The GAVI Alliance is a global health partnership that seeks to close the gap in vaccine services. A recent estimate pointed to 27 million children in poor countries who aren’t reached by immunisation services. As a result, about 1.4 million children die of illnesses that are no longer a threat in wealthier countries where children routinely received the needed vaccines.
Established in 2000 as a private philanthropy joining corporations, foundations, international agencies and governments, GAVI has invested well over $1 billion in immunisation as an engine for child survival. According to World Health Organization, the GAVI Alliance has helped deliver vaccines to 213 million children in poor countries, preventing an estimated three million premature deaths.
GAVI works to: accelerate access to underused vaccines; strengthen health and immunisation systems, and encourage new immunisation services and vaccines.
The International Finance Facility for Immunisation (IFFIm) is a multilateral institution that taps global capital markets to finance vaccines in the world’s poorest countries. Created in 2006, IFFIm secured binding pledges from six European countries against which it has issued bonds in the capital markets. The proceeds—amounting to $862.3 million in the two years following its inception-- flow to the GAVI Alliance, which is dedicated to accelerating the delivery of life-saving vaccines to populations in the world’s 72 poorest countries.
Bolstered by expanded donor pledges, IFFIm plans to raise about $4 billion to support the GAVI immunisation effort over ten years. The result is the delivery of tens of millions of vaccinations against such known childhood killers such as measles, diphtheria, tetanus, Haemophilus influenzae type b (Hib), and Hepatitis B.
UNITAID is an international drug purchasing facility launched in 2006 to finance treatments for people suffering from HIV/AIDS, malaria and tuberculosis.
The bulk of UNITAID’s funding comes from a “solidarity levy” on air tickets issued in participating countries. The governments of France and Brazil led the initiative, with initial participation from the Chile, Norway and Britain. Another 24 countries later added their support, along with the Bill & Melinda Gates Foundation. UNITAID has the negotiating power to bring about lower prices for available medicines, so that health budgets can support more treatments.
In its first two years of existence, UNITAID mobilized US $730 million for treating HIV/AIDS, malaria and tuberculosis, and committed $450 million to projects stretching across 90 countries.
Because pharmaceutical companies lack financial incentives to develop vaccines for diseases affecting the world’s poorest citizens, international leaders developed Advance Market Commitments (AMCs), which are donor-backed pledges to purchase future vaccines for use in low-income countries. An AMC creates a future market for medical technologies that aren’t yet available, with the aim of stimulating pharmaceutical companies to invest in the needed research, development and manufacturing capacity. The mechanism has been employed to ignite development of a new vaccine for pneumococcal diseases, a major childhood killer in developing countries, and eventually, could be marshaled to address global health threats such as malaria or HIV/AIDS.
Debt 2 Health Increases Country Investment in Health Services
Debt2Health is designed to free up some of the financial resources currently tied up in global debts to strengthen the battle against HIV/AIDS, tuberculosis and malaria. Under the arrangement, lenders forgive a portion of the debts owed by particular low-income countries; the governments of the borrowing countries, in turn, commit to redirect the resulting savings to projects financed by the Global Fund To Fight AIDS, Tuberculosis and Malaria. Since the arrangement was established in 2007, Germany has engineered debt swaps with Indonesia and Pakistan. Kenya and Peru are also in line to benefit from the Debt2Health arrangement during its pilot phase. Negotiations with other creditors are underway.
Product (Red) Shows Power of Consumer-Driven Philanthropy
Product (Red), created by U2 lead singer Bono and social innovator Bobby Shriver in 2006, represents a revolution in consumer-driven philanthropy, where profits from the sale of specific products are partly dedicated to fighting disease.
(Red) functions as a new brand licensed to partner companies that include household names such as American Express, Apple, Emporio Armani, Motorola and Starbucks. A participating company pays a licensing fee and creates a product line using the (Red) logo, and then shares up to 50% of the resulting profits with the Global Fund to Fight AIDS, Tuberculosis and Malaria. Through the end of 2008, Product (Red) generated $120 million for the Global Fund. These funds supported HIV/AIDS programs in Ghana, Lesotho, Rwanda and Swaziland.
Managed by the Millennium Foundation for Innovative Finance for Health, The Voluntary Solidarity Contribution (VSC), a long-term additional and sustainable funding solution, is the chance to bridge the gap in financing health. Small contributions have already proven effective increases in access to treatments for HIV/AIDS, tuberculosis and malaria, as shown by UNITAID's tax levy on plane tickets.
Via a simple click, passengers can choose to add a small contribution of $2 (or more) to the cost of their reservation in order to save lives in developing countries. Donating this way becomes easy and inexpensive, a small act which will create a global solidarity movement of like-minded individuals dedicated to the reduction of global health inequalities.
Leading stakeholders of the travel industry have already expressed their full commitment to implementing the VSC. The contribution mechanism itself will be launched in the first half of 2010. The Millennium Foundation is also developing partnerships with other industries, so that this "micro-contribution" could extend beyond the travel world, enabling other industries to join in the effort to improve global health.
The Millennium Foundation and the VSC also benefit from major support from governments, international organizations and foundations dedicated to health issues. The World Health Organization, the Bill & Melinda Gates Foundation, the Clinton Foundation, many nongovernmental organizations and countries such as the United Kingdom, France, Norway, Brazil, Chile and South Korea widely recognize the potential of the VSC to bridge the health financing gap and improve the lives of many.
A Currency Transaction Levy would impose a small charge on currency trades to support global health efforts. Trading in international currencies, representing a total value of about $3.2 trillion a day, has become the world’s largest financial market. Because of the size of the market, a micro-tax—too small to influence market behavior—could raise as much as -- $33 billion according to one estimate-- to advance improved health in low-income countries.
Support for international taxes to help achieve the Millennium Development Goals has been growing. Stamp Out Poverty, a network of major non-governmental organizations such as Save the Children, ActionAid, and World Vision, has launched a push for adoption of a levy on foreign exchange transactions, most especially on the most traded currencies, such as sterling and the euro.
Carbon Markets, Taxes Could Help Combat Disease
Efforts to slow climate change will lead to new markets, taxes and policies governing carbon, the principal cause of the greenhouse effect that leads to warmer temperatures and other long-term shifts in weather patterns. Two approaches have emerged in the international dialogue: a carbon tax to reduce emissions, and a cap-and-trade system, whereby governments would set limits on total carbon dioxide emissions, then award or auction off allowances to companies for specific levels of carbon dioxide emissions. Companies could trade the allowances on the open market. Either taxes on carbon emissions, or taxes on trading of the emission allowances, could create a stream of revenue to support improved health care in low-income countries. Within the European Union’s cap-and-trade system, Germany has allocated for development a part of the proceeds generated through an auction of carbon dioxide allowances.
Arms Taxes Could Force a Development Gain from a Scourge
Wars and weapons purchases among and within low-income countries set back development and divert resources from achievement of the Millennium Development Goals. In his analysis of conflicts over the decades, author Paul Collier has argued that violent conflict amounts to “development in reverse,” lowering investments in health and education, increasing corrupt behaviors, and accelerating the outward migration of people and financial assets.
A tax on arms transactions could be viewed as a form of compensation for some of these costs, creating revenue streams to be channeled into financing public health priorities, including fighting HIV/AIDS, tuberculosis and malaria. Although the $50 billion international arms market could be a robust source of finance, potential problems abound: there is no enforcer of an arms tax; non-complying countries or illicit traders could gain market share; if governments already inclined to purchase weaponry received the funds (to support healthcare goals), they might be encouraged to expand weapons purchases.