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Global Health Policy Blog


This post is joint with Lawrence MacDonald

One result of President Obama’s visit to the UK last month was a statement on the UK-US Partnership for Global Development in which the U.S. President and Prime Minister David Cameron “reaffirm [their] commitment to changing the lives of 1.2 billion poor people in the world today." In the statement they promise to work together on a range of important development issues: economic growth, conflict and fragile states, aid (accountability, transparency, results), global health, girls and women, and climate change.

It’s a long and familiar list of what matters in rich-world development policy (notably absent: trade). Buried in it is an important, real-world commitment to ensure that the Global Alliance for Vaccines and Immunization (GAVI) “has the resources it needs to do its job.” On the part of the UK, at least, this is more than an empty promise. On Monday, Prime Minister Cameron will host GAVI’s first ever pledging conference, which aims to secure US$ 3.7 billion to vaccinate 250 million additional children and save 4 million lives between 2012 and 2015.

The UK, Norway, Sweden and Australia have all signaled that they will pledge significant contributions. It’s widely anticipated that the UK and the Gates Foundation may each pledge in the neighborhood of $1 billion.

GAVI is asking the United States, which has yet to signal the amount of its pledge, to provide $450 million over the next three years. This would be money extremely well spent.

Studies have repeatedly shown that vaccines are one of the most cost-effective means for reducing suffering, saving lives, and improving productivity. This month’s issue of Health Affairs synthesizes much of what we know about the importance of childhood vaccination to health and well-being. Full coverage of vaccination against pneumococcal and Haemophilus influenza type b pneumonia and meningitis, rotavirus, pertussis, measles, and malaria over the next ten years could save 6.4 million lives and avert 426 million cases of illness, $6.2 billion in treatment costs, and $145 billion in productivity losses. Over the past decade, the GAVI Alliance has been successful in driving down the cost of new vaccines and supporting the poorest countries in the world in the rapid expansion of their vaccination programs.

Pledging for three years instead of just one, as the United States frequently does, is absolutely crucial for GAVI to continue to lower vaccine prices; if GAVI can make longer-term contracts with vaccine manufacturers, its negotiating leverage increases enormously.

Providing adequate U.S. funding to GAVI would also allow the U.S. Global Health Initiative to report annual progress on children vaccinated to Congress, an important step in improving accountability.

It’s not as if the United States is unwilling to spend money to improve global health: The FY 2012 Budget Request includes more than US$ 7 billion for HIV/AIDS to provide antiretroviral treatment and medications to prevent mother to child transmission to 3.8 million people and to provide care and support from 11 million people living with HIV/AIDS. Vaccinating children against common childhood diseases can actually help to lower the costs of coping with the HIV/AIDS epidemic. For example, according to the Sabin Institute, HIV-positive children are up to 40 times more likely to get pneumococcal disease than HIV-negative children. Protecting these children with pneumococcal vaccine would not only improve their survival and reduce suffering, it would also help to create herd immunity to these diseases that could protect others, including other immune-compromised children and adults.

Bottom line: providing $450 million over three years to GAVI to help vaccinate 250 million children is both compassionate and cost-effective. I’ll be watching closely to see how much the United States, with the world’s biggest economy, contributes to this important, life-saving effort.

Update 6/13/11:

Today the U.S. announced that it will contribute US$ 450 million to GAVI to cover the 2012-2014 period, subject to Congressional approval. This is great news, although the pledge amount actually represents a declining U.S. share of contributions to GAVI given the success of the pledging conference. In total, donors committed US$ 4.3 billion, exceeding the $3.7 billion target, bringing GAVI’s total available resources for the period 2011 to 2015 to $ 7.6 billion.


CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.