangerous for the future of Africa and the world. Now more than ever, the world needs to rally around models that deliver lifesaving tools to countries at an affordable cost, or risk returning to a time when millions of children died needlessly. Launched in 2000, Gavi enables African countries to procure quality-assured, affordable vaccines. Today, it provides access to vaccines that protect against 20 infectious diseases, including polio, measles, meningitis, and human papillomavirus, or HPV. Its partnership with countries has transformed the health and economic fortunes of the continent, by helping to vaccinate 469 million children and avert 12 million deaths between 2000 and 2023. In my own work with Gavi, I valued the alliance’s approach to partnering with countries such as Tanzania. Working with our Ministry of Health, we decided which vaccines to introduce, and when, based on our health needs. We shared responsibility for financing our immunization programs and increased our contributions as our economy grew. Since 2008, more than $1.1 billion has been co-financed by African countries, and many are progressing toward fully funding their own immunization programs. This model has benefited the continent over time. Every $1 spent on immunization in Gavi-supported countries returns $54 in wider economic benefits. Like other African governments, we were uncompromising about vaccine safety. We followed the science, years of research and testing, and would never introduce new vaccines unless they cleared rigorous international safety standards. Gavi-supported vaccines exceed these standards, which is why African leaders, doctors, and parents have counted on the alliance for 25 years. Gavi also works with local organizations and faith leaders to educate communities about the benefits of immunization, so they can make informed decisions about their health. Vaccines have done more than save lives; they have helped African countries grow. They keep our children healthy so they can go to school, run, play, and become productive members of their communities. They build stronger health systems, boost economies, and make societies more resilient. These benefits are not confined to the continent. They ripple outward, bolstering regional stability, global trade, and collective health security. By 2050, more than 1 in 4 people on the planet will be African, with more than half under the age of 25. That means vaccinating an African child today is not just about saving a life – it is about securing the future economic engine of the world. Knowing all of this, I fail to see the rationale for scaling back support for Gavi. Without full funding for Gavi, the transformation of health in Africa over the past 25 years is at risk. Rollouts of new, lifesaving vaccines are likely to be delayed. Millions of children who have yet to be vaccinated may miss out on lifesaving protection. Infectious diseases such as cholera, polio, and measles could resurge, with outbreaks occurring more frequently in Africa and globally, and already strained health systems could be stretched to the breaking point. Today’s world is full of difficult choices. African leaders must choose how much to invest in health amid rising debt and other domestic challenges. Donors must choose where to invest shrinking aid budgets at a time of interlocking global crises. Choosing to invest in Gavi, in vaccines, should not be a difficult choice. It’s an investment with an immeasurable return — millions of lives saved, billions in economic benefits, and a brighter future for Africa and the world. Central African Republic, Rwanda, and Uganda’s recent pledges of $1 million each to Gavi is a powerful reminder that African countries are not just recipients of support — they are contributors to global health. I call on donors to close the remaining funding gap, on African governments to deepen their investment and leadership, and on all of us to defend the right of every child — no matter where they are born — to access lifesaving vaccines. I hope we make the right choice before it is too late for the children of Africa.