Combining health and social protection measures to reach the ultra ...

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are revealing previously unrecognized populations at risk and
therefore significantly increased the demand for the vaccine –
something that usefully allows supply market stability, better
forecasting and production scale-up, with benefits to both
producers and purchasers. The result: a marked reduction in
the size and frequency of yellow fever outbreaks in Africa in
the immediate future and increased availability of vaccine
where most needed.
IFFIm has also contributed strongly to the work on the
reduction of measles deaths globally. Again on the principle
of early, robust action, US$ 139 million of IFFIm support
went to the Measles Initiative in February 2007. Nearly 240
million children will have been immunized against measles in
supplementary campaigns in 2007. This is a very successful
initiative, which has already seen a reduction in global
measles deaths from 480 000 in 2003, to an estimated
170 000 in 2010. The vaccination campaigns do more than
save lives from measles; they also provide the opportunity for
insecticide-treated nets that protect against malaria to be
distributed, and other aspects of child health to be targeted,
with de-worming tablets and vitamin A supplements.
In each of these areas, in protecting and fostering healthy
children, IFFIm is contributing in valuable ways to building up
the bedrock of a healthy economy.
IFFIm’s origins and its special context go back to the late
1990s, when G8 governments looked back at the past 50
years of giving, and recognized that what was needed was a
more focused purpose. This resulted in the Millennium
Development Goals. At the same time, Bill & Melinda Gates
were searching for a focus for their philanthropy. One of the
answers was immunization – and a new model for more
efficient delivery. Their initial US$ 750 million dollars gift
founded that model in 2000 – the GAVI Alliance. Six years
later, that proven concept provided the match IFFIm needed
for the prompt execution of its funds. The Gates’ “demanding
dollar” in many ways was the trigger for others, like Gordon
Brown, then UK Chancellor of the Exchequer, to pay close
attention to how to get better value for aid and to lead the
international support for this new funding facility.
On the face of it, IFFIm investors are rational investors,
responding to an impressive offer – a triple-A-rated bond
offering a good return. The bonds were priced comparably to
other sovereign/supranational issuers, and the initial offer was
well over-subscribed with almost US$ 2 billion of demand.
The defining difference – that which sets it apart from the
others – is IFFIm’s goal. It is not just an investment end in
Health extension worker 18-year–old Ajebush Wakalto (right)
prepares to vaccinate young Brucktayet Teshome (far left, in her
mother’s arms) at the local health post in Timbicho, Ethiopia. She,
and 30 000 others like her in the programme, form the centrepiece
of the health component of the country’s poverty reduction
strategy, bringing a range of health advice to local communities
and providing essential basic preventive care, such as
immunization.
itself. It has a greater purpose: one that allows bond investors
to give directly to the frontier of health care, one that has
inspired individuals and companies to work pro bono to bring
this idea to fruition. It makes a profound difference.
The bonds were subscribed for not only by the traditional
types of investors such as central banks, pension funds,
money managers, and insurance companies, but also, in a
reflection of its fundamental humanitarian purpose, by
individuals such as His Holiness Pope Benedict XVI.
It is the hope and the intent of all of us who are associated
with this new instrument that it will make the necessary
impact. July 2007 was the mid-point in the MDG timeframe.
It is generally acknowledged that progress towards the healthrelated
goals is too slow and too little. Initiatives like the
International Finance Facility for Immunization and the GAVI
Alliance are two strong allies in the efforts to speed up
progress, confronting and offering solutions to the core
challenge of inequitable access. ❏
Alan R Gillespie CBE, is Chairman of the International Finance
Facility for Immunization (IFFIm) and also Chairman of The Ulster
Bank Group, a subsidiary of the Royal Bank of Scotland plc.
Following a 25-year career in investment banking with Citibank and
Goldman Sachs & Co., he has been engaged in public service as
Chairman of the Northern Ireland Industrial Development Board
and as Chief Executive of the UK’s Commonwealth Development
Corporation. He is a graduate of the University of Cambridge where
he took his BA, MA and PhD degrees.
References
1.
IFFIm’s sponsor governments include France, Italy, Norway, South Africa,
Spain, Sweden and the United Kingdom. Brazil has announced its
intention to join. IFFIm issues triple-A rated bonds with a financial base
consisting of long-term (10–20 years) legally binding commitments from
sovereign donors. The borrowings and risk are handled under prudent
financial policies, with the World Bank acting as Treasury Manager.
Goldman Sachs acted as Financial Advisor in establishing IFFIm and
Deutsche Bank and Goldman Sachs lead-managed the inaugural bond
issue.
2.
The GAVI Alliance was created in 2000 as a public-private partnership
accelerating delivery of life-saving immunization to the world’s poorest
children. The Alliance includes a wide range of development partners,
developing country and donor governments, WHO, UNICEF, the Bill &
Melinda Gates Foundation, the vaccine industry, research and technical
agencies, public health institutions, nongovernmental organizations and
the GAVI Fund (the resource and funding arm of GAVI).
3.
GAVI’s “country-specific” programmes include the provision of
immunization safety equipment such as single-use syringes and disposal
boxes, as well as the provision of new and underused vaccines such as
those against hepatitis B, yellow fever, rotavirus and pneumococcal
disease.
4.
WHO projections.
098 ✜ Global Forum Update on Research for Health Volume 4