Gavi seeks to broaden GCC donor base

Vaccine alliance in talks to expand Gates-backed anti-poverty fund for health projects in Muslim countries, says board chair

Gavi, The Vaccine Alliance, the world’s biggest funder of vaccines for developing nations, is in early talks with the Islamic Development Bank to leverage an existing $2.5bn fund to boost its activities in lower-income Muslim countries.

Geneva-based Gavi hopes to use the blueprint behind the Lives and Livelihoods Fund (LLF) - a joint project between IDB and the Bill & Melinda Gates Foundation to reduce poverty and disease in 30 Muslim states - to extend financing for immunisation and to strengthen health systems in the Middle East, Africa and Asia.

“The fund very much reflects how we want to do business in the healthcare sector,” said Ngozi Okonjo-Iweala, chair of Gavi’s board and a former Nigerian finance minister. “We are in discussions with IDB and the LLF to see how we can be a partner in these efforts and extend their approach.”

The LLF uses a mix of loans and grant funding to unlock cheap finance for developing Muslim states. Over the next five years, IDB will lend up to $2bn for projects in health, agriculture and infrastructure. The Gates Foundation is raising $500m in grants to reduce the interest payments on these loans, putting in $100m itself. Qatar, Saudi Arabia, Abu Dhabi and the Islamic Solidarity Fund for Development have pledged sums totaling $300m.

“If we could scale this work up using concessional loans offset by Gavi grants, it could double or triple the funding available for the health sector. We could reach many more people,” said Okonjo-Iweala, during a visit to the GCC. Gavi would likely seek donations from both Gulf governments and the private sector, she added.

Gavi has succeeded in immunising almost 580 million children since 2000, averting more than 8 million deaths. Using funding from sources such as governments and the Gates Foundation, the alliance bulk-buys and delivers vaccine programmes in poorer nations unable to afford shots at market prices. According to Gavi, for each $1 spent on vaccines, $18 are saved in healthcare costs, lost wages and lost productivity.

Of the 73 countries Gavi operates in, 31 are Muslim-majority countries, including Yemen, Afghanistan and Pakistan.

"A lot of philanthropic dollars could be better channeled, if we develop the right instruments for donors"Gavi raised $7.5bn in 2015 to finance its activities from 2016 to 2020. It has also previously used sukuk – or Islamic bonds – to convert future donor pledges into cash-in-hand to help finance projects, with its debut issuance raising $500m in 2014.

The alliance plans to return to the Islamic bonds market in the near future, Okonjo-Iweala said, and is keen to see sharia-compliant instruments play a greater role in humanitarian funding.

“The [development] industry is not being nearly as innovative as it could be. We see a lot of financial engineering going on around the world, but it hasn’t yet intersected with philanthropy,” she said. “I think a lot of philanthropic dollars could be better channeled, if we develop the right instruments for donors.”

This could also help Gavi in adding more Muslim countries to the donor base for its vaccine programmes, after gaining first-time pledges last year from Saudi Arabia, Qatar and Oman. The three Gulf states promised a combined $38m in 2015, with Alwaleed Philanthropies - the foundation of Saudi's Prince Alwaleed bin Talal - giving a further $1m. Saudi Arabia last week released the first tranche of its $25m, five-year pledge, to help fund immunisation efforts in Yemen. The Gulf donor's pledges will be matched by the Gates Foundation.

A $33m donation in 2011 by Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi, was used to scale up immunisation drives in Afghanistan. The funding, which was also matched by Gates Foundation, helped drive a 7 per cent rise in vaccination rates to 2015, said Okonjo-Iweala.

“He is an extraordinary individual,” she said. “He genuinely understands the economic and human benefits of immunisation.”

Okonjo-Iweala last week visited Saudi Arabia, Qatar and the UAE in an effort to drum up further support for Gavi’s work. The alliance is seeking additional funding towards a $220m Ebola fund that aims to strengthen healthcare systems and Ebola vaccine stockpiling in countries including Guinea, Liberia and Sierra Leone; the three African states worst-affected by last year’s pandemic.

A second $300m fund will work to drive innovative solutions in the cold chain, and upgrade or replace equipment. Improving cold chain technology – which keeps vaccines refrigerated and stable from the manufacturer to the field – is critical to reducing vaccine wastage, and lowering costs. This is particularly true in developing nations where gaps in the cold chain are a hurdle to effective immunisation campaigns. Gavi has put in $50m and is seeking $250m more, said Okonjo-Iweala.

“Ebola showed us what can happen when healthcare systems are weak,” she said. “Wherever you are sitting in the world, you have to be willing to invest in strengthening them – and not in time of crisis, but beforehand. Prevention saves lives, and we need global support for this.”