Helen Evans, Deputy CEO of the GAVI Alliance addresses the 65th session of the WHO Regional Committee for South-East Asia in Yogyakarta, Indonesia
Thank you, Chair.
It was just over two years ago, at the World Health Assembly in 2010, when Dr Margaret Chan signalled that immunisation programmes had made an impressive contribution to reducing child deaths when she stated: “Over half of the (30%) drop in child mortality since 1990 is attributable to immunisation”.
I would like to congratulate the Member States and partners here today for the joint efforts to strengthen immunisation programmes. The declaration of 2012 as the “Year of intensification of routine immunisation” in the South-East Asia Region is an important milestone, and we look forward to our continued collective efforts in working towards achievement of the immunisation targets adopted in the regional framework.
Leadership and commitment
I would like to commend the Regional Director and the Member State delegates for their leadership and commitment to intensification of routine immunisation in the South-East Asia Region. While GAVI’s strategy focuses on accelerating the uptake of new and underutilised vaccines, at a broader level, any distinction between “new” or “routine” is rather artificial, especially if we consider what has been achieved in the region with pentavalent vaccines.
Since 2000, GAVI has supported 65 countries worldwide to bring into their routine immunisation innovative products like pentavalent.
Helen Evans, Deputy CEO, GAVI Alliance
I am delighted to also commend the Region for achieving and maintaining a polio free status since January 2011 – an incredible achievement – and we wish the Region well in the upcoming certification process.
Sustaining high immunisation coverage
As we have seen in many low and middle income countries, there are many challenges to increasing and sustaining high immunisation coverage, high quality data and surveillance and the ongoing commitment to maintaining this focus. This can be addressed through a broader alignment between immunisation programmes and health systems, as we know that health system strengthening, or HSS support, has a vital role to play in contributing to improved routine immunisation outcomes.
By the end of 2011, GAVI has provided US$358 million globally in direct support to health system strengthening (HSS), of which over US$36 million has been disbursed to the South-East Asia Region.
HSS linked to immunisation outcomes
I applaud country representatives and the Regional Director for the recent measures taken to make sure that GAVI HSS funding is more closely linked to immunisation outcomes. In the recent Annual Progress Reports submitted to GAVI, we have seen countries in this region taking steps to re-programme their health system grants to help strengthen routine immunisation activities.
For example, Bangladesh has prioritised certain districts to improve the immunisation programme. Similarly, Myanmar, DPRK and Sri Lanka have strengthened primary health care activities. Importantly, this is in close collaboration with local partners and civil society.
Since 2000, GAVI has supported 65 countries worldwide to bring into their routine immunisation innovative products like pentavalent – the 5-in-one shot which combines the traditional vaccines of diphtheria, tetanus, and pertussis with hepatitis B and Haemophilus influenzae type b. I am very pleased to note that seven of the nine GAVI-eligible countries in the Region have already successfully introduced pentavalent vaccines, with the remaining two, Myanmar and Timor-Leste, planning to introduce before year end.
Looking further ahead, we know that in much of the world, diarrhoea and pneumonia are two major killers of children under five. More than half of the GAVI-eligible countries worldwide have been approved for pneumococcal vaccine support, and almost as many for rotavirus vaccines. We would encourage countries in this region to consider whether these vaccines should be a priority in their contexts. We support country-driven approaches and recognise the central role of national leadership in the successful introduction of new vaccines.
Global Vaccine Action Plan
One aspect of the country-driven approach is inherent in the vision and strategy of the Global Vaccine Action Plan, or GVAP. The GVAP resulted from the Decade of Vaccines collaboration and recognises the powerful role that vaccines can and do play to improve health. GAVI – by which I mean the whole Alliance - supports this Plan, and GAVI’s programmes are central to its success.
GAVI has been instrumental in reducing the delay between when a new vaccine is available in high-income countries to when it is introduced into low-income countries, exemplifying one of the GVAPs principles of assuring equity in vaccine uptake.
Achievements of all
The Alliance is first and foremost a partnership: countries lead the vaccine uptake, integrating them into routine immunisation programmes built on stronger health systems and services. WHO ensures the quality and safety of vaccines through its prequalification system and for many countries. UNICEF procures the vaccines demanded by countries.
Collectively, GAVI pools demand, shapes the market and coordinates the contributions from partners and countries. The achievements of one are the achievements of all.
Year of intensification of routine immunisation
What will make this “Year of intensification of routine immunisation” a success will be the attainment of the targets set out in its Framework document, which will require careful monitoring of progress. The World Health Assembly agreed that each year Regional Committees should report on progress. Given that 85% of the 23 million children still unimmunised live in GAVI-eligible countries, GAVI is keen to work with this and other Regional Committees to make sure that this is a substantive process that provides an opportunity for countries to demonstrate the progress they have made in protecting their children against life threatening diseases.
The coordination and planning that you are all considering at this meeting calls for a special session at the next Regional Committee Meeting, ensuring a mechanism to track progress and build on your successes. GAVI stands ready to play a part in this process.