Prime Minister Stephen Harper attending the Organisation Internationale de la Francophonie (OIF) has just committed Canadians to donate $500 million to help vaccinate children in developing countries.
While the news reports could be interpreted that Canada is spearheading this vaccination project, the fact is that our commitment is just part of a global initiative that we have belonged to since about 1998 when Jean Chretien was our prime minister. The project is called GAVI (Global Alliance for Vaccines and Immunization). And it is a tale worth telling.
In 1974, the World Health Organization (WHO) established the Expanded Program on Immunization because only about five per cent of the world’s children were receiving the available vaccines against children’s preventable infectious diseases. It was a spectacular success. By 1990, 80 per cent of the world’s children had been immunized against tuberculosis, diphtheria, tetanus, pertussis, measles and polio. Then other priorities took over – such as the battle to contain HIV infections. Funding dried up. By the end of the 1990s, 30 million children in developing countries were no longer fully immunized. Approximately five million children died during that decade because of it.
In 1998, James Wolfensohn, the head of the World Bank, brought together WHO, UNICEF, academics, health ministers from developed and developing countries, international agencies (including Rotary International) and the pharmaceutical industry. The agenda was how to start getting vaccines to children who needed them. Then Bill and Melinda Gates stepped in. Setting up a second summit, the Gates Foundation pledged $750 million and GAVI was created.
Worldwide vaccinations began again in 2000. Since then, 440 million children have been immunized with an expanded range of vaccines including Hepatitis B and Hemophilus Influenza B. Six million deaths have been prevented.
How does it work? The GAVI business model presently has two major components – a partnership model and a financing model.
For the former, the board of governors includes representatives of all the groups called to the first conference. WHO works with developing countries’ health ministries on vaccine use and appraisal. UNICEF makes bulk vaccine purchases for distribution. The World Bank is in charge of raising funds.
With regard to the financing model, there are three methods – the U.K. government and the Bill and Melinda Gates Foundation have set up a matching fund for the private sector. Secondly, government backed ‘vaccine bonds’ are sold through capital markets. Thirdly, pharmaceutical companies receive a government-guaranteed price for producing pneumococcal vaccines (the largest killer of children younger than five).
GAVI, to date, has spent $12 billion – that’s $30 per immunized child or $2,000 per life saved.
The Harvard School of Public Health reported, “The rate of return on investments in immunization is about the same as for primary education. If we had calculated the value of averted medical costs, welfare benefits associated with other effects – in addition to productivity gains – vaccination would likely blow the socks off other forms of development aid.”
Coca-Cola annual sales revenue in 2013 was $46 billion. And that’s the real thing.
Alan Murdock is a local pediatrician.
