London
 21 June 2001

Global Alliance for Vaccines and Immunization Board Meeting

Colleagues,

Poor people are explicit about the importance of maintaining good health and avoiding serious illness in order to earn and learn. Preliminary results from the Commission on Macroeconomics and Health confirm that investing in people's health is essential if they are to reduce their poverty. This is particularly important among the world's poorest communities.

We know from experience that immunization is one of the most cost-effective health interventions available today. Access to effective immunization contributes to the well-being of all societies.

During the 1980s the proportion of the world's children immunized with six antigens for common childhood illnesses rose dramatically. As we all know, this success was not sustained during the last decade. In addition, the world's poorest people, who are generally most at risk, have not been able to access the newer cost-effective vaccines such as hepatitis B.

Two years ago we came together to respond to this challenge - to contribute to poverty reduction and the well-being of disadvantaged societies. We looked for a better way to respond to the needs of children and increase their access to immunization.

We set out to respond in a way that encourages countries to offer sustained immunization services for all their children.

We set out to bring together governments, private entities, NGOs and UN agencies around the best available evidence.

We set out to make sure that countries are at the centre of the process of how we move forward. Establishing priorities and setting realistic objectives. Using measurements of quality and impact to ensure optimal performance.

We set out to encourage new investment:

• Enabling those who provide funds to see a clear link between the funds they provide and children protected.
• Ensuring that their resources are routed through health systems that perform well.
• Encouraging investments that are additional to what is already available from national and international sources.
• Enabling donors to pool their resources, pursue simple solutions and demonstrate that they are achieving results quickly.

We set out not to micromanage, not to encourage vertical programmes, and to avoid a great deal of additional work for national authorities. What mattered was the use of best practices within the specifics of the country situation.

We set out to break new ground and to pioneer new principles.

Looking back on the last two years, since GAVI was born, I think our score sheet is good.

Last year we invited the 74 poorest countries to submit proposals to the GAVI Secretariat. Before the end of last year financial support started to flow. Vaccines started to reach countries at the turn of the year. To date 54 countries have responded and the fund has commitments amounting to US$ 375 million.

What has made this success possible?

The first generous US$ 750 million donation from the Bill and Melinda Gates Foundation was crucial. Nothing lends credibility like money in the bank. It turned a fledgling initiative into a serious player overnight. Over the years, many good ideas have appeared on the drawing boards for how to reach more children in developing countries with life-saving vaccines. This time there was the early confidence and commitment of the Gates family. In short, when the world’s most successful businessman believes in the concept, there must be something to it.

A firm, substantial and multi-year commitment gave GAVI the freedom to move fast. We could go straight from the launch to the task of distributing money for vaccines, without being slowed down by time-consuming fund-raising. Other contributions have come in, and the longer-term perspective and commitments have stimulated countries to undertake multi-year planning.

The Gates contribution inspired other donations, from the Governments of the United Kingdom, Norway, the Netherlands, the United States and from others.

From the beginning, GAVI has been trusted by a broad range of partners.

Nothing saves time like trust. It simplifies communication and avoids the need to duplicate work. This has allowed for a tremendously smooth and fast decision-making process.

We have moved quickly: speed has kept the procedures simple.

We have resisted pressures to make the GAVI process comprehensive, complex or laborious. We have avoided high transaction costs for countries. We have kept decision making at country level, supporting it through the regional and local expertise that lies with governments, civil society, research groups, WHO, UNICEF and other agencies. Skills and expertise have been mobilized from where they are, rather than being recruited globally and then transferred to specific programmes.

GAVI is a model for new initiatives. It shows that global partnerships do not need large secretariats to administer their activities.

Colleagues,

Over the past two years, we have seen a growing consensus around the way forward for global health. This consensus draws heavily on the lessons learned from GAVI, as well as from other emerging partnerships for health.

We need:

• A sharp increase in resources,
• Continuing strategic research to develop necessary drugs and vaccines, and
• Effective operation of health systems - even in situations of severe under-funding.

Systems should use the service providers that deliver evidence-based intervention strategies well, in ways that respond to people's circumstances and needs.

It is essential to have independent authoritative monitoring and review of results, relating these results to investments made.

We need continued political and social mobilization about the central importance of investing in health.

Last, but not least, we must have effective, fast and transparent mechanisms for moving money to where it is needed, and spending it well.

I look forward to discussing details of these elements over the next two days.

Secretary of State, Clare Short,

At the meeting you hosted here in London, two years ago, you encouraged us all to put health at the centre of development, and to see investing in health as critical for poverty reduction. GAVI stands out as one of the successes of global public health efforts at the beginning of this century.

In your second White Paper, you encouraged us to demonstrate how the forces of globalization can be made to work for the secure future of humanity. Our Alliance shows how this can happen in practice.

Your Government has worked with others to carry forward the concept of a Global Health Fund as a means to further address those conditions that undermine attempts to reduce poverty in poor societies.

Thank you for your leadership. Thank you for agreeing to come here today and to give us your insights on the way forward.