On Tuesday, the European Commission announced it will contribute €175 million (almost $240 million) to fund the GAVI Alliance’s global immunization efforts over the next six years.
At its replenishment conference in Brussels, GAVI issued an appeal for an additional $7.5 billion to help protect more than 300 million children from life-threatening diseases and save up to 12 million lives by 2020. This would be on top of $2 billion already raised and allocated for 2016-2020, a 15 percent increase over the funds for the present funding cycle.
So what does the EU’s executive arm want from the Alliance to make the case for its generous commitment? Not much, according to European Development Commissioner Andris Piebalgs.
“Before committing, we closely followed GAVI’s business model and ambitions. We are convinced that it is a very good and strong model,” Piebalgs said during an interview with Devex on the sidelines of the pledging conference in Brussels. “There could be minor improvements, but there are no preconditions for us to increase support for GAVI. We are accepting GAVI as a unique vehicle, as … the best vehicle to achieve our common goals and to prevent so many children from dying every year.”
The commissioner added that to maximize impact on the ground, synergies between the Alliance’s impact and support for both health systems and maternal health should be better explored. This, he said, would allow GAVI to strengthen the health systems of its partner countries even more. In this sense, Piebalgs cited the example of Myanmar, where the Alliance has made a notable impact in creating a health system practically from scratch through a dramatic increase in health care investment.
Piebalgs also sees GAVI as a catalyst to tackling the problem of so-called “invisible children.”
“GAVI has experience in working in areas where children aren’t registered and with the immunization certificate they get some kind of identification. GAVI could be a system that reaches every child,” he said.
Asked how the relationship between the EU and the Alliance has evolved over the years, Piebalgs noted that they have always been good partners and never had substantial difficulties, but he does anticipate at least two possible future challenges over the vaccine distribution process.
“My warning is always about two things. Whenever you operate these services, goods or money, there is a risk of funds being misused, so we are very much calling for a very good control system to avoid misuse of the funds we give to the GAVI system,” he explained. “My second recommendation is to continue working on a resource framework, and on the cost-benefit analysis.”
But does the European Union think the Alliance’s model could be replicated in other sectors? From analysis conducted so far, Piebalgs was reluctant to make assumptions: “It’s a unique model, but still requires more study.”
“What I like in GAVI is that it involves also the corporate sector and industry. Industry is not only a money earner, but it takes also some corporate responsibility,” noted the commissioner.
One example of this, he pointed out, is how even five years after a country “graduates” from eligibility, the Alliance will continue to offer some vaccines at the same discounted price. This will be particularly relevant by 2020 to 22 nations, six of which — Bhutan, Cuba, East Timor, Indonesia, Sri Lanka and Ukraine — will still be able to apply for pneumococcal vaccines through GAVI and UNICEF at Advance Market Commitment terms and conditions if they agree to pay the $3.5 million vaccine co-payment from the outset, even if by then they won’t meet the conditions for financial support for new drugs.
“It’s a commitment of crucial importance to take people out of poverty,” Piebalgs said.
On the sidelines of the conference, Devex also spoke to GAVI CEO Seth Berkley, who discussed the importance of partnering with the private sector, especially pharmaceutical companies.
For instance, GlaxoSmithKline announced in Brussels that it would continue to provide all the 22 graduating countries by 2020 with new vaccines at the discounted GAVI rates as they start implementing their own immunization programs. GSK provides vaccines for pneumococcal disease, the rotavirus and cervical cancer to the Alliance for rates that are sometimes as low as one-tenth of the price in the developed world.
“The private sector and the pharmaceutical sector are critical partners in everything we do,” Berkley said. “We have agreements with all major suppliers of vaccines, and we are constantly looking for new suppliers to create a healthy space.”
But partnering with drug manufacturers is not enough.
GAVI’s chief executive explained that their model is to blend the skill sets of many different companies that have signed up to the initiative to help them overcome mainly distribution challenges such as logistics or the value chain.
He mentioned the Alliance’s ongoing partnership with British telecommunications firm Vodafone, which is working with GAVI to use mobile technology “to better understand data, better follow up on vaccines, and monitor where the vaccines are in the supply chain.”
“And if that goes well, we can scale up,” Berkley said.
Piebalgs agreed and added on partnerships: “It very much depends on how the private sector sees the future, concerning labor standards and the responsibility it holds toward poor people. Those are issues that very much depend on the ethics of the private sector.”
“Ethical behavior is a crucial factor in the whole process and I believe that GAVI has this dimension of private sector involvement not only as one of the partners necessary to create the vaccines but also as a social partner, a responsible partner. I think this is a good model that needs to be replicated,” the commissioner concluded.
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