UNICEF Press Centre
"Change the World With Children"
http://www.unicef.org/newsline/02prgavi1printer.htm

Press Centre
Business-like approach to funding health programs in poor countries
may save more than two million lives in 5 years
NEW YORK, 1 February - Two years after its official launch at the
World Economic Forum annual meeting in Davos, Switzerland, the Global
Alliance for Vaccines and Immunization, or GAVI, reports that its goal-
oriented approach to development aid could raise basic immunization
rates in funded countries by 17 percentage points and increase
coverage of hepatitis B vaccine from 18 to 65 percent by 2007,
ultimately saving more than two million lives, according to new data
released at the World Economic Forum today.

GAVI is a public-private partnership focused on increasing access to
vaccines among children in poor countries. Partners include national
governments, UNICEF, WHO, The World Bank, the Bill & Melinda Gates
Foundation, the vaccine industry, public health institutions and
NGOs.

"GAVI was born out of the growing recognition that the global
community must work harder to reduce the gap between rich and poor
countries, and that we all must work together in new and
unconventional ways," said UNICEF Executive Director Carol Bellamy,
current Chair of the GAVI Board.

At the time of its launch, GAVI also unveiled its financing arm the
Vaccine Fund, created with $750 million from the Bill & Melinda Gates
Foundation. Additional contributions have since increased the total to
$1.2 billion. The fund provides vaccines and financial support to the
74 poorest countries - those with less than $1000 GNP per capita - to
improve their health systems and introduce newer vaccines such as
hepatitis B.

GAVI partners introduced a new idea in international development:
outcome-based grants that give governments responsibility and autonomy
to decide how money is used, but if they don't show results, the
funding stops. To ensure accountability, an initial effort to audit
country data was undertaken in 2001 by an independent consortium that
included the international auditing firm, Deloitte Touche Tomatsu.

"GAVI has not only made remarkable progress in improving the prospects
for the world's children, in many ways it is the precise embodiment of
the increasing trend of taking a private sector approach to a public
problem", said Professor Klaus Schwab, President of the World Economic
Forum.

While traditional health initiatives often start off by hand-picking
countries to participate in a pilot project - thereby slowing down the
process - GAVI threw the doors wide open, letting any country apply,
as long as it was one of the poorest in the world. After just two
years, 66, or 90% of eligible countries have applied for Vaccine Fund
support, and 53 countries have already been approved - including some
in the most difficult situations such as Sierra Leone, Liberia, and
Afghanistan. Proposals from another 13 countries are pending, and most
of the remaining 8 eligible countries are expected to apply this year.

"The pace at which the GAVI partners have designed a program funding
process, solicited and reviewed proposals, and distributed vaccines
and resources to the field is unheard of in the history of
international initiatives", said GAVI Executive Secretary Tore Godal,
a public health physician with years of international health
experience.

GAVI partners are of course meeting hurdles, such as the weak state of
health infrastrucure in countries, rampant unsafe injection practices
and shortages of the most in-demand vaccines. These challenges have
compelled the alliance to be flexible, creating and adapting policies
to adjust to the realities in countries. For example, to address the
problem of unsterile needles, the GAVI Board approved a new policy for
the Vaccine Fund to provide auto-disable syringes - fitted with a
mechanism that prevents re-use - for all routine immunizations in
countries.

GAVI's quick pace and approach have been criticised by some who are
concerned that countries do not have the capacity to comply with
GAVI's funding requirements. While a recent study on the impact of
GAVI from a country perspective concluded that "GAVI was generally
seen as a positive development in all four countries" visited,
countries were "concerned about the overall pace of the application
process" and some "found the process of collating information
difficult."

Acknowledging the dire need for more resources to help overworked
health staff in countries, Dr Godal welcomes the criticism. "Most
international health initiatives are condemned for going too slow. It
is an incredible twist of irony to be criticised for going too fast",
he said.

GAVI officials do accept, however, that in places where resources are
extremely scarce, more support must be found. They stress that the
Vaccine Fund cannot be considered the answer to all resource needs; it
is intended to be a catalyst for other sources of funding including
increases in national governments' own health budgets, other bilateral
donor funding and development loans, or through mechanisms such as
debt relief.

In fact, GAVI's role as a catalyst has been documented. According to
the same study, health officials in Tanzania's Ministry of Health
"viewed the initiative as a catalyst to attract a greater proportion
of government budget to the [immunization] program", and further, that
"donors were also increasing pledges and expenditure."

The GAVI data are based on the plans prepared by the countries and
partners in the 53 approved countries. Five-year commitments to these
countries total more than $800 million. GAVI partners estimate that
this investment could result in more than two million lives saved,
based on current data of disease burden and immunization costs. The
projected results are subject to change, both because some countries
may not reach their targets, and others may surpass them.

# # # #

The Global Alliance for Vaccines and Immunization (GAVI) is a public-
private partnership formed in response to stagnating global
immunization rates and widening disparities in vaccine access among
industrialized and developing countries. The GAVI partners include:
national governments, the vaccine industry, NGOs, foundations,
research and public health institutions, the United Nations Children's
Fund (UNICEF), the World Bank Group and the World Health Organization
(WHO). The Vaccine Fund is a new financing resource created to support
the GAVI immunization goals, providing financial support directly to
low-income countries to strengthen their immunization services and to
purchase new and under-used vaccines.

For further information, contact:

Lisa Jacobs +41 79 447 1935

Heidi Larson, UNICEF New York, e-mail hlarson@unicef.org 1 212 326
7762
or +1 646 207 5179