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Public-Private Partnerships for Health and Development

Jan 21, 2012 Written by  Seth Berkley, MD, Guest Contributor
Child_VaccineThe health of people is intricately linked with the health of the global economy.  High mortality and morbidity rates in poorer countries drag down whole economies and have major trade, social, and health implications beyond a nation’s borders. New models to address age-old problems that hinder growth are needed in order to ensure developing countries become long-term business and trade partners who can contribute to re-igniting the global economy.

One of the most cost-effective models in global health leverages private expertise and public health knowledge to save people's lives and protect health through the power of immunization.  The GAVI Alliance, which was formally launched at the World Economic Forum in 2000, is a public-private partnership that uses innovative market-based solutions to ensure that sustainable supplies of life-saving vaccines reach the world's poorest children.  And it is paying huge dividends. From 2000 through 2011, GAVI supported countries in saving more than 5.5 million lives and prevented life-long disabilities for countless millions more.

Keeping people healthy supports economic growth and helps reduce poverty. The Copenhagen Consensus Centre estimates that a population’s health is as important as income per capita, geographic location, and the institutional and economic policy environment in determining the robustness of economic growth.  It rates expanded immunization coverage for children as fourth on a list of the 30 most cost-effective ways to advance global welfare.

The GAVI Alliance combines the private sector's technological innovations, UNICEF’s procurement expertise, the World Bank’s financial know-how, the World Health Organization’s wealth of best practices and scientific data, and the tremendous breadth of experience of our foundation, government and civil society partners.

GAVI is achieving what was thought impossible before public and private sector partners sat at the same table: directed foreign aid investments to create a viable market for vaccines in developing countries.  In doing so, the Alliance has helped to ensure continued research and development from vaccine manufacturers; encouraged emerging, developing country manufacturers to enter the market; and increased the supply of vaccines while bringing down their cost.

This is particularly true for the vaccine to prevent pneumococcal disease which causes pneumonia, meningitis, and sepsis, and takes the lives of more than half a million children each year worldwide, the vast majority of them in Africa and Asia.

Pneumococcal vaccines have been available in richer nations for more than a decade but they were too expensive for developing countries. To address this challenge, GAVI launched an Advance Market Commitment (AMC) designed to accelerate the availability of effective and affordable pneumococcal vaccines for children in poorer countries.

In an AMC, donors commit funds to guarantee the price of vaccines once they have been developed.  These commitments give vaccine manufacturers the incentive to invest in vaccine research and development, and to expand manufacturing capability.  In exchange, the firms sign legally-binding commitments to provide the vaccines at a steeply reduced price to developing countries.  Since GAVI began introducing support through the AMC, more than 3.6 million children have been immunized and an estimated 38,000 children’s deaths averted. Another 10 million more are expected to receive the vaccine by the end of 2012.

GAVI relies on other innovative financing tools to find better ways to raise and apply resources, and attract participants in its public-private efforts. Most recently, the Bill & Melinda Gates Foundation and the UK Department for International Development (DFID) helped GAVI launch a matching fund with a combined pledge of US $130 million. The fund will double the impact of contributions made by new GAVI partners from the corporate and foundation sectors. The goal is to raise US $260 million for immunization by the end of 2015.

Four private sector organizations have already pledged amounts that will be matched by DFID and the Gates Foundation:  ARK (Absolute Return for Kids), Anglo American Plc, JP Morgan, and the “la Caixa” Foundation—Europe’s second largest. Health is a key driver for development, and a healthy workforce is critical to long-term prosperity. Vaccines boost development not only directly through savings on treatment and long-term medical costs, but also indirectly by improving children’s cognitive development and educational attainment, giving them the opportunity to grow into productive adults.  And it pays off. Eradicating smallpox through vaccination cost $100 million over a 10-year period up to 1977. That investment, according to a WHO estimate, has since been saving the world about $1.3 billion a year in treatment and prevention costs.  This has allowed developing nations to shift focus and resources on building healthy economies rather than on social triage.

New and innovative approaches to improving health will be critical if developing countries are to grow their economies and contribute globally.  And there is still a ways to go. Each year, 1.7 million children die from vaccine-preventable diseases. Public-private partnership models, like GAVI, can impact individuals and improve global economic prosperity.

Seth Berkley, MD, is the CEO of the GAVI Alliance and a global advocate on the power of vaccines. A medical epidemiologist by training, he is also the founder and former President and CEO of the International AIDS Vaccine Initiative (IAVI).

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