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Why GAVI also needs health systems

I am at a meeting of the GAVI Civil Society Steering Group – a group of NGOs and community groups which advises the Global Alliance for Vaccines and Immunisation.

After the huge success of the Pledging Conference in London last month, we need to make sure donors also recognise the (much more difficult) challenge of building health systems in developing countries.

Save the Children threw its weight behind the GAVI Pledging Conference and, alongside many other NGOs and civil society groups, helped to ensure that the target for pledges was exceeded and $4.34billion was pledged on 13 June.


The fact that the GAVI board and donors recognise the important role that we all played needs to give us increased influence.  GAVI already has strategies and approaches which Save the Children strongly supports – see our report here.

They already see the need to help countries deliver vaccines, not just buy them.  This is why they are putting together a Health Systems Funding Platform.

Donor governments like the UK are very attracted to supporting vaccines because vaccines are clear, measureable products.

Vaccination is a quick intervention with lifelong benefits. The funding goes to a Geneva-based institution rather than straight to developing country governments. The donors can attribute specific results as a link between how aid money is being spent and outcomes.

More than vaccines

However, to improve child health, as well as to deliver vaccines, donors need to be doing things which are much more complicated and more challenging.

Historically, the UK has been a leader in getting donors to pool their money to support health systems. They led initatives like the International Health Partnership+ which aims to put funding behind government-led health plans.

Much of this is difficult to measure. It is risky as it gives money directly to the governments of poor countries. It is very hard to show results which can be attributed to UK money, especially as it is pooled with other money.

Functioning systems

However, it is incredibly important. Poor children in poor countries need functioning health systems, with enough staff properly paid, with sufficient funding and the right principles for universal access.

If these were in place, they would be able to ensure vaccination, maternal and newborn care, HIV treatments and deal with the thousand other problems that health services must cope with.

The money that GAVI has for this purpose is a small drop. Donors now need to take proper action to ensure sustainable health systems and accept that showing simple outcomes from their spending is not always possible.

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