Sabin Vaccine Institute Receives $9.2M Gates Foundation Grant to Pursue Sustainable Immunization Financing

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The Advocacy Project will aim to increase awareness and appreciation of the value of immunization in fifteen countries that are receiving time-limited support from the Global Alliance for Vaccines and Immunization (GAVI), leading to increased government and external contributions and, ultimately, fiscally sustainable immunization systems. Though the countries have agreed to achieve this goal, added encouragement and follow-up are now needed to maintain focus and build momentum. The Sabin Vaccine Institute will field a seven-person team that will collaborate closely with Ministries of Health and Finance, WHO, UNICEF, the World Bank and other global immunization partners. If successful, budgets in these countries will be adequate to finance routine immunization system operations, all traditional vaccines and some proportion of newer vaccine procurement by 2013.

The Sabin Vaccine Institute (SVI) announced today a $9.2 million grant from the Bill & Melinda Gates Foundation for a global advocacy effort to help countries finance their national immunization systems. Over the next six years the Sabin Advocacy Project for Sustainable Immunization Financing will work closely with 15 developing countries and with the GAVI Alliance, a global donor partnership which includes, among others, the World Health Organization, UNICEF and the World Bank Group. GAVI has awarded seventy-three countries substantial grants to strengthen their immunization systems. The aim of the Advocacy Project is to help the countries increase the fiscal space for immunization by attracting new sources of funding.

Developing countries are currently immunizing around 70% of their children, preventing around 2.6 million deaths each year at a cost of US$20 per child. Despite progress, immunization delivery must increase in order to reach toward the larger Millennium Development Goal of reducing child mortality by two-thirds by 2015.

In economic terms, child immunization is a "best buy". Experts estimate a year of healthy life is gained for each US$14-20 spent on immunization. In many countries the rate of return to immunization exceeds that to education. Countries are reaching more children than ever before, and their programs are incorporating newer and underutilized vaccines against influenza, hepatitis, yellow fever and rotavirus.

Investments in immunization are increasing almost everywhere, but costs are increasing faster. The cost of fully immunizing a child now exceeds all government per capita public health expenditures in a majority of GAVI project countries. The countries have pledged to secure additional funding sources before their GAVI grants run out, so new financing strategies must be found.

The new Gates Foundation grant augments the Institute's ongoing vaccine advocacy work, which centers on introducing new vaccines worldwide. "What is new here is the agency role we will play for both the countries and the GAVI partners", said SVI Executive Vice-President and Principal Investigator Ciro de Quadros. A seven-person Advocacy Project team will ensure that key government decisionmakers in the fifteen project countries are knowledgeable about their national programs and will seek to involve more domestic private sector and civil society groups in immunization. "It is indeed targeting the very critical aspects of country ownership and long-term financial sustainability", remarked GAVI Executive Secretary Julian Lob-Levyt. Taking a page from successful experiences in the Americas, the Advocacy Project will arrange regular exchanges, peer-review meetings and feedback to key actors to inculcate a sense of healthy competition among the project countries. "Developing countries have made important strides in protecting children with vaccines, and securing sustainable funding for immunization will ensure that these benefits are maintained for future generations ", said Jaime Sepulveda, Director of Integrated Health Solutions Development for the Bill & Melinda Gates Foundation.

Most countries are gradually increasing their immunization budgets, but not fast enough to prevent an additional 1m deaths with the newer vaccines. New funding sources, both public and private, are needed to close the gap:

  •     One option is to increase domestic government spending. Any reallocation of government funds must pass an "additionality" test by showing that immunization funding increases do not come at the expense of other vital programs.
  •     Second, engaging the private sector will generate both cash and in-kind support. With their connections to senior government officials, private business leaders are poised to become influential immunization champions.
  •     The third option is to find new external funding. Governments can find new donors. Some donors may be invited to "buy down" portions of the external debt and earmark the proceeds for immunization.

Sustainability is assured when countries are meeting all their immunization costs through some combination of long-term domestic and external funding. The Advocacy Project expects the fifteen countries to have reached this goal by 2015.

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The Albert B. Sabin Vaccine Institute's mission is to prevent disease by advancing development of new vaccines and increasing immunization rates.


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