Dr. Gro Harlem Brundtland
Director-General
World Health Organization |
Oslo, Norway
13 June 2000 |
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GAVI Symposium |
Thank you, Prime Minister.
First of all, it is a great privilege and joy for me to be back home here in Oslo. But this visit is special. As leader of WHO, I have had many occasions to work with the Norwegian government. Norway is a powerful supporter of the vital work now underway to promote equitable health and human development throughout our world. Thank you for your extraordinary contribution.
This time I speak on behalf of a global alliance whose aim is to move more effectively towards key common goals. I will be speaking in my capacity as Chair of the Board of the Global Alliance for Vaccines and Immunization.
We have all been working in immunization for a long time. This is not new. What is new are the seamless partnerships we are forging, the new common understanding. And the urgency with which we are working.
Because finally, now, it is better understood: ill health is not just an outcome of poverty, it is a cause of poverty.
Health is now at the heart of the development agenda.
Health is now accepted as a powerful tool in the fight against poverty.
We must move quickly. It is now time to catch the changing tide.
And if ill-health is a major contributor to poverty, infectious diseases are the major contributor to ill-health among the poor.
Malaria, measles, diarrhoea, tuberculosis, and of course, AIDS are diseases that most parents here in Norway don't worry much about. But these diseases together cause 14 million deaths per year, and immeasurable suffering to individuals, families and communities.
Yet 3 million of those deaths are from diseases that could have been easily prevented - if
all the world's children had received the vaccines that now only some children routinely receive.
It is right that we should take this personally. Imagine you are a new parent within a poor community in a poor country. You know that babies die, but you don't know how to prevent the death. You can't be sure that your little baby will survive - indeed, the chance of death is high. This affects your view of life, and of possibilities - for yourself and your family.
Reducing a baby's chance of dying has profound effects on all of the lives that touch it. Profound effects on the larger community as well. This is the power of immunization.
It is an unacceptable tragedy that today, nearly one million children die of measles every year because they didn't have access to the very cheap and effective vaccine that is available.
It is an unacceptable tragedy that today, years after vaccines against hepatitis B and
Haemophilus influenzae type B became available, most of the people who face the greatest risk of contracting those infections, do not have access to them.
Even though we all have been involved in immunization for a long time, done a lot of work, and achieved a lot of successes - we still have a long way to go.
And the GAVI partners don't want to just see results, we want to see sustainable results. Quick solutions offer brief resolutions. Change must be lasting. And sustainable.
It is clear that we cannot get there without the involvement of all partners involved in immunization, health and development. The challenges and opportunities today are bigger than any one partner can tackle - or even two. No, we need everyone - industry, NGOs, multinationals, bilateral agencies, international development banks, and most crucially, the active involvement of national government health programmes.
So the GAVI partners are moving rapidly along two parallel tracks. While we work to make a difference on the ground, we are building the system - organizing ourselves with policies, processes and procedures, to secure a sustained partnership and commitment.
As we build this new system, we strive for transparency. Because building and maintaining partnerships requires trust.
By definition, a partnership brings entities together which may not always agree, or see things the same way.
And that is their strength - to integrate different views, build upon the relative strengths, experience and expertise of the different players. To create a whole that is greater than the sum of its parts.
But partnerships can stumble into inaction when there is disagreement. When differing views are shared, and partners can only agree to disagree.
When there is too little trust, disagreement turns to discord. When there is too little patience, people throw up their hands in frustration.
And that leads to inaction.
In the GAVI partnership, we have made a commitment. To do whatever it takes to build that trust and secure cooperation from the partners. Build a system that works. In countries, and on the international level.
So let me bring you up to date on some of our progress. On both tracks.
First, in our drive to make a difference on the ground, we are moving full steam ahead with providing support directly to countries. A commitment of 750 million dollars over five years from the Bill and Melinda Gates Foundation is helping make that happen. In a big way.
GAVI did not exist one year ago. In July, the Global Fund for Children's Vaccines will begin making its first disbursements! It shows what can happen when there is a commitment to working quickly. And when there is a new mechanism to help smooth the way.
Because of the urgency, we're trying something different. Unorthodox. Through it, we hope to capitalize on past immunization successes and recent developments in vaccine technology to rapidly expand the use of lifesaving vaccines in low income countries.
How is it different? We work directly with countries. They control the process. They tell us what they need. For example, we had initially planned for the Fund to provide the new and under-used vaccines to countries. We planned that support for infrastructure would be best provided through the direct action of partners, and not through the Fund. But we listened to countries. They told us that you can't do one without the other.
So now, two forms of support will be available to countries, right from the start. Countries can use GAVI funds both to strengthen their services and introduce new and critically under-used vaccines to their populations.
When funds are granted to strengthen services, governments will decide how best to use them. They will be given in two parts - up-front payments for investments in the government's plans, and retrospective payments that reflect the performance that was actually achieved.
This is a new idea, a performance-based system of funding. We will watch it very closely to see how it works.
The Fund has been designed not to replace current resources or pre-empt new sources of funding. Instead, it is provided to leverage extra support. The Fund is thus designed as a foundation for governments to secure backing from other sources.
The Fund works in a rapid response manner. It is not 'business as usual'.
And the countries are responding. When we put out a request to eligible countries for expressions of interest, they poured in. Nearly a 75% response rate.
And last month, during the World Health Assembly, one by one, Ministers of Health told us they would get their proposals in by the first review in July. That they didn't want to wait for the next review in the fall. No less than 29 countries. Clearly, they see the urgency.
GAVI Partners, too, are adjusting to the rapid pace, and response style. We have worked well together, displaying the desirable attributes of a successful partnership. Commitment, patience, and trust. We share values and objectives, and while we might make mistakes, we learn from them quickly.
We are working out how to review proposals from countries applying to the Global Fund. The first round will be watched closely, and we want to make sure that the future will improve upon the present.
We are exploring the structure of this new alliance - does the Board function appropriately? Does it fully reflect its constituencies? How about the working group - should we develop regional working groups? Do we need a research and development task force? What is the competitive value of the GAVI partnership to speed the development of new vaccines?
We are discussing how best to ensure that GAVI contributes to the polio eradication effort. How to synergize efforts -to keep the momentum and the goal of polio eradication, while building new momentum around sustainable, improved, routine immunization services.
Polio eradication is on the right track. Much of the world has been declared polio-free. Or will be soon. We are so close. We must finish the job in every country.
In countries where there still is wild polio virus, we will sharpen focus, to continue to prioritize eradication efforts. And we will maintain routine immunization in the process.
We are exploring new ways of working with the vaccine industry, as private contributors to global immunization. We are discussing how national governments can construct new plans for keeping financing flows constant.
These meetings are lively -the debates fuelled by a spirit of commitment.
The tide is turning. We are taking new paths, making new discoveries, that will make better and lasting change.
As Heads of State debate the major political issues facing our world, health issues are prominent on the agenda.
As we meet like this, we find the path that takes us to the people, to the communities. To where the change needs to be felt.
So by the time we meet again, we can say: we have saved lives and improved lives.
We have made a difference.
Thank you.
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