VACCINATIONS HAVE SAVED AN ESTIMATED 2.3 MILLION LIVES [Seattle Times, April. 2007] The world's richest man has called it his best investment. When Bill Gates anted up the first $750 million for childhood vaccinations, immunization rates were actually falling in many of the world's poorest countries. Seven years and another $750 million later, vaccinations have reached a record high in the developing world. The seed money provided in 1999 by the Bill & Melinda Gates Foundation has blossomed into an international collaboration called the GAVI Alliance that has provided new vaccines to nearly 140 million children around the globe. The World Health Organization calculates those vaccines saved an estimated 2.3 million lives. The Gateses were expected to confirm those results at the World Economic Forum in Davos, Switzerland. The GAVI donation was the Seattle-based Gates Foundation's first major foray into global health, the short-hand term for the fight against diseases afflicting the poor. Originally called the Global Alliance for Vaccines and Immunizations, GAVI now receives money from 17 donor nations, including members of the European Union and the United States. It replaced an ineffective United Nations program called the Children's Vaccine Initiative, which had collapsed in the face of turf battles and meager funding. "GAVI and its partners are leading a major turnaround in children's health," Melinda Gates said in a statement. In addition to the $1.5 billion from the Gates Foundation, GAVI has received $2.3 billion in funding commitments from world governments. The organization also has backing to issue $4 billion in bonds. The United States contributes about $70 million a year — roughly the same amount as Norway. The Gateses are expected to use their platform in Switzerland to call for more donations, both public and private. "GAVI has demonstrated that with the right resources and leadership, it is possible to make dramatic health gains in poor countries," Bill Gates said in the statement announcing the gains. "We need to build on this success. No child should be denied access to lifesaving immunizations." While immunization rates have climbed to 77 percent in developing nations, an estimated 28 million children still don't receive vaccines, and about 2.5 million die of vaccine-preventable diseases each year, said GAVI spokesman Jean-Pierre Le Calvez. An additional $1 billion a year is needed to plug that gap and ensure children in poor nations get newly developed vaccines, such as those for pneumonia and a common form of diarrhea, Le Calvez said. "Still, 600,000 kids die of measles every year," he said. "We can prevent that so easily." In a speech to 300 CEOs in Davos, Switzerland, Melinda Gates pointed out that even the foundation's staggering wealth — a $30 billion endowment to be matched with $30 billion from mogul Warren Buffet — would cover the health budgets of developing nations for only one year, Le Calvez said. "If it were a nation, the foundation would have a GDP larger than many of the countries we work with ... but you need more government backing if you're going to solve these problems," he said. GAVI also plans to spend about $500 million over the next five years to bolster the health systems in poor nations by helping pay salaries for medical workers and encourage them to stay in their native countries. Poor salaries and prospects have driven a massive exodus of nurses and doctors from impoverished African and Asian countries to the United States and Europe. "Without strong health systems, you cannot step up the delivery of vaccines," Le Calvez said. [Picture: A child in Cambodia receives an injection last October.]

COUNTRIES COMMIT TO LONG-TERM FUNDING FOR VACCINES By GORDON BROWN and BILL GATES [Orginally published in the November 7, 2006 issue of The Independent.] Financial markets are not usually associated with saving lives. Today, with the launch of the International Finance Facility for Immunisation (Iffim), that is about to change. A bond that uses long-term financing to help pay for vaccines will ensure that millions of children in the poorest countries have a fighting chance at a healthy life. This facility will significantly increase predictable resources for development and ignite a broader debate around innovative ways to raise and spend donor dollars, both public and private, on global health. Financing techniques to deliver existing health interventions, as well as to promote research and development on new tools, could become a powerful force in the fight to end preventable diseases over the coming decades. Two to three million children under the age of five die every year from diseases for which we have, or soon will have, a vaccine. The Gavi Alliance (formerly the Global Alliance for Vaccines and Immunisation) was created in 2000 to address this appalling situation. With an initial pledge from the Bill & Melinda Gates Foundation, Gavi has immunised more than 115 million children against such diseases as hepatitis B and yellow fever, likely preventing 1.7 million deaths. Yet each year, nearly 30 million children still miss out on essential immunisations, leaving them vulnerable to devastating illness or death. That is why innovation is desperately needed to overcome funding constraints and provide more resources in a shorter period of time, while ensuring a better predictability of aid flows. The launch of the first Iffim bonds will help save some of these children by giving Gavi new funds to expand its immunisation work, by starting to bridge the gap between the money that is available and the money that is needed. Long-term, legally binding aid commitments from six donor countries—the United Kingdom, France, Italy, Sweden, Spain and Norway—have been made to Iffim, which can use that funding stream as collateral to raise money in capital markets right now. It will deliver an extra $4bn to Gavi over the next 10 years. This means we can immunise 500 million children against vaccine-preventable diseases before 2015, saving some 10 million lives. And we can get one step closer to eradicating polio, just as we have done with smallpox. Front-loading these resources not only saves lives now but also reduces the spread of disease. Without front-loading, investing this $4bn over 15 years, would save only 2.5 million lives and leave millions more at risk from infection. In September, at the UN, a new programme was kicked off to raise money to buy drugs for Aids, tuberculosis (TB) and malaria as cheaply as possible on behalf of the poorest countries. Unitaid, the agency overseeing the funds, expects to raise €50m this year and €300m next year, largely from a tax on airline tickets. That is a significant increase over current funding. France proposed the idea, and now 19 countries have indicated their support. As with Iffim, the benefit of this new scheme is not solely the amount of the resources but their predictability, which then allows for the negotiation of cheaper prices for these lifesaving drugs. We hope other schemes will be equally creative. New approaches to financing can also elicit more and better research and development (R&D) around global health. One way is through product-development partnerships, which fund and manage portfolios of new candidate drugs, vaccines and diagnostics for diseases such as malaria, HIV and TB. With the help of more than $2bn from the Gates and Rockefeller foundations and governments including the UK and the Netherlands, 15 new partnerships with universities and private companies have put more than 40 products into clinical testing in less than 10 years. That contrasts with the mere 21 medicines out of 1,500 that were approved for treatment between 1975 and 2005 specifically for tropical diseases. Another promising way to encourage R&D is to create a credible market for new products. An Advance Market Commitment (AMC), whereby donors supplement the purchasing power of the poorest countries, could provide strong commercial incentives for companies to accelerate the development of new and improved vaccines for diseases such as pneumococcus and malaria. We need more donors to join these financing initiatives. We need more minds devoted to finding creative solutions. By matching the power of medical advance with innovative finance we can fill the gap between what we are capable of and what we are willing to do—and unleash the power of human ingenuity and goodness to save millions of lives. As Mahatma Gandhi once said: "The difference between what we do and what we are capable of doing would suffice to solve most of the world's problems." [The writers are the Chancellor of the Exchequer and the chairman of Microsoft.]

BRAZIL TO CONTRIBUTE $US 20 MILLION OVER 20 YEARS [LONDON 9 March 2006] The President of Brazil, Luiz Inacio Lula da Silva, announced today that Brazil will contribute US$20 million over 20 years to the International Finance Facility for Immunisation (IFFIm). Brazil joins six European nations—France, Italy, Norway, Spain, Sweden and the United Kingdom—in committing funds to this innovative financing mechanism which will drastically reduce the number of poor children who die every year from vaccine-preventable diseases. The IFFIm is expected to provide US$4 billion of financing for immunisation over a period of ten years by raising capital against donor pledges made from 2006 to 2025. This investment is expected to prevent 5 million child deaths between 2006-2015 and more than 5 million future adult deaths. The new funds will support the work of the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunization), a leading global health partnership that includes UNICEF, the World Health Organization, the World Bank, the Bill & Melinda Gates Foundation, and representatives of the vaccine industry in both industrialised and developing countries. "The new International Finance Facility for Immunisation has the capacity to save millions of lives that would otherwise be needlessly lost,” said U.K. Chancellor of the Exchequer Gordon Brown, in response to the Brazilian president’s announcement during a state visit to the United Kingdom. “That is why I am delighted that President Lula has committed to support this innovative new financing mechanism today. President Lula has worked tirelessly on fighting international poverty for many years and I look forward to continuing to work closely with him towards the Millennium Development Goals." “Brazil’s contribution is particularly exciting,” said Dr. Julian Lob-Levyt, Executive Secretary of the GAVI Alliance. “It illustrates a significant commitment on the part of one of the world's four major emerging economies to playing a growing role in addressing the problems of the poorest nations.” “We are grateful for Brazil’s contribution to IFFIm,” said Lob-Levyt. “We look forward, as well, to benefiting from Brazil’s expertise as both a consumer and producer of vaccines. This nation has had great success in encouraging the growth of a vibrant national vaccine industry, and in carrying out nationwide efforts that immunise children in even the hardest-to-reach rural areas.” With new funding from IFFIm, GAVI will work with its partners to scale up their efforts, reaching millions more children with life-saving vaccines, while providing significant new support to strengthen health systems. The IFFIm will be overseen by a charity that will be headed by a volunteer five-member board. "The design of this innovative financing mechanism is particularly exciting because it allows capital to flow directly from the markets to a place where it can have a tremendous impact on the lives of the world’s poor," said Alan Gillespie, chairman of the Ulster Bank Group and chair of the IFFIm board. "Instead of losing excess liquidity in the capital markets to profit-making entities, we are harnessing some of it for development." Since its launch in 2000, GAVI has demonstrated that development assistance is effective when funds are targeted and flexibility is built into the process. Countries eligible for GAVI support have seen improved immunisation coverage rates and have successfully introduced new vaccines. “Key to this success has been GAVI’s approach,” said Lob-Levyt. “It rewards results, but allows recipient nations to develop their own plans for reaching their immunisation goals. Their success has in turn attracted the attention of donors. “These increases in funding for immunisation through GAVI have been possible only because countries have delivered results,” Lob-Levyt said. “Brazil's decision to participate in IFFIm, along with that of France, Italy, Norway, Spain, Sweden and the United Kingdom, represents a vote of confidence, not only in GAVI, but in the 72 nations we have worked with in the last five years." Dr. Ciro de Quadros, President and CEO of the Albert B. Sabin Vaccine Institute, in Washington, DC, and chairman of GAVI’s Independent Review Committee, noted that Brazil is announcing its support for IFFIm the same week that it introduces one of two new rotavirus vaccines, a decision that demonstrates the nation’s deep commitment to its own children. “This year the government will immunise three million newborns against the disease that causes dehydrating diarrhoea and kills 500,000 children globally every year,” de Quadros said. The impact of global immunisation efforts is reflected in the more than 1.7 million early deaths that will have been prevented as a result of support by GAVI up to the end of 2005. Since 2001, the GAVI Alliance has supported the immunisation of 115 million children with new generation vaccines. The number of children reached with these vaccines—against deadly diseases such as hepatitis B and yellow fever—is expected to climb to 225 million by 2008, according to the WHO. The impact of the Alliance also has been felt in the vaccine industry. As a large buyer of vaccines, GAVI has stimulated new and unprecedented market interest in producing vaccines. While a few years ago there was only one manufacturer of the combined Diphtheria-Tetanus-Pertussis-Hepatitis B vaccine, for example, 11 companies have submitted bids to begin supplying the vaccine in 2006. Lob-Levyt noted that the GAVI Alliance is playing a role in the development of another complementary potential investment in immunisation, one designed to create a financial incentive for the development of vaccines for diseases that primarily affect poor countries. In partnership with the World Bank, GAVI is advising the G7 on Advanced Market Commitments (AMCs), and how that pilot should be developed. The joint recommendations from GAVI and the World Bank will inform a decision by G7 at their Spring Meetings in April. At the Paris Conference on Innovative Development Financing Mechanisms on 28 February, France and the UK also announced that contributions from airline ticket sales would be used to fund an International Finance Facility that would provide additional resources for health, including to raise funds to purchase drugs needed to fight pandemics, such as AIDS, tuberculosis and malaria, as well as for other sectors. “Of the more than 10 million children who die before reaching their fifth birthday every year, 2.5 million die from diseases that could be prevented with currently available or new vaccines,” Lob-Levyt said. “These innovative new ideas for how to cover the costs of developing and delivering new vaccines and other global health solutions will be crucial in reducing the death toll. We know that IFFIm is just the beginning.” The GAVI Alliance An alliance of all the major stakeholders in immunisation, the GAVI Alliance includes among its partners developing country and donor governments, the World Health Organization (WHO), UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, NGOs, and the Bill & Melinda Gates Foundation. It is estimated that more than 1.7 million early deaths will have been prevented as a result of support by GAVI up to the end of 2005. GAVI's efforts are critical to achieving the Millennium Development Goal on child health, which calls for reducing childhood mortality by two-thirds by 2015. Of the more than 10 million children who die before reaching their fifth birthday every year, 2.5 million die from diseases that could be prevented with currently available or new vaccines. [Dr. Akira Homma, director of Fiocruz, -- also known as Bio-Manguinhos-- currently represents the developing world vaccine industry on the GAVI Alliance Board.] For more information, please contact: Cathy Bartley at tel: +44 207 635 1593 or +44 7958 561 671 or email: cathy.bartley@ukonline.co.uk Nicole King at tel: +1 202 478 1041 or email nking@gavialliance.org

GATES and CANADIAN PM STEPHEN HARPER PLEDGE $139 MILLION for AIDS RESEARCH

[kaisernetwork.org, February 21, 2007] Bill Gates, co-founder of the Bill & Melinda Gates Foundation, and Canadian Prime Minister Stephen Harper on Tuesday announced a joint $139 million initiative to establish a research institute for the development of an HIV/AIDS vaccine, Toronto's Globe and Mail reports. According to the Globe and Mail, the Canadian government will provide about $111 million over five years and the Gates Foundation will provide $28 million to the initiative, called the Canadian HIV Vaccine Initiative. The initiative aims to develop a preventive HIV/AIDS vaccine within 10 years and will build a research facility to support Canadian scientists and other researchers worldwide. According to the Globe and Mail, the funding will be used to develop vaccine candidates and bolster the ability to run clinical trials. The research facility will be the first in the world with the production capacity to manufacture experimental vaccines for clinical trials, the AP/Sun-Sentinel reports. The Canadian government will accept proposals from provinces interested in hosting the facility, according to a spokesperson for Canadian Health Minister Tony Clement. According to Gates, the initiative will run under the Global HIV Vaccine Enterprise. "Every year that can be saved in the delivery of this product literally translates into millions of lives saved," Gates said, adding, "Most scientists think that it probably will take more than 10 years. We could get lucky. It could happen sooner than that. But with all top problems, the more energy we put into it, clearly that's going to cut down the amount of time required." The World Health Organization, the International AIDS Vaccine Initiative and the Canadian AIDS Society all praised the initiative. Monique Doolittle-Romas, executive director of the Canadian AIDS Society, said the initiative was a "very welcome announcement to the HIV/AIDS movement," adding that a vaccine is "considered to be our best hope in preventing the transmission of HIV/AIDS." The society in a statement said that a vaccine is a long-term solution and that there is an immediate need for HIV/AIDS prevention, education and support services. IAVI CEO and President Seth Berkley said the initiative will "coordinate critical domestic research with ongoing international efforts to tackle one of the most significant public health challenges we face today" (IAVI release, 2/20). Harper at a news conference announcing the initiative said, "While the ultimate goal is to develop a cure, we must also work on preventive measures to halt the spread of the disease."

FOUR COUNTRIES PLEDGE $70 MILLION TO ZIMBABWE

[kaisernetwork.org, February 20, 2007] Germany, New Zealand, Sweden and the United Kingdom on Thursday pledged $70 million to Zimbabwe to help the country address the growing number of children who have lost one or both parents to AIDS-related illnesses, Reuters South Africa reports. The funding will be jointly administered by UNICEF, nongovernmental organizations and the government to ensure that AIDS orphans have access to services such as education and health care. The $70 million will go toward a five-year, $250 million program aimed at AIDS orphans in Zimbabwe. The program was launched on Thursday under an agreement signed by UNICEF, 21 NGOs and the government and will aim to fund and support an additional 150 community-based groups in the country. Under the agreement, the NGOs and community-based groups will aim to increase school enrollment among orphans and vulnerable children; support school nutrition programs; increase the number of children with birth certificates; increase access to food, health care, water and sanitation; and prevent abuse and violence aimed at children. UNICEF estimates that about 1.6 million, or one in four, children in Zimbabwe have lost one or both parents to HIV/AIDS. "In a complex and difficult environment, this is an outstanding agreement between a diverse group of key institutions," UNICEF Zimbabwe representative Festo Kavishe said. He added, "Combined, we are reaching out to hundreds of thousands of orphans across the country, and we are doing it effectively and cost efficiently."