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Despite the international community’s commitment to ensuring universal access to health by 2030, vaccine inequity persists.
Even today, at least 2 million people still die every year from diseases that could be prevented by vaccination.
Globally, 14.3 million children have not received any routine vaccines, rising to one in five children in low-income countries.
At the height of the COVID-19 pandemic, 70% of vaccines were administered in wealthy countries, as opposed to 0.3% in the poorest countries.
The African continent has only 13 vaccine-manufacturing companies, covering at most
1% of its population’s needs and making it dependent on the goodwill of other nations.
These vaccine inequities impact the lives of millions of children, women and families worldwide and reinforce the North-South divide. Unequal access to vaccines also creates the conditions for the emergence of pandemics, with well-known knock-on consequences.
And yet vaccination is one of the most cost-effective solutions for improving the health and future of populations.
Over the past 50 years, vaccines have helped prevent at least 154 million deaths worldwide, thanks to progress in research and international cooperation.
This action in favor of equitable access to vaccines must be continued and strengthened.
This is precisely the mission of Gavi, the Vaccine Alliance, an international partnership that aims to support the vaccination of 500 million children between 2026 and 2030. At the Global Forum for Vaccine Sovereignty and Innovation, co-organised on 20 June 2024 in Paris by France, the African Union and Gavi, the partnership announced that 9 billion dollars would be needed to achieve its mission.
The Forum also saw the launch of the African Vaccine Manufacturing Accelerator (AVMA), an initiative aimed at producing vaccines "made in Africa".
Throughout 2024, efforts will be made to meet the financial needs identified on 20 June and thus accelerate the achievement of the Sustainable Development Goals in health.
Will France and the international community rise to the occasion ?
Discover our special report on vaccine inequity around the world.
On 20 June in Paris, France, the African Union and Gavi organized the launch event for Gavi’s replenishment campaign. The Alliance presented its funding requirements for the period 2026-2030, aimed at fighting at least 20 diseases and support access to immunization programs in 54 countries.
Gavi’s 2026-2030 Investment Opportunity details the need for $9 billion, including $1.7 billion for the International Finance Facility for Immunization (IFFIm), to immunize an additional 500 million children by 2030, saving 8 to 9 million lives.
2.4 billion dollars have already been pledged by contributing governments and philanthropic organizations, including 1.58 billion from the United States and at least 813 million from France. The Gavi replenishment will continue throughout the year, during which public and private donors will be invited to make their financial contributions. The final replenishment event is scheduled for late 2024 or early 2025.
The Forum for Vaccine Sovereignty and Innovation also marked the launch of the AVMA (African Vaccine Manufacturing Accelerator) initiative, which aims to support the African continent in producing its own vaccines. As part of this initiative, commitments of $1.2 billion to AVMA were confirmed by the international community, including $318 million from Germany, $233 million from the European Commission, $150 million from Italy, $150 million from the United States and $100 million from France. Around $1 billion of these commitments came from the reallocation of funds initially earmarked for the Covax initiative, which ended at the end of 2023.
In the last 50 years, vaccines have helped to avert at least 154 million deaths worldwide. However, there are still major disparities in access to vaccines between countries.
Gavi, The Vaccine Alliance, is a partnership established in 2000 between governments, WHO, UNICEF, the World Bank, the Gates Foundation, the pharmaceutical industry and health research institutions to improve access to vaccines in the poorest countries. The organization supports vaccines access for more than half of the world’s children against 20 infectious diseases.
Gavi accelerates vaccine coverage in the poorest countries by grouping demand for vaccines with suppliers ; guaranteeing sustainable financing ; and "shaping" the vaccine market like a global purchasing facility. Gavi also helps to improve global health security by supporting health systems strengthening and responding to epidemics. Today, a child born in a Gavi-supported country is 70% less likely to die before their fifth birthday than in 2000.
Gavi has demonstrated its ability to respond to emerging health threats through rapid, coordinated action with its partners. Since 2022, the Alliance has been closely monitoring the Mpox epidemic and has taken a number of steps to respond. In June 2024, its Board of Directors approved the creation of a global stockpile of Mpox vaccines, in collaboration with WHO and CDC Africa. Gavi is also supporting the response to the epidemic in the DRC and neighboring countries, while investing in innovative mechanisms and training to strengthen future responses. However, the pursuit of these efforts remains dependent on the funding Gavi will receive to implement its next strategic phase.
One of Gavi’s cross-cutting objectives is to the health systems of the countries it supports. Between 2021 and 2022, Gavi invested over $1.3 billion in health systems strengthening.
In response to climate change, which contributes to the spread of certain diseases, Gavi has also heavily invested in vaccines against « climate-sensitive » diseases, including cholera, meningitis, yellow fever, and more recently, malaria.
Gavi aims to focus on the poorest countries and seeks to empower them to eventually fully cover immunization costs according to their means. In this way, Gavi now supports 54 countries, compared to 73 at its launch in 2000.
The exponential debt of the poorest countries, ongoing polycrises, and the contraction of resources in industrialized countries pose concrete risks to immunization efforts. Today more than ever, it is crucial for the international community to mobilize funding and respond to these global challenges.
During the previous Gavi replenishment in 2020, 31 governments and eight organizations collectively pledged $8.8 billion to fund Gavi’s 2021-2025 strategy and the fight against COVID-19. The top contributors were, in order : the United Kingdom ($2.1 billion), the United States ($870 million), France ($813 million) and Norway ($796 million).
Since 2021, these contributions have already enabled more than 130 million children to be vaccinated, averting 2.4 million deaths.
Gavi has also developed several "innovative" financing instruments to carry out its activities, aiming to diversify sources of funding and mobilize more funds from the markets. These currently account for about a quarter of the Alliance’s total funding.
Among these innovative mechanisms, the International Finance Facility for Immunisation (IFFIm) was set up to ensure Gavi’s funding is stable, flexible and sustainable. It operates by issuing bonds on the capital markets ("vaccine bonds") in partnership with Gavi and the World Bank. Between 2006 and 2023, IFFIm generated funding for 18% of Gavi’s programs.
At the presentation of its new investment opportunity, entitled Gavi 6.0, Gavi will outline its replenishment target. It is likely the replenishment goal will be higher than in 2020 given the challenges to be addressed between 2026 and 2030.
The event on June 20 also marked the launch of the AVMA, or Accelerator for Vaccine Production in Africa. This mechanism will financially support regional vaccine production on the African continent by providing up to one billion dollars over the next ten years.
About 99% of vaccines administered in Africa are not produced on the continent. During the COVID-19 pandemic, this lack of vaccine sovereignty resulted in a considerable delay in the roll-out of immunization campaigns: by the end of 2021, 9 % of the African population had been vaccinated, compared with 48 % of the world’s population. Currently, the African continent has 13 vaccine manufacturers spread across eight countries, of which only four are in sub-Saharan Africa: Senegal, Nigeria, Ethiopia and South Africa.
The creation of new vaccine manufacturers on the continent involves tackling several challenges, such as investment in human capital, technology transfer and entry into a competitive global market.
The AVMA is specifically intended to address this last point, through two types of funding designed to offset certain initial production costs, which can be high for new market entrants. This incentive financing will particularly focus on manufacturers of priority vaccines for the African continent, such as against cholera, malaria, measles-rubella and Ebola.
