What are Gavi's chances in getting its $7.5B request?

Press conference at the Gavi, the Vaccine Alliance pledging conference in June 2011. The alliance will hold its second pledging conference on Jan. 26-27 in Berlin, Germany. Photo by: Ben Fisher/ Gavi / DfID / CC BY

Bare.

That’s how a document showing a breakdown of donor pledges to Gavi, the Vaccine Alliance for the period 2016-2020 looked back in September 2014. Direct contributions to the public-private partnership only amounted to $226 million, of which the bulk came from the European Commission. The United Kingdom, South Korea and India contributed as well.

But this is expected to change come Monday, as donor governments, foundations and corporations converge on Berlin, Germany, to pledge support for the organization’s work for the next five years.

Some donors have already made their intentions known in advance of the conference. The EU, for instance, pledged 25 million euros ($28.9 million) annually until 2020. Norway committed to provide “at least” $215 million every year from 2016 to 2020. The United Kingdom and Canada, meanwhile, committed 1 billion pounds ($1.5 billion) and 500 million Canadian dollars ($404.64 million) for the same period.

In today’s tough fiscal environment, $7.5 billion — Gavi’s replenishment target — is a tall order. That request is more than double the money the alliance asked for in its last pledging conference in 2011. That time, donors pledged more than $4 billion for the alliance — higher than Gavi’s $3.7 billion target.

Will a recent rebranding bring in more pledges?

Nicole Bates, the deputy director for global policy and advocacy of the Bill & Melinda Gates Foundation, told Devex back in April that “donor confidence is high.” But she also stressed the importance of Gavi being able to make its case as to why donors should continue to support its work in this challenging fiscal space.

That last bit has kept Gavi busy over the past year, as it did not only go through a rebranding of its name and logo, but it also ramped up communication efforts so donor governments and their taxpaying constituents would have a better idea and be better informed of the work the alliance does. A few months after the rebrand, Pascal Barollier, Gavi’s director of communications, said they are slowly seeing its impact.

But the true test of that will be seen at the pledging table. Will Gavi’s donors maintain the same levels of support as in previous years — or will they boost their generosity and strive to meet the alliance’s target? Will the “repackaged” Gavi attract new donors?

For the period 2011-2015, the United Kingdom had the biggest contribution — direct and through other funding mechanisms — to Gavi, providing $2.37 billion. This was followed by the Bill & Melinda Gates Foundation ($1.32 billion), Norway ($757 million), the United States ($533 million), France ($471 million) and Italy ($429 million).

And how about Gavi’s corporate donors? Will they continue to simply provide matching funds to the alliance? Will pharmaceutical companies heed the call of medical groups like Médecins Sans Frontières and finally make groundbreaking commitments to expand access to lower-priced vaccines?

No one really knows at this point. But here’s what different actors are expecting from the pledging hall.

A call for expanded access to lower-priced vaccines

MSF, which this week released a damning report on vaccine prices, is still crossing its fingers that pharmaceutical companies would make “significant commitments” to lower vaccine prices offered to Gavi.

In particular, the international medical and humanitarian group  is hoping pharma giants Pfizer and GlaxoSmithKline would begin offering their pneumonia vaccines for just $5 per three doses per child. In addition, it has been urging big pharma to increase to 10 years the price freeze it is currently offering countries that have graduated from Gavi support. At present, these vaccines are offered at $3.50 per dose to Gavi-supported countries and $7 per dose to medical groups like MSF and some countries that no longer receive support from the alliance.

MSF is also reiterating its calls to donors to “push on” pharmaceutical companies to further lower the prices they offer to Gavi and make long-term commitments to graduating countries. Moreover, It is expecting Gavi to announce its long-term plan to help countries “facing the financial cliff of a looming graduation.”

“We are not asking donors to make their pledges conditional,” Kate Elder, MSF’s vaccination policy adviser, told Devex, “but would like to have donors express the urgency of pharma [companies] reducing prices so that they can get more bang for their taxpayer buck, as well as [address] the acute needs of graduating countries.”

The International Federation of Pharmaceutical Manufacturers & Associations, for its part, stressed the need for stakeholders to focus on the “progressive transition” of countries from Gavi support toward “fully self-sufficient, country adapted and evidenced-based immunization programs” for their populations.

Laetitia Bigger, IFPMA senior manager of vaccines policy, told Devex that with more children now immunized and more countries graduating from Gavi support in the next few years, it signals we now have healthier economies and societies.

“The social and economic progress achieved by these countries demonstrates clearly that the public health value of a vaccine goes beyond its sticker price,” she said.

A group of nongovernmental organizations meanwhile are calling on donors to make significant commitments to Gavi, and make sure they meet the replenishment goal.

“Current donor projections suggest that the replenishment could fall at least half a billion dollars short of its fundraising target,” the group, which includes large international NGOs like BRAC, Save the Children, ONE, World Vision and even the Gavi Civil Society Steering Committee, noted in a statement. “All donors say they support immunization and want to see Gavi fully funded. [But] words won’t vaccinate a child — what’s needed now is cash.”

In October, Gavi CEO Seth Berkley told Devex that in the coming period, the alliance’s focus will be more on coverage and equity, sustainability, and expansion of its market-shaping work. As such, it will be crucial to work more closely with its partners, including governments, to reach the hard-to-reach populations, which in some places may not be residing in the remote, far-flung areas, but in slums. Gavi targets to immunize 300 million children for the next five years.

If Gavi’s donors meet — or exceed — the alliance’s $7.5 billion funding target, how can the public-private partnership use this money more efficiently in the next five years?

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About the author

  • Ravelo jennylei

    Jenny Lei Ravelo

    Jenny Lei Ravelo is a Devex Senior Reporter based in Manila. She covers global health, with a particular focus on the World Health Organization, and other development and humanitarian aid trends in Asia Pacific. Prior to Devex, she wrote for ABS-CBN, one of the largest broadcasting networks in the Philippines, and was a copy editor for various international scientific journals. She received her journalism degree from the University of Santo Tomas.