GAVI Alliance (Geneva)

Africa: Gavi Past, Present and Future - Seth Berkley's Opening Plenary

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With the Partners' Forum now officially up and running in Dar, Dr Seth Berkley delivered a visionary speech this morning touching on GAVI's past, present and future. Here are some key excerpts.

PAST

About the Baobab tree, the Forum's symbol: "the baobab tree has a special significance in Africa. It's revered. People gather under its branches to discuss important issues and talk to their ancestors.

This Forum is a time for us to come together and discuss. We should start with our founders and the question is how are we doing. I think we are living up to their vision. As of 2014, every single GAVI country will be using the DTP3 vaccine. It is a routine vaccine and that is what we are trying to do."

PRESENT

Rollout of pneumococcal vaccine: it's an extraordinary story that this vaccine (pneumococcal) was made available in developing countries about a year and a half after it became available in high-income countries.

The ultimate goal would be simultaneous introduction in north and south. That's what we want. Never again will a company have a life-saving vaccine and ask 'when' will it reach a developing country. The question should only be 'how'.

On the heroic efforts of health workers in developing countries: health workers do whatever it takes to get the vaccines out there ... camels, donkeys ... It's heroic. It's getting the vaccine into her hands so she can vaccinate and it's going to lead to healthy children in school."

FUTURE

The fully immunised child: WHO recommends that every child has 11 antigens: BCG, DTP3 (diphtheria-tetanus-pertussis), measles, polio, hepatitis B, Haemophilus influenzae type b, pneumococcal, rotavirus, rubella and human papillomavirus.

So should we be looking at DTP3 or the fully immunised child as an indicator of immunisation coverage? What we want is every child, everywhere protected by the full number of antigens.

Conceptually, this is where we want to go. If we want to do this, current estimates predict that by 2030, only 50 percent of children will be fully immunised. This is not good enough; we need to reset our aspirations.

Technology: we also need to use technology. Every village household has one cell phone in it and often two or more. Why is it that we are not looking at vaccine stock using GPS, so a flashing red light on an interactive map tells us immediately there is a stock problem in a local health clinic. This is not far fetched. This is what is happening in most of the world for supply chains. We just haven't used it in immunisation.

Inconsistency in immunisation data: can we measure immunisation rates? Our numbers really aren't very tight. We're shooting in the dark against a target, because we don't have the tools to really allow us to understand what is happening. This is a critical goal going forward.

Flowering of our effort: when we think about the field of immunisation, we're back to the (baobab) tree. We need to bring together all the critical parts of immunisation, to become part of routine immunisation. Something extraordinary will happen, we will see the flowering of this effort, and we will see something extraordinary happen.

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