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When I worked as a public health nurse in Ghana earlier in my career, among my most rewarding moments was delivering an immunization to a child; their short-lived cries a reminder that this moment of pain was a child’s gateway to a healthy life.
As my career in health and development evolved, so too did my view of the complex global choreography behind that one jab: from a nurse’s hand, through a chain of refrigeration facilities, to the government offices where health policies develop, up to the global stage where donors announce commitments to the GAVI Alliance, a public-private partnership that works to ensure new vaccines are available to the world’s most vulnerable children.
GAVI’s support has been essential to the successful efforts of countries like Ghana to reach more children with new vaccines. Sustaining progress, however, depends on continued donor commitments to GAVI, and the creation of plans that outline how recipient countries will sustainably finance immunizations beyond GAVI support. Achieving both these goals will require citizens to hold recipient countries and donors accountable to the world’s children.
I personally witnessed the euphoric moment in June 2011 when, despite a global economic downturn, world leaders collectively stepped up to commit an additional $US 4.3 billion to GAVI, enabling the institution to commit to averting 4 million future deaths by 2015.
We’ve had a lot to live up to since then, but so far we have risen to the challenge. In its Mid-Term Review report released October 14, GAVI announced it is on pace to avert 4 million future deaths by 2015. Over the past two years, GAVI has funded a total of 67 new vaccine introductions and campaigns, and has prevented 1.1 million deaths.
This progress hinges on the continued efforts of donor to fulfill their pledges and continue signaling their support for GAVI. ACTION – a partnership of 10 global health advocacy organizations – recently released an accountability tool to track donor commitments to GAVI. In general, many donors are on track to fulfill their pledges to GAVI, but 11 countries – including Australia, France, and Japan – are still on the hook to deliver or extend their funding.
Amidst shaky global economics, citizens around the world must vocalize to their leaders that continuing to fund the global fight against preventable child deaths is high on their own priority lists.
The tracking tool also shows that the vast majority of recipient countries are contributing to the cost of GAVI-supported vaccines. Since 2007, all countries applying to GAVI for new vaccine support have been required to co-finance a portion of the cost of requested vaccines. In 2011 and 2012, recipient countries contributed $US 96 million, and in 2012, 55 out of 64 countries made their co-financing payments on time.
While this is a commendable picture, it doesn’t tell the full story. Recipient countries must take the extra leap and make a concerted effort to develop viable plans for how they will sustainably finance immunizations in the long-term, so that gains made through GAVI can be sustained and built once countries ‘graduate’ from GAVI support.
GAVI and other international actors can support citizens and their civil society representatives to hold recipient governments to account, and ensure they create these forward-looking sustainable immunization finance plans. As countries graduate from GAVI support, civil society oversight and advocacy will also be critical to ensuring continued progress.
I no longer personally deliver vaccines, but I’m convinced that ensuring all children are reached with lifesaving vaccines – a basic and proven tool that lays the foundation for a healthy life full of potential – is one of the most noble goals humanity can collectively work towards. We’re almost there, but not quite.
Ultimately, we are all accountable to the children we have promised to save.
Joan Awunyo-Akaba is the civil society representative on the GAVI Alliance Board. She is Founder and Executive Director of Future Generations International (FUGI), a Ghanaian-based NGO working on health promotion and development, and holds a PhD in medical sociology from the University of Ghana Legon (2007). A registered nurse, she is a community health development consultant and an expert in childhood immunization advocacy; behaviour change communication; and water, sanitation, and hygiene.