The seeds of Gavi's mission were sown in the nineties when immunisation rates in poor countries stagnated - less than 10 years after global vaccine coverage had soared to unprecedented levels
When WHO founded the Expanded Program on Immunization (EPI) in 1974 to deliver basic vaccines to developing countries, global immunisation rates barely registered five percent. By 1990, thanks to WHO and UNICEF's Universal Childhood Immunisation campaign, a remarkable 80% of the world's children were being immunised with the six EPI vaccines -- tuberculosis, diphtheria, tetanus, pertussis, measles and polio.
Sadly, in the 1990s, this progress ground to a halt as child immunisation was overtaken by other donor priorities. Suddenly, developing countries were struggling to maintain vaccination campaigns and pharmaceutical companies had no incentive to invest in supplying vaccines to the poorest parts of the world.
30 million children not immunised
By the start of the new millennium, children born in industrialised countries were receiving an average 11-12 vaccines; their counterparts in poor countries could count on half that number. Nearly 30 million children in developing countries were not fully immunised.
Newer more expensive vaccines routinely given to infants in the rich world - such as the hepatitis B (HepB) and Haemophilus influenzae type b (Hib) vaccines - were reaching virtually none of the world's poorest children.
With serious questions being raised about the future of vaccination efforts, the head of the World Bank James Wolfensohn convened a summit of WHO, UNICEF, academics, health ministers, international agencies and the pharmaceutical industry in March 1998.
Their agenda: how to start getting vaccines to children who needed them most.
Six months later, Bill and Melinda Gates added to the momentum by hosting a dinner at their home for leading scientists to discuss what could be done to overcome the barriers preventing millions of children from receiving basic vaccines. Bill and Melinda challenged their guests to come back with proposals for "breakthrough solutions."
In March 1999, a second summit at Bellagio in northern Italy provided the answer to the Gates' challenge. Rather than setting up a new international organisation, the existing major players in global immunisation - the key UN agencies, leaders of the vaccine industry, representatives of bilateral aid agencies and major foundations - agreed to work together through a new partnership: the Global Alliance for Vaccines and Immunisation (Gavi, the Vaccine Alliance).
The Vaccine Alliance's dream of delivering vaccines to millions of the world's poorest children moved a step closer to reality in November 1999, when the Gates Foundation pledged US$ 750 million over five years to Gavi. Two months later, in January 2000, Gavi was formally launched at the World Economic Forum in Davos, Switzerland.