With Global Leadership, Gavi Aims To Vaccinate 500 Million Children By 2030

The ice and snow that blanket Pakistan’s Khyber Pakhtunkhwa province in winter are no match for Zubaida Bibi. The proud frontline health worker is on a self-described mission to “save the future of our children” from polio.

In 1988, there were 350,000 estimated wild polio virus (WPV) cases in more than 125 countries. Last year, there were just twelve WPV1 cases in two countries–Afghanistan and Pakistan.

Bibi can still remember a time when parents used to hide their children from health workers. “I got to know the community very well, built their trust,” she explained to the Global Polio Eradication Initiative (GPEI). Now, some parents ask for her by name to vaccinate their children.

A few months back, I shared a story about one of the greatest global health successes of the past 30 years: the reduction in child mortality. Much of this success can be traced to vaccinations and people like Bibi who walk door to door through the scorching heat and freezing cold to meet parents where they are and explain the life-saving benefits of vaccines.

While many organizations play a critical role in vaccinating the world’s most vulnerable, few have done more to save lives than Gavi, The Vaccine Alliance. Gavi has unveiled an ambitious five-year plan to immunize 500 million children and save 8 million more lives by 2030. Here’s what it could mean for the future of global health.

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The History Behind Gavi

In the 1950s, the world experienced a smallpox outbreak that affected nearly 60 countries. The World Health Organization (WHO) was still in its infancy, but by 1980, smallpox became the first infectious disease to be eradicated. That incredible achievement inspired global health advocates to ponder what other diseases could be tackled next. The 1980s represented a vaccination boom against diseases like polio and measles, but progress was short-lived. As populations grew, vaccines did not keep pace. Issues surrounding equity made some vaccines available in the Global North, but not in the Global South—the same problem happened with therapeutics in the AIDS fight.

At the 1990 World Summit for Children, public and philanthropic sector leaders, including the United Nations Children’s Fund (UNICEF), the United Nations Development Programme (UNDP), The Rockefeller Foundation, the World Bank and the WHO came together to launch the Children’s Vaccine Initiative. Over the next decade, this partnership worked to increase vaccine coverage for diseases, including tuberculosis, polio, and measles, catalyzed vaccine research, and spurred coordination around vaccine supplies.

In 2000, the Children's Vaccine Initiative gave way to the Gavi Alliance, now Gavi, the Vaccine Alliance (Gavi), a transformative public-private partnership that aimed to save lives and protect people's health, especially children. To date, Gavi has allocated roughly $23 billion towards increasing global immunizations in low-and middle-income countries thanks to generous contributions from donors, including the United Kingdom, Norway, and the United States, as well as the Gates Foundation (Disclosure: (RED), the organization that I lead is a Gates Foundation grantee).

Gavi’s Impact

Since its creation in 2000, Gavi has helped vaccinate over 1 billion children in the world’s poorest countries, preventing more than 17.3 million deaths. It vaccinates against 20 diseases ranging from measles to Human papillomavirus (HPV).

In recent years, the organization has also evolved to address the growing nexus between climate change and global health. As temperatures rise, Gavi has been on the front lines, combating waterborne diseases like cholera and animal driven diseases like yellow fever and malaria that thrive in warmer climates.

There’s plenty of work to do. While HPV vaccine coverage for girls has risen steadily since 2020, COVID-19 posed a major setback for immunization coverage as a whole. This summer, the WHO and UNICEF presented new data showing 2.7 million additional children are unvaccinated or undervaccinated compared to pre-COVID-19 levels in 2019. In 2022, over 14 million children missed out on life-saving diphtheria, tetanus, and pertussis (DTP) vaccines and another roughly 6 million children were only partially vaccinated.

“The latest trends demonstrate that many countries continue to miss far too many children,” said UNICEF Executive Director Catherine Russell in a statement. “Closing the immunization gap requires a global effort, with governments, partners, and local leaders investing in primary healthcare and community workers to ensure every child gets vaccinated, and that overall healthcare is strengthened.”

What’s Next?

Earlier this year, Gavi launched its case for investment titled “Protecting Our Future.” The roadmap outlines the organization’s strategy through 2030 and calls for at least $11.9 billion in funding to put Gavi on a path to vaccinating half a billion children over the next five years. To date, Gavi has received roughly $2.4 billion in pledges. This includes a $1.58 billion pledge from the United States over the next five years, an 8% increase from America’s last replenishment pledge.

As part of its plan, Gavi also announced the creation of the African Vaccine Manufacturing Accelerator (AVMA). One of the many important lessons coming out of the coronavirus pandemic was that African countries cannot count on the world’s wealthiest countries to equitably share vaccines. Africa accounts for nearly one-fifth of the world’s population, but by January 2022, it had received just 6 percent of all COVID vaccines produced, leaving millions of African frontline workers, seniors, and immunocompromised individuals vulnerable. The AVMA aims to invest $1.2 billion to scale vaccine production on the continent.

Gavi’s aggressive fundraising will ultimately culminate in a final pledging event–likely sometime in the spring 2025. This will be a major global health moment, the first of several over the next year as the Global Fund to Fight AIDS, TB and Malaria will also host its replenishment in 2025. While these two organizations have distinct missions, the future of global health is dependent on both of them having the resources they need to provide simple, cost-effective global solutions to ensure universal access to disease prevention and treatment.

Hope For The Future

In recent years, vaccines have attracted renewed attention, resurfaced painful past wrongs, and have sparked issues around misinformation, inequity, and injustice. Zubaida Bibi is an example of how global health advocates can slowly build community trust and support for vaccines.

“I know every pregnant woman and can tell you when she is due. Now, mothers regularly ask me about the next vaccination campaign,” she said.

What workers like Bibi will work on next after polio remains unclear. What’s for certain is that Gavi and its frontline workers remain some of the world’s best hopes for protecting children from devastating diseases and preventing future outbreaks before they become pandemics.