GAVI, the Vaccine Alliance, in the current COVID-19 crisis
ALIFDO caught up with Jelena Madir, General Counsel of Gavi, the Vaccine Alliance. Lawyers from GAVI joined the ALIFDO membership earlier this year.
ALIFDO: Jelena, I imagine many of our members are not aware of what GAVI does. Can you enlighten us?
Jelena: Established in 2000, Gavi, the Vaccine Alliance aims to improve access to immunisation in the poorest countries of the world. Between its inception and the end of 2018, it has contributed to the immunisation of nearly 800 million children and has helped prevent more than 13 million deaths from vaccine preventable diseases. These impressive achievements are the result of the collective efforts of the Alliance partners. We are structured as a public private partnership, which brings together multilateral organisations such as the World Bank, the WHO and the UNICEF; the Gates Foundation; donor and implementing country governments; research institutions; civil society organisations and vaccine manufacturers. Each of these Alliance partners plays a unique role in achieving the underlying goal of improving access to immunisation in the poorest countries, and the Gavi Secretariat both funds and coordinates these contributions.
ALIFDO: In these times of crisis, what is Gavi doing specifically to help the international effort that is underway to manage the current COVID-19 crisis?
Jelena: With COVID-19 now reported in almost all Gavi-eligible countries, we are providing immediate funding to health systems, enabling countries to protect healthcare workers, perform vital surveillance and training, and purchase diagnostic tests.
Gavi Secretariat and its Alliance partners are also working to maintain ongoing immunisation programmes, in order to avoid future deaths resulting from a range of preventable diseases including measles, yellow fever, polio, meningitis, pneumonia and diarrhoea. This has been particularly challenging, given that a number of routine immunisation programmes have been suspended and vaccine supply chains have been disrupted. Finally, we are playing a central role in policy developments in order to ensure a global response to COVID-19 that is equitable and fair, so that once we have a vaccine it will be accessible to anyone that needs it.
ALIFDO: How are the lawyers in your team contributing to these objectives?
Jelena: Like probably all ALIFDO lawyers, right now we are juggling numerous urgent restructuring requests. For example, emergency budget reallocations in our countries have resulted in a higher risk of co-financing defaults and vaccine stock-outs, so we are looking at ways in which we can adjust the existing co-financing obligations. Similarly, we are having to revisit a number of grant and partnership agreements and have them reprogrammed for the acquisition of the likes of personal protective equipment (PPE) and infection prevention and control (IPC) activities. Of course, many of these programmatic changes require Board approval and we are therefore heavily involved in the drafting of Board papers and ensuing discussions.
In addition, we are playing a central role in structuring innovative financing instruments to fund the availability of the COVID-19 vaccine. One such instrument is the advanced market commitment (AMC), which entails guarantees -- typically from donor governments -- for an amount of funds to subsidise the purchase of an unavailable vaccine against a specific disease in developing countries. Generally, an AMC is used in circumstances where the cost of developing a new vaccine is too high to be worthwhile for manufacturers without a guarantee of a certain quantity of purchases. In exchange for this guarantee, participating manufacturers must commit to supply vaccines for the long term at a pre-agreed, sustainably low price that developing countries can afford. Gavi set up the AMC for the pneumococcal vaccine in 2009 and is now considering a similar mechanism for the COVID-19 vaccine.
The AMC would not be used to fund the actual development of the COVID-19 vaccine. Instead, it would be used to accelerate its availability by ramping up production and procurement in advance, while the most promising and suitable vaccines are still in development. Other financial instruments can be used to finance the actual vaccine development, such as Gavi’s IFFIm (International Finance Facility for Immunisation), which has been issuing vaccine bonds in the world’s capital markets since 2006.
Certainly an interesting time to be a lawyer in the global health space!
ALIFDO: Thank you for speaking us today. Stay safe!
Interview conducted by Christoph Sicking, ALIFDO.
May 2020.
Jelena: Established in 2000, Gavi, the Vaccine Alliance aims to improve access to immunisation in the poorest countries of the world. Between its inception and the end of 2018, it has contributed to the immunisation of nearly 800 million children and has helped prevent more than 13 million deaths from vaccine preventable diseases. These impressive achievements are the result of the collective efforts of the Alliance partners. We are structured as a public private partnership, which brings together multilateral organisations such as the World Bank, the WHO and the UNICEF; the Gates Foundation; donor and implementing country governments; research institutions; civil society organisations and vaccine manufacturers. Each of these Alliance partners plays a unique role in achieving the underlying goal of improving access to immunisation in the poorest countries, and the Gavi Secretariat both funds and coordinates these contributions.
ALIFDO: In these times of crisis, what is Gavi doing specifically to help the international effort that is underway to manage the current COVID-19 crisis?
Jelena: With COVID-19 now reported in almost all Gavi-eligible countries, we are providing immediate funding to health systems, enabling countries to protect healthcare workers, perform vital surveillance and training, and purchase diagnostic tests.
Gavi Secretariat and its Alliance partners are also working to maintain ongoing immunisation programmes, in order to avoid future deaths resulting from a range of preventable diseases including measles, yellow fever, polio, meningitis, pneumonia and diarrhoea. This has been particularly challenging, given that a number of routine immunisation programmes have been suspended and vaccine supply chains have been disrupted. Finally, we are playing a central role in policy developments in order to ensure a global response to COVID-19 that is equitable and fair, so that once we have a vaccine it will be accessible to anyone that needs it.
ALIFDO: How are the lawyers in your team contributing to these objectives?
Jelena: Like probably all ALIFDO lawyers, right now we are juggling numerous urgent restructuring requests. For example, emergency budget reallocations in our countries have resulted in a higher risk of co-financing defaults and vaccine stock-outs, so we are looking at ways in which we can adjust the existing co-financing obligations. Similarly, we are having to revisit a number of grant and partnership agreements and have them reprogrammed for the acquisition of the likes of personal protective equipment (PPE) and infection prevention and control (IPC) activities. Of course, many of these programmatic changes require Board approval and we are therefore heavily involved in the drafting of Board papers and ensuing discussions.
In addition, we are playing a central role in structuring innovative financing instruments to fund the availability of the COVID-19 vaccine. One such instrument is the advanced market commitment (AMC), which entails guarantees -- typically from donor governments -- for an amount of funds to subsidise the purchase of an unavailable vaccine against a specific disease in developing countries. Generally, an AMC is used in circumstances where the cost of developing a new vaccine is too high to be worthwhile for manufacturers without a guarantee of a certain quantity of purchases. In exchange for this guarantee, participating manufacturers must commit to supply vaccines for the long term at a pre-agreed, sustainably low price that developing countries can afford. Gavi set up the AMC for the pneumococcal vaccine in 2009 and is now considering a similar mechanism for the COVID-19 vaccine.
The AMC would not be used to fund the actual development of the COVID-19 vaccine. Instead, it would be used to accelerate its availability by ramping up production and procurement in advance, while the most promising and suitable vaccines are still in development. Other financial instruments can be used to finance the actual vaccine development, such as Gavi’s IFFIm (International Finance Facility for Immunisation), which has been issuing vaccine bonds in the world’s capital markets since 2006.
Certainly an interesting time to be a lawyer in the global health space!
ALIFDO: Thank you for speaking us today. Stay safe!
Interview conducted by Christoph Sicking, ALIFDO.
May 2020.
