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

Innovationare revealing previously unrecognized populations at risk andtherefore significantly increased the demand for the vaccine –something that usefully allows supply market stability, betterforecasting and production scale-up, with benefits to bothproducers and purchasers. The result: a marked reduction inthe size and frequency of yellow fever outbreaks in Africa inthe immediate future and increased availability of vaccinewhere most needed.IFFIm has also contributed strongly to the work on thereduction of measles deaths globally. Again on the principleof early, robust action, US$ 139 million of IFFIm supportwent to the Measles Initiative in February 2007. Nearly 240million children will have been immunized against measles insupplementary campaigns in 2007. This is a very successfulinitiative, which has already seen a reduction in globalmeasles deaths from 480 000 in 2003, to an estimated170 000 in 2010. The vaccination campaigns do more thansave lives from measles; they also provide the opportunity forinsecticide-treated nets that protect against malaria to bedistributed, 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 healthychildren, IFFIm is contributing in valuable ways to building upthe bedrock of a healthy economy.IFFIm’s origins and its special context go back to the late1990s, when G8 governments looked back at the past 50years of giving, and recognized that what was needed was amore focused purpose. This resulted in the MillenniumDevelopment Goals. At the same time, Bill & Melinda Gateswere searching for a focus for their philanthropy. One of theanswers was immunization – and a new model for moreefficient delivery. Their initial US$ 750 million dollars giftfounded that model in 2000 – the GAVI Alliance. Six yearslater, that proven concept provided the match IFFIm neededfor the prompt execution of its funds. The Gates’ “demandingdollar” in many ways was the trigger for others, like GordonBrown, then UK Chancellor of the Exchequer, to pay closeattention to how to get better value for aid and to lead theinternational 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 bondoffering a good return. The bonds were priced comparably toother sovereign/supranational issuers, and the initial offer waswell over-subscribed with almost US$ 2 billion of demand.The defining difference – that which sets it apart from theothers – is IFFIm’s goal. It is not just an investment end inHealth extension worker 18-year–old Ajebush Wakalto (right)prepares to vaccinate young Brucktayet Teshome (far left, in hermother’s arms) at the local health post in Timbicho, Ethiopia. She,and 30 000 others like her in the programme, form the centrepieceof the health component of the country’s poverty reductionstrategy, bringing a range of health advice to local communitiesand providing essential basic preventive care, such asimmunization.itself. It has a greater purpose: one that allows bond investorsto give directly to the frontier of health care, one that hasinspired individuals and companies to work pro bono to bringthis idea to fruition. It makes a profound difference.The bonds were subscribed for not only by the traditionaltypes of investors such as central banks, pension funds,money managers, and insurance companies, but also, in areflection of its fundamental humanitarian purpose, byindividuals such as His Holiness Pope Benedict XVI.It is the hope and the intent of all of us who are associatedwith this new instrument that it will make the necessaryimpact. July 2007 was the mid-point in the MDG timeframe.It is generally acknowledged that progress towards the healthrelatedgoals is too slow and too little. Initiatives like theInternational Finance Facility for Immunization and the GAVIAlliance are two strong allies in the efforts to speed upprogress, confronting and offering solutions to the corechallenge of inequitable access. ❏Alan R Gillespie CBE, is Chairman of the International FinanceFacility for Immunization (IFFIm) and also Chairman of The UlsterBank Group, a subsidiary of the Royal Bank of Scotland plc.Following a 25-year career in investment banking with Citibank andGoldman Sachs & Co., he has been engaged in public service asChairman of the Northern Ireland Industrial Development Boardand as Chief Executive of the UK’s Commonwealth DevelopmentCorporation. He is a graduate of the University of Cambridge wherehe took his BA, MA and PhD degrees.References1.IFFIm’s sponsor governments include France, Italy, Norway, South Africa,Spain, Sweden and the United Kingdom. Brazil has announced itsintention to join. IFFIm issues triple-A rated bonds with a financial baseconsisting of long-term (10–20 years) legally binding commitments fromsovereign donors. The borrowings and risk are handled under prudentfinancial policies, with the World Bank acting as Treasury Manager.Goldman Sachs acted as Financial Advisor in establishing IFFIm andDeutsche Bank and Goldman Sachs lead-managed the inaugural bondissue.2.The GAVI Alliance was created in 2000 as a public-private partnershipaccelerating delivery of life-saving immunization to the world’s poorestchildren. 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 technicalagencies, public health institutions, nongovernmental organizations andthe GAVI Fund (the resource and funding arm of GAVI).3.GAVI’s “country-specific” programmes include the provision ofimmunization safety equipment such as single-use syringes and disposalboxes, as well as the provision of new and underused vaccines such asthose against hepatitis B, yellow fever, rotavirus and pneumococcaldisease.4.WHO projections.098 ✜ Global Forum Update on Research for Health Volume 4