GAVI the Vaccine Alliance

GAVI, the Vaccine Alliance, is a global health partnership dedicated to increasing access to immunisation in low- and middle-income countries. Established in 2000, GAVI brings together public and private sector organisations to expand vaccine coverage, strengthen health systems, and ensure equitable distribution of life-saving immunisations. It plays a crucial role in global health security by addressing vaccine-preventable diseases and supporting pandemic response mechanisms.

Background and Establishment

GAVI was created in response to declining immunisation coverage in the 1990s, particularly in poorer countries where millions of children lacked access to essential vaccines. Its formation was driven by the need to mobilise resources, coordinate international efforts, and make vaccines affordable.
The alliance is a public–private partnership that includes:

• National governments of donor and implementing countries.
• The World Health Organization (WHO).
• The United Nations Children’s Fund (UNICEF).
• The World Bank.
• Vaccine manufacturers (both multinational and developing country producers).
• Research and technical agencies.
• Civil society organisations.
• The Bill & Melinda Gates Foundation, a founding partner and major donor.

Mission and Objectives

The central mission of GAVI is to save lives and protect people’s health by increasing equitable and sustainable use of vaccines. Its objectives include:

• Ensuring equitable access to new and underused vaccines.
• Strengthening health and immunisation systems to deliver vaccines effectively.
• Supporting financial sustainability of vaccination programmes in partner countries.
• Reducing disparities in vaccine coverage among different regions and populations.
• Responding to global health emergencies with vaccine-based interventions.

Funding Mechanism

GAVI operates on an innovative funding model that combines donor contributions with market-shaping strategies. Key mechanisms include:

• Donor pledges from governments and private foundations.
• The International Finance Facility for Immunisation (IFFIm), which raises funds by issuing bonds in capital markets backed by donor commitments.
• Advance Market Commitments (AMCs), which provide incentives for manufacturers to invest in vaccines for developing countries by guaranteeing purchase volumes.
• Co-financing by countries, ensuring that partner governments gradually assume responsibility for vaccine financing as economies grow.

Achievements and Impact

Since its inception, GAVI has made substantial contributions to global health:

• Immunised more than 1 billion children in the world’s poorest countries.
• Prevented over 17 million future deaths through vaccination programmes.
• Expanded access to vaccines for diseases such as hepatitis B, Haemophilus influenzae type b (Hib), pneumococcal disease, rotavirus, and human papillomavirus (HPV).
• Contributed to the eradication and near-elimination of diseases such as polio and measles in several regions.
• Reduced the price of vaccines in developing countries by fostering competition and securing bulk procurement agreements.

Role in Pandemic Response

GAVI has been a key actor in global responses to health emergencies:

• During the COVID-19 pandemic, it co-led the COVAX Facility, a global initiative to ensure equitable access to COVID-19 vaccines worldwide.
• Supported rapid distribution of vaccines to low-income countries that lacked purchasing power.
• Helped strengthen cold chain and logistics infrastructure for large-scale vaccine deployment.

Challenges and Criticism

While GAVI has achieved considerable success, it faces challenges:

• Sustainability: Ensuring partner countries can fully finance vaccine programmes once donor support tapers off.
• Equity gaps: Disparities remain in coverage within countries, particularly in remote and conflict-affected regions.
• Vaccine hesitancy: Misinformation and cultural barriers affect uptake in some communities.
• Dependence on donors: Heavy reliance on donor funding makes long-term planning vulnerable to shifting political priorities.

Significance

GAVI has transformed global access to immunisation by creating sustainable markets for vaccines, lowering costs, and building strong delivery systems. Its work has contributed significantly to achieving global health goals, including those outlined in the Sustainable Development Goals (SDGs), particularly Goal 3: Good Health and Well-being.