Lancet Editorial: The GAVI Alliance—successes and ongoing challenges

The Lancet  
Oct 19, 2013  Volume 382  Number 9901  p1309 – 1380
http://www.thelancet.com/journals/lancet/issue/current

Editorial
The GAVI Alliance—successes and ongoing challenges
The Lancet
[Full text] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2962127-3/fulltext

GAVI’s Mid-Term Review, published on Oct 14, examines the organisation’s progress midway through the period 2011—15. It notes that by 2014, 73 countries with GAVI’s support will introduce five-in-one pentavalent vaccines, including fragile states—Haiti, Burma, Somalia, and South Sudan. The costs of new, priority vaccines, such as those targeting pneumococcal and rotaviral infections, are falling owing to GAVI’s efforts. Countries are graduating from GAVI support to self-financing of vaccines, and provision of new vaccines to those most in need is speeding up.

The report is published ahead of a mutual accountability meeting on Oct 30, in Stockholm, Sweden, to take stock of GAVI’s progress in immunisation and resource mobilisation since 2011.    A Lancet Series on the New Decade of Vaccines, in 2011, highlighted some predicaments facing GAVI—eg, a need to scale-up country commitments, high prices for new vaccines that are slowing delivery, and a need for GAVI to evaluate performance more effectively.

GAVI notes, however, that 2 years after its successful pledging conference in London, 243 million children will be reached with GAVI-supported vaccines in developing countries during 2011—15. Still, at least 22 million children worldwide do not have access to the basic package of childhood vaccines each year. Despite this gap, GAVI argues that it is reaching its strategic goals, which include acceleration of the uptake and use of under-used and new vaccines, strengthening of health systems to improve immunisation coverage, and improvement of vaccine market conditions for developing countries.

Despite the achievements documented in the report, challenges remain: looking for better ways to collect country-level data and ensuring supply chains are more reliable; addressing low-income countries’ unique and challenging needs with individualised approaches; and ensuring sustainability of immunisation programmes in countries wealthy enough to no longer be eligible for GAVI support. GAVI should continue to work hard and successfully to address these issues, to ensure that all children are protected against vaccine-preventable diseases, wherever they live.