GAVI

RECENT POSTS

May 15, 2012 | 12:18 PM | By

Doctors Without Borders criticizes Gates-backed global vaccine strategy

UN

Bill Gates at World Health Assembly

The global health strategy to expand childhood immunizations, largely backed by the Bill & Melinda Gates Foundation, is too focused on new vaccines and neglects the fundamental need to improve basic public health and immunization programs in poor countries.

So says Medicins Sans Frontieres (MSF), aka Doctors Without Borders, in a new report issued today by the organization entitled The Right Shot: Extending the Reach of Affordable and Adapted Vaccines.

The medical relief and aid advocacy organization is critical of a new, 10-year, multi-billion dollar “Global Vaccines Action Plan” expected to be adopted by global health leaders at the World Health Assembly meeting next week. The plan is largely funded by the Gates Foundation.

MSF says it favors expanding access to new vaccines — just not at the expense of basic immunizations.

“Twenty percent of the world’s children aren’t even getting the basic vaccines,” said Kate Elder, MSF vaccine policy adviser. The Gates Foundation is driving much of the global health policy decisions around vaccinations, Elder noted, and “Bill Gates’ priority is new vaccines.” The philanthropy’s influence is distorting the agenda to favor new vaccines over basic improvements, she said.

Daniel Berman, MSF’s deputy director for access, cited a recent initiative to distribute a new $7-per-dose pneumococcal vaccine in DR Congo in the middle of a measles outbreak. Why, Berman asked, are donors and health agencies pushing this new, expensive vaccine in Congo if Congolese children still aren’t getting a 30-cent measles vaccine?

The approach appears aimed more at supporting drug industry desires to promote new products than at finding the most efficient and sustainable means for fighting the diseases of poverty, he said.

UNICEF

The Right Shot may be a new report from MSF, but it is hardly a new criticism of the Gates Foundation’s approach to vaccines. Others have criticized the philanthropy before for a tendency to place industry interests above the concerns of poverty advocates.

The Seattle philanthropy, though contacted in advance of the report’s release, declined to comment or respond today to the MSF criticism – or to the group’s call for a new global strategy with more emphasis on beefing up basic, routine immunizations. The organization sponsored by the foundation to promote the new global strategy, the Decade of Vaccines collaboration, also did not respond.

Jeffrey Rowland, spokesman for the Global Alliance for Vaccines and Immunization, GAVI, did respond to the criticism. Continue reading →

FILED UNDER: Health, Bill & Melinda Gates Foundation, Doctors Without Borders, GAVI, Medicins Sans Frontieres, vaccines, World Health Organization
January 26, 2012 | 9:15 AM | By

Gates Foundation boosts funding and confidence in troubled Global Fund

World Economic Forum

Bill & Melinda Gates at Davos 2010

The Bill & Melinda Gates Foundation has pledged another $750 million to the ‘troubled’ Global Fund to Fight AIDS, Tuberculosis and Malaria.

Associated Press Gates Injects $750 Million in Troubled Global Fund

Washington Post Gates Injects $750 Million in Troubled Global Fund After Director Resigns

Troubled seems to be part of the Global Fund’s official title these days.

Yesterday, Reuters reported that the head of the Global Fund, Michel Kazatchine, quit due to funding cuts. That’s not quite right. It is true that this initiative created to fight AIDS, TB and malaria has seen funding decline as donors have reneged on their promised pledges.

Kazatchine appears to have resigned largely due to the allegations of mismanagement and tolerance of corruption in an internal shake-up. Some accused donors of using these allegations — which seemed to me a bit hyped as I wrote here and here — as an excuse not to come through with the promised funds.

The subsequent failure of donors and governments to follow through on funding to the Global Fund following this flap made Canadian politician and former UN AIDS ambassador Stephen Lewis absolutely apoplectic.

All this makes the announcement today by Bill Gates at the World Economic Forum in Davos, Switzerland very welcome news to many in the global health community. Davos is the same place he and Melinda announced more than a decade ago that they were giving the same amount of money to launch the Global Alliance for Vaccines and Immunization (GAVI).

Here’s a series of reports from 2001, in the wake of that announcement, I wrote for the Seattle PI.

There just seems to be something the Gateses like about announcing global funds at Davos and giving that $750 million figure. Some saw GAVI as a model for the later creation of the Global Fund.

Both are collaborative international projects that award grants to poor countries based on their performance in combating diseases of poverty — one aimed at fighting the top three killers and the other aimed at boosting childhood vaccinations in poor countries.

Both have trouble with “fraud and mismanagement” which, to some extent, comes from them handing over more control of in-country operations to, uh, countries not known for doing too well at combating fraud and mismanagement. But if the subcontractor shirks on the plumbing, the contractor pays for the leaks.

After the Gates announcement, Sarah Boseley at The Guardian raised an interesting question in her article today The Global Fund – saved and wrapped in a US flag?

With the Gates Foundation stepping in where the international community has stepped back, Boseley asks if the Global Fund risks becoming a bit too unilateral, less European. That may sound petty from an American perspective, but it’s not. These initiatives really can only succeed if they are truly multilateral.

Politics aside: Between these two funds over the past decade, more than 10 million deaths have been prevented and some disease rates in poor countries have been significantly reduced. Not a bad return.

Here’s a pretty good video from the Global Fund making its case with a little help from Bono, Bill Gates, Bill Clinton and others (many of whom who are probably now in Davos):

FILED UNDER: Health, AIDS, Bill & Melinda Gates Foundation, GAVI, Global Fund, Michel Kazatchkine, Stephen Lewis
October 18, 2011 | 9:00 AM | By

Queen of England bestows honor on PATH’s gizmo guy

Flickr, UK Ministry of Defence

Queen Elizabeth

The Queen of England has bestowed an exalted honor on PATH’s top gizmo guy.

“She said global health was a rather big subject and must involve a lot of travel,” said Michael Free, chief of technology for PATH, who had in fact stopped off in London to be received by the Queen before embarking on a month-long trip of global health travel.

Last week, Free was made an Officer of the Order of the British Empire in recognition of his team’s many inventions and innovative approaches aimed at helping solve health problems in the developing world. It’s not quite as prestigious as a Knighthood but better than a sharp poke in the helmet.

PATH

Michael Free

One of Free’s inventions was the single-use, auto-disabling syringe — a device now in common use worldwide, here in the U.S. as well, aimed at reducing the transmission of disease through accidental needle sticks.

But Free was also likely honored for his much broader and critical role in helping give birth to PATH in the 1970s.

How this British farm boy, raised in creamy Devonshire, ended up in Seattle working on some of the most innovative solutions to developing world health problems offers insight into the evolution of PATH and, to some extent, the entire field of global health.

“In the beginning, our approach was not well-received by either the public or private sectors,” said Free. “It was a bit out-of-the-box.”

Continue reading →

FILED UNDER: Basics, Battelle, Bill & Melinda Gates Foundation, condoms, family planning, GAVI, Michael Free, PATH, Queen Elizabeth, vaccines
September 27, 2011 | 1:03 PM | By

The obscure bug that set off Bill Gates, awakening a geeky giant

Tom Paulson

Nelson Zambrana cradles his child sick from rotavirus in Nicaraguan hospital

It kills anywhere from a quarter-million to half-a-million kids every year and is one of the world’s leading causes of child mortality.

But it wasn’t too long ago hardly anybody had even heard of it.

Rotavirus — the killer bug that set off Bill Gates and gave direction to his philanthropy.

“No matter where we looked in the world, about 40 percent of all kids under 5 years old in hospitals for severe and life-threatening diarrhea had rotavirus,” said John Wecker, head of Seattle-based PATH’s vaccine access and delivery program. PATH has a long history advocating for a rotavirus vaccine.

“We’d go into these countries where huge numbers of kids were dying from diarrhea and they’d say ‘Rota what?” Wecker said. “We don’t have that here. Nobody had ever heard of it.”

Today, an international group that represents the Bill & Melinda Gates Foundation‘s single largest philanthropic project aimed at expanding children’s vaccinations announced it was launching a major new global jab against rotavirus and another big killer of young children, pneumococcal disease. The campaign focuses on Africa, where these two infectious diseases are rampant.

“The death toll of rotavirus and pneumococcal infections in Africa is particularly devastating, and this is where these vaccines will make the most significant impact, not only in lives saved, but also in terms of healthy lives lived,” said Seth Berkley, CEO of this group known as GAVI, the Global Alliance for Vaccines and Immunization.

It’s a major milestone for GAVI, for a number of reasons, but in a way just another big step forward in a decade of significant progress for this alliance created to expand access to childhood immunizations in poor countries.

Since it was launched, hundreds of millions of children have been vaccinated and an estimated 5 million deaths prevented.

That’s more deaths averted than has so far been credited to the much-larger Global Fund for Fighting AIDS, TB and Malaria — or any other single project in the global health arena, for that matter. Continue reading →

FILED UNDER: Health, Bill & Melinda Gates Foundation, GAVI, John Wecker, pneumococcal disease, rotavirus, Seth Berkley, vaccines
September 21, 2011 | 10:04 AM | By

Did something that matters happen at the UN global health summit?

Tom Paulson

The media covering the media covering President Obama speaking at the UN

The big global health meeting at the United Nations has come and gone I still can’t quite tell if anything actually happened.

Maybe that’s normal, when it comes to how things get done at the UN.

After all, the Obama Administration has said if the UN were to recognize Palestine as a state, it would be “merely symbolic.” And yet they’re still fighting like hell to keep it from happening.

I came to New York to cover a meeting called the UN High-Level Meeting on Non-Communicable Diseases, which concluded yesterday. This was billed as a historic moment in global health, only the second time the UN has held such a meeting. The last one, in 2001, launched the Global Fund to Fight AIDS, TB and Malaria — a massive, if imperfect, effort that has saved millions of lives.

The aim of this week’s special session on global health at the UN General Assembly meeting is potentially even more significant than it may sound.

On the surface, it was a call to expand the already strained global health agenda to include non-infectious killers like cancer, diabetes and heart disease — the NCDs (or non-communicable diseases). That’s a big deal because it adds a lot to the agenda, given that chronic diseases kill more people (about 36 million per year) than AIDS, TB and malaria combined.

But it may be even bigger than that.

If you dig a little deeper here, this is the big — mostly unspoken — question: Is this move to get chronic disease on the agenda actually a move away from the standard disease-oriented approach to global health — and toward a more “systems” approach? Continue reading →

FILED UNDER: Health, GAVI, Gro Harlem Brundtland, non-communicable diseases, Seth Berkley, UN Week
July 18, 2011 | 10:34 AM | By

Fight against top cause of deadly diarrhea, rotavirus, launched today

Tom Paulson

No doctor, no medicine at clinic in rural Nigeria

It is a stunning fact that bears repeating:

Diarrhea is one the world’s big killers. Every year, diarrhea is estimated to kill anywhere from one to 2 million people, children mostly — about as many die annually from malaria.

Much of this is due to dirty, contaminated water.

But a major cause of the most severe and deadly form of diarrhea is a bug called rotavirus. Bill Gates has said it was when he read about this virus, or more accurately the stunning number of deaths it causes in poor countries (about 500,000, a half to a third of the global diarrhea death toll), that initially set him on his global health mission as a philanthropist.

Today, a global immunization project (which, not incidentally, was launched by the Gates Foundation and Seattle-based PATH a decade ago) has started expanding access in Africa to vaccines that prevent rotavirus infection.

The Global Alliance for Vaccines and Immunization, GAVI, today announced the first child — in Khartoum, Sudan — to be vaccinated in a new rotavirus immunization campaign that aims to reach millions of vulnerable children in 40 low- or middle-income countries.

“Rotavirus vaccines save children’s lives and our mission is to ensure we get these vaccines to children in Africa and throughout the developing world as quickly as possible. These are the places where rotavirus has the most devastating impact”, said Helen Evans, GAVI interim CEO.

GAVI, as you may recall, recently completed a highly successful fund-raising campaign that has allowed it to expand its portfolio of vaccines to include new vaccines against pneumonia and rotavirus.

Here’s a nice perspective on the rotavirus vaccine roll-out by John Wecker of PATH, one of those who have worked for years to expand access to the vaccine worldwide.

 

FILED UNDER: Health, GAVI, John Wecker, rotavirus vaccine, vaccines
July 1, 2011 | 10:31 AM | By

Winners and losers in global health

Flickr, by AMagill

Circle of money

One of the uncomfortable realities about the field of global health is that it often appears made up of many organizations championing worthy causes that compete for money.

Andrew Harmer, a researcher at the London School of Hygiene and Tropical Medicine, offers his perspective in a blog post “Winners and losers in the global health aid money go-round.”

Harmer begins by noting the recent — surprisingly successful — fund-raising effort by the Global Alliance for Vaccines and Immunization (GAVI), which raised $4.3 billion in new funds to get poor kids vaccinated, as compared to the failure of the Global Fund to Fight AIDS, TB and Malaria a while back. Continue reading →

FILED UNDER: Basics, GAVI, Global Fund