Gavi at 20: How far have we come and how far can we go?

20 Jan 2020

This month marks 20 years since the creation of Gavi, the Vaccine Alliance. Founded in 2000, by 2018 Gavi had immunised over 760 million children, delivering lifesaving interventions in over 60 countries saving 13 million lives. Gavi’s 20th birthday provides an important opportunity to celebrate Gavi’s achievements, and to focus minds on the remaining challenges. 

The successes of Gavi in the last 20 years are unparalleled and are due in large part to Gavi’s unique model, which works to harmonise the public and private sectors to enable children in the poorest countries to access to vital services. Gavi’s approach is multifaceted. Not only does Gavi support the delivery and introduction of new and lifesaving vaccines to the world’s poorest countries, but it also works with vaccine manufacturers to ensure vaccines are available at affordable rates. Gavi also works with countries to develop strong and resilient health systems, such as supporting in country leadership and management to address health challenges, vital for sustaining the progress made in Gavi-supported countries. 

A female healthcare worker in Bangladesh crosslegged sits on a rug showing a with a circle of people a fact sheet about immunisation.
Gavi has been working in Bangladesh since 2003. Here a healthcare worker in educates parents from a rural area about the importance of immunisation. A critical part of the success of immunisation campaigns is generating demand – engaging with communities to ensure parents trust the safety and efficacy of vaccines and are motivated to make sure their children complete recommended immunisation schedules on time. 

Gavi not only save lives but transforms economies. Every $1 invested in immunisation in Gavi supported countries yields a return of $54 when the wider societal impacts of that investment are considered. Gavi enables children around the world to ‘survive and thrive’ as they realise their right to good health, prosper and achieve their full potential. An investment in Gavi is one of the most effective use of aid money, not only for the UK, but for any international donor seeking to save and improve lives globally.  

Despite remarkable successes, challenges still remain. Many children around the world do not have the crucial vaccines they need. In 2018, almost 20 million children were not reached with routine immunisation services. Slow progress has been made on improving immunisation coverage in the last 10 years. This must change as we enter the ‘decade of delivery’ for the Sustainable Development Goals, leaving us with just 10 years to end all preventable child deaths, one of the key commitments of the SDGs. 

In June, the eyes of the world will be on London for Gavi’s replenishment conference. At this event, international donors will make new financial commitments to Gavi for the period 2021-25. During this period, Gavi plans to immunise an additional 300 million children. Gavi have vowed to adopt a renewed focus on the hardest to reach children. Gavi will continue to work with vaccine manufacturers to ensure that the world's poorest countries have access to affordable life saving vaccines. Additionally, Gavi will aim to increase the number of infectious diseases it vaccinates against to at least 18 by 2025 (it was only 6 when Gavi began). 

A fully funded Gavi in 2020 will be needed to reach these ambitious targets, and at least $7. 4billion will be needed from international donors. As the host and leading donor, the UK has a vital role to play; first, to make a substantial pledge to Gavi; and, secondly, to influence other nations to follow suit with ambitious financial pledges.   

However, it is not just financial commitments that Gavi need to secure in order to reach more unimmunised children. Gavi will finalise its 2021-2025 strategy this year, which will have enormous implications for children around the world. RESULTS are calling for Gavi to adopt renewed approaches that improve its ability to reach children regardless of where they live. This will require new and tangible commitments to delivery of vaccines to the hardest to reach developed through a clear strategy based on the lessons learned from the previous period. Gavi must also continue to work with countries and the private sector to establish new and innovative solutions to improving access to vaccines and introduce improved policies that help countries sustain and continue immunisation services after Gavi reduces or withdraws its funding as countries increase in income (a process known as transition). 

Gavi’s remarkable success in the last 20 years must be acknowledged, but we must now focus our attention on capitalising on the opportunities that lie ahead, starting with sufficient funding and a comprehensive strategy. As the world looks on, our actions in 2020 will set the precedent for the decade of delivery.  

Neil Raw

Policy Advocacy Officer (Child Health)

Neil Raw works as our Policy Advocacy Officer (Child Health) leading the policy team's work on immunisation, transition and sustainable financing for health. Before working for RESULTS UK, Neil studied International Development, before completing a Master’s degree in Applied Human Rights. He...

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