Improving Universal Access to Immunization: The role of France and the EU

This is the fourth blog in our World Immunization Week Series, featuring a piece every day from a different ACTION partner. Today's blog is from Fanny Voitzwinkler (@globalhealthadv) and Bruno Rivalan, policy and advocacy managers at Global Health Advocates France (@GHA France).

It only takes one shot.

Immunization is widely known as a public health ‘best buy’. It saves lives, is cost-efficient, and is easy to deliver. But from conception to inoculation, the vaccine cycle can look like a long road full of obstacles.

First up is research: huge financial and human investments are needed to develop effective vaccines that can prevent children from contracting deadly diseases. It can take two decades to find the right vaccine candidate, have it extensively tested, and get regulatory approval to use it worldwide after it has been proven safe and effective.

And once effective vaccines are finally available on the market, countries need to ensure they can buy the magic bullets that will help their next generation thrive.  Unfortunately, the reality is that the costs of vaccines and vaccination are often far greater than what poorest countries can afford.

Back in 2000, an innovative partnership between civil society, industry, donors, governments and technical agencies known as the GAVI Alliance was created to address this particular issue. GAVI‘s first mission was to ensure that the poorest countries can enjoy substantial reduction on vaccines prices through pooled procurement and joint purchases.  Based on their income status, today 70 of the world’s poorest countries can access those negotiated prices and immunize their children against deadly diseases. A decade after its creation, GAVI’s model can be seen as a success story: 440 million additional children have been immunized.

Once vaccines prices are reduced for  the world’s poorest countries, the delivery and administration of the actual shots to the poorest children remains the sole responsibility of countries themselves. Here comes the final hurdle: ensuring purchased vaccines reach all children. Today, more than 22 million children around the world are still not reached with vaccines.

As simple as it may seem, vaccination is only one element in a much larger picture:  without infrastructure to keep vaccines cold, recorded data to see who is to be immunised, and a qualified hand to actually give the shot, reaching vulnerable and marginalized children will remain impossible.

All dimensions of a strong health system – including infrastructure, skilled health workers, effective information systems, and  good governance – are therefore crucial to deliver the magic bullets to each and every child.

If GAVI has made efforts towards strengthening health systems to date, there is much room for improvement. Ensuring strong coordination with all development partners at the country level, strengthening communities systems, harmonizing salaries and bonuses for health workers with the country systems, systematically integrating civil society in coordinating committees and grants proposals are elements that need to be increasingly taken into account by GAVI and its partners.

A growing number of recommended immunizations have contributed to the rise of vaccines and non-vaccines costs and now more than ever, we need global support to carry us through the three key moments of the vaccine cycle: research, purchase, and delivery. To ensure sustainable immunisation systems and ensure universal access to vaccines we know what is needed: long-term predictable financing, inclusive country ownership, strong health systems and affordable pricing at the core of immunisation programmes.

This year, GAVI will seek a replenishment of its funding from donors so it can continue its work for 2016-2020, representing an opportunity to accelerate political momentum on immunization. In less than a month, the European Commission will host the pre-replenishment conference in Brussels, which will gather Ministers and Presidents of donor and recipient countries from around the globe.

We hope that newer EU member states, which do not yet invest in global immunisation, will seize this opportunity to come forward and make their first pledge in favour of global health but the traditional donors are have also a responsibility

We are also disappointed that both France and the EU institutions are not keeping their promise by fulfilling their commitments and being ambitious enough in their support to the GAVI Alliance.

The French government cannot hide behind the economic crisis as an excuse for cutting its overseas development budget and ending programs that contribute to save children’s lives.

As for the EU institutions, being the third largest foreign aid donor comes with responsibility. Scaling up support for GAVI, and ensuring its support is predictable over the next year, is a bare minimum.  

With EU elections right around the corner, the EU and its member states should remember that human life is a value people will vote for, and that ensuring healthy lives for future generations outside Europe is a smart investment in Europe’s own development and stabilty. 


Global Health Advocates France works to build and strengthen political and financial commitment from the European Institutions and the French government around the three critical stages of the vaccine cycle. In order to reach universal immunisation coverage for all children, we work to ensure that France and the EU invest into research and development for new vaccines to better fight poverty-related and neglected diseases; are ambitious and invest more in the GAVI Alliance especially in light of its replenishment meeting at the end of 2014; and continue to put health systems strengthening at the core of their global health policies, address the shortage of human resources for health and strengthen community systems.