26 – Graça Machel-Nelson Mandela dialogue

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Graça Machel-Nelson Mandela dialogue series


Copyright The Elders/2010/Jeff Moore

Zain kicked off by asking Graca Machel to describe the highlights of her role as an international advocate for women and children’s rights.

Graca described herself as a ‘simple African’ woman exposed to conflict as Education Minister in Mozambique.

Witnessing women and children caught in conflict and atrocities, she realised she was in a position to bring the world’s attention to her country’s plight.

Asked to name the biggest challenge in health, Graca pointed to the need to reach out as service providers to women and children at family level: is a pregnant mother attending clinic, is she being looked after. Local community leaders, she said, have to understand that it is in their interests to save mothers, wives, children.

Graca looked back on her time as GAVI Board Chair, describing the then GAVI Fund as a small organisation with a clear mandate to mobilise vaccines for everyone.

The beauty of GAVI came when it was transformed into an Alliance that has produced tangible results.

The other guests joined the dialogue widening the discussion GAVI’s and immunisation’s success:

Seth Berkley stated a focused mission, vaccines and the fact people in developing countries know first-hand the diseases vaccines stop.

Richard Sezibera cited his own country where a dedicated network of health workers has changed everyone’s lives.

Babatunde Osotimehin pointed to political will.

The discussion then shifted to sustainability with Graca stressing that Africa must take responsibility for health and education and stand on its own feet.

Babatunde raised concern that Africa’s current seven percent growth was based on extractive industry.

Seth noted GAVI’s co-financing and market-shaping approach to sustainability.

Richard agreed that the onus lay on developing countries to reach universal coverage but said the principle must be global not just African to ensure resources would be available.

Zain shifted the debate to improving supply chain capacity with Babatunde responding that developing countries need to draw on private sector expertise in supply chain management.

Seth added that GAVI was already working with Coca Cola in Ghana on supply mechanisms. Discussing other cutting edge approaches,

Richard said it would be important to use modern technology to reduce the transaction costs of delivering health. It should be possible, he said, to deliver first class healthcare with only a modest increase in health worker. Mobile phones could democratise health care by monitoring maternal mortality and training health workers. 

US$ 1 = US$ 18

A study in Health Affairs covering 73 Gavi-supported countries over the 2011–2020 period shows that, for every US$ 1 spent on immunisation, US$ 18 are saved in healthcare costs, lost wages and lost productivity due to illness. If we take into account the broader benefits of people living longer, healthier lives, the return on investment rises to US$ 48 per US$ 1 spent.

Ozawa S, Clark S, Portnoy A et al. Return on investment from childhood immunizations in low- and middle-income countries, 2011-20, Health Affairs 2016

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