Gavi at 20: Lessons Learned from the World's Leading Vaccine Alliance | DAVOS 2020

20 years ago of the world countries are the ones who are getting the least vaccines. And so we needed to find the resources to get countries to adopt the vaccine. So that would be protected against diseases. Get me is the difference to blow bubble initiative of bring all the different players to work together to get immunization for the children of the world at the dramatic increase that happened over the years that followed illustrates how important initiative was and still is and we still need

is there sufficient funding for Gabby for the future of today and tomorrow Rachel block 4 minute to do so warm and in many ways as a role model. Gabby does this better than anybody is bringing all of those groups around a common table and having a shared Vision to move forward. I think that's the secret sauce of gavi. I think of you has done exceptionally. Well since Inception in 20 mm, it has immunized over 760 million children and young lives. This is for me a very special. Moment I said it but I think 50 years of existence.

I've got a soprano to discuss is celebrating its 20th birthday. I look like a child be we were actually super Midwife if I may say so. We're all sitting together baby gate to see doctor channel of the World Health Organization just promising forecast which has been made and immunization efforts, which we're living in poor countries are not fully. Demonized so we see gracious keep stuff from a blood sugar of 750 billion is of public-private partnership what high speed achieved in the last 20 years? I think it's all the

dreams which you may have had that's a time and what I particularly appreciate its not only like same way you are providing assistance is not characterized by But by being efficient and the Really applying suppress of managerial approach to to make sure as many children as possible can be integrated into a C vaccine efforts don't know video. Please. Try me in congratulating Gabby for its 20th anniversary. Thank you Professor Schwab. Good afternoon, everyone and welcome to the session on Garvey as it turns 20 as we just heard and you

saw in the video the Global Alliance for vaccine and immunization is a public-private partnership and it has was created 20 years ago and has done a tremendous job of having vaccinated 760 million people and save 13 million lies. It has done this to. Welcome. It has done this through being very single-mindedly focused on his mission to save children's lives and to protect everyone's Health by increasing immunization, especially in poor countries. So what has

been the key to success for Garvey? And what is the Future Future Vision as gavi enters its next phase panel and I'm very pleased to introduce the panel to discuss this very important questions and to my left is his Excellency Felix shisha cardi the president of the Democratic Republic of the Congo we have Set Berkeley Chief Executive Officer of Garvey. We have Christopher Elias president and the global development program at the Gates Foundation Hudson from Chief Executive Officer of sanofi.

And then and goes E mc wonja Eva Lou from Gabby. So maybe I will start asking a question with the president here. You have recently faced some challenges and dealt with some of these in your own country as it relates to outbreaks of vaccine-preventable diseases like measles and Ebola how have you handled those and what role has that means being able to play there for you? Message to the thermosphere location. Yeah, I don't dislike it under doctor's note. We organized the nurse agency emergency cell in my country and from 21

cases that time between 0 and 3 cases per day so I can say that the illness disappearing vaccinations and thanks to Rapid treatment for the real people. First as we saw the Gates Foundation has been a founder of gavi and 20 years ago. This was launched you have been involved in it yourself directly. What is the model that has made gavi as successful as it is? Thank you, sweetie and let me join others in wishing a professor Schwab. Congratulations on the 50th anniversary of the world

economic forum is celebrating David 20th anniversary the other organization that turns 20 this year is the Bill and Melinda Gates Foundation is it it was one of our first one of our largest and one of our best investments and it reflects, you know, it's hard to imagine where we were 20 years ago with under five child mortality almost double what it was is today and as Professor Schwab said the gavi model has been one of the best examples of analyze I've committed individuals

institutions partners coming together for common purpose to reduce under-5 child mortality. Largely through the prevention of vaccine-preventable diseases and Wild Bill and Melinda May Day of phenomenal generous gift in 20 years ago. It was really just to spark the alliance and to bring in many other partners governments you and agencies WHL UNICEF the World Bank where they are at the launch 20 years ago to say we all need to come together to solve one of the world's biggest problems and we've seen that happen. We seen the gavi model expand the

number of vaccines available to Children almost threefold in the last 20 years. We've seen it work with the industry to bring down the per vaccine prices dramatically in some cases and in some ways not by changing the profit motive of the industry, but providing clear signals about the demand about the supply what was needed from the industry so that they could shape their efforts in the development of vaccines. And the production of vaccines to me to Market a market that gavi Aggregates for the poorest countries of the world and through that helps to make

vaccines more affordable and available to children around the world to tremendous expansion in the number of children reach perfect scene Thor 2 million lives saved as a consequence in the last 20 years last generation. We've also seen important models in terms of financial sustainability the fact that God requires even the poorest countries in the world to co-finance according to their means and to ultimately graduate as they achieve the economic growth that preventing vaccine-preventable diseases house to fuel you see a model of sustainability with significant proportions of the

actual immunization cause now being born by countries themselves, and I think in the spirit of of the theme of today's conference one of the great things that he's accomplished, To reduce the inequity 20 years ago vaccines would come out of a robust pipeline of Science and Technology and quickly be taken up by the world's richest countries in the lag between those Innovations being available to children in rich countries and children in poor countries was about 15 to 18 years and growing in a society where we

see growing and equities in many dimensions. Davi has fought that tied and his reduce the inequities the rotavirus vaccine was launched in poor countries the same year. It was launched in rich countries. So I think it's a it's an incredible model. It's got some incredible challenge is left for the next 20 years, but I think we have a lot to celebrate today. But thank you for that since moving to you. Of course, you have been driving the engine behind the success, but as you look forward to the future what else needs to happen and what is the vision for Garvey? So thank you and letting

let me add my thanks to the Forum. I've been coming for a long time and and it's amazing how we bring together decision-makers and have them focus on these important problems, but it isn't only vaccine people. It's obviously people working across all of the different areas that can help drive forward this agenda. As Chris is just said the model is really interesting and has been successful. We've launched 433 new vaccines. We've been able to lift up coverage over 20 percentage points for the basic vaccine. But we are are we today well vaccines

are the most widely distributed Health intervention today 90% of children worldwide get at least one dose of vaccine as part of a routine vaccines system that last 10% though. Those are the ones two-thirds of those zero. Children are below the poverty line if they're not getting vaccines. Not getting any health intervention. So if they get sick, they're less likely to recover if they have an epidemic that starts in those communities. There's not the system to pick it up. So what we'd like to do is not just pivot but but continue the work to

really work with countries to try to focus in on those that are left behind and once we bring vaccine to them, of course, you got the secret is vaccines don't deliver themselves. So what we're bringing is a health worker a supply chain a date is System of a cold chain, and with that we really create that the kind of setup for universal health coverage and Primary Health Care, of course without prevention. We can't afford those types of health issues last thing I'd say on that is that not every country will be able to completely reform their health systems by 2030 the year the sdgs

are done, but we could immunize every child and that would make a dramatic differ. This is one of our main goals. Of course, we still want to continue to work on epidemics. We still want to make sure the new vaccines that come out we'll be there. But but that's the primary pivot that I'm going to try to do great and it's interesting because you talked about, you know, creating markets financing vaccines Innovation. So Paul and I guess you are representing the Innovation Park in The Upfront to actually having like seeing and what would you say from your standpoint in the overall

industry standpoint? Do you feel ready to be able to support that? I think the the success of Gabby is actually quite impressive because we I believe that we went from having vaccines for sixth disease is 218 diseases. So what else is industry able to do for the Future Vision? Thank you and let me have my congratulations together twinsies. Let me also add actually at congratulations for the Alaska at Bloomberg at public service award. I know how prestigious. Isn't it says a lot about the work that's being done. You mentioned in your opening

actually that I think it was 760 million at Patients vaccinated or immunized to end at 13 million child deaths avoided I'm the tragedy that wooden fold. But those who know I've been in the industry close to 30 years. I've only recently taken over eyes at the CEO of sanofi and I feel like a vaccine is a very special place. We have an incredible team that's in a few David love Sr team the world to do is exceptional not been in the industry. Long time. You ask a little bit about preparedness and Readiness and if we could time for second question which which ecosystem but up front as I told

manufacturing sites Meadow People, I'm staggered by the pool to action The Purpose Driven nature of the work is in this area. This is ready for me at least having been around. Anytime this is something above and beyond whilst does a huge amount of pride in what we do and Industry around medicines. There was a seems to be an extra Cooling and it can be everything from polio right through to influenza. There is a speed does a discipline. When is the next Twins because people know what's at stake and I think it's quite incredible the work. It's the first time that I've

worked with an organization such as shopping. And it pulls it must have been folded the time what it can bring together because it is one of those challenges account physically be solved by an individual contributor. It needs to collaboration. It needs to call to action unit 4 oz weed puts a full would you know tremendous opportunities for patients with yellow fever with cholera with all pennsylvanians wholesale to bring something to the Apostle David Bowie shows me actually it inspires me for other areas across the disease is what is

actually possible if you do it right now because I'm you and I'm enjoying the credible work that's been done. There is Tums to do for sure. You know, we all def the world's biggest producer of injectable polio vaccine. We have made of a 16 billion doses in the last 30 years of oral polio, you know, there was still work to do in Pollo itself. So there is something important about the ecosystem and if we get time I'd like to talk about how maybe we could be together,

So ngozi your of course the chairwoman of Garvey and there's a lot there that you are playing the role, but I think you bring a very interesting perspective from a development standpoint and also having being Finance Minister because as we heard the financing Aztecs were very well from your standpoint. What do you see that countries need to do in terms of making themselves actually prepared, you know for being that have sustainable at some point but off the process. Well, thank you very much Rita. Let me also join others in saying that this is a happy moment

in WeChat both the Forum and gavi are celebrating. I think we really need to think about it because this is a success story and in the world where there is so much uncertainty and people are you know, so dismal about many things here is one story of something working at scale so that we can talk about on your question about how to institutionalize is really important. One of the reasons. I was excited to join Gabriel's Church of the board is because it's an organization that wants to work itself out of a job. So ganzi try to get some stuff from the start as worked at 3 Sunset said

try to make sure countries are involved in managing and financing their own program. For instance in this next. We're going in 2021 to 2025 countries are going to pay 41% of the total cost of vaccines 3.6. Billion dollars and try to work with them in a progressive fashioned soda, increasingly take charge and until they they graduate so that's one of the things the way we work with that makes it possible. So it's not act like a sudden saying that you wake up overnight and silky now you're in charge of your own program. So that's one

Progressive taking about the financing and of course supporting them to mobilize more domestic resources so that they can pay for the vaccines. The other aspect of the finals is the country's being helped to negotiate with Pharmaceuticals. You know, we have a mechanism so that their vaccines can be affordable. So that's on the finance side one of the factors that even if you have the finals if you don't have the capacity on the ground to deliver that, you know, you need to have a whole value chain with the cold chain with the

workers, you know, so well Can with community-based organizations to deliver working with the government itself to deliver Civil Society? This is one of the aspects that is critically important as countries take over that capacity on the ground, but I think he's data, you know for the government to know that it is succeeding in reaching, you know, the right levels of immunisation fights children, whether if you're 81% as we have an average now would like to move to 95 so that the child we have enriched is covered. You have to have data you have to monitor

so building. Capacity to get good data is also very important. Thank you your Excellency to come back to you. So hard the panel talk about what Gabby has done and how they have done it. And also what countries can do so as you think about what you want to achieve in your country. What would be your ass? Cuz Garvey and others on this panel and how can they help you? What would we wear are the areas of need? Where are the gaps and what might you recommend as areas that we could develop in?

Thank you. I think that the shortcomings are to be found in the level of vaccinations become Pathways. It's a routine vaccination response vaccination when there is an epidemic are witches of intriguing about something which I think is very relevant EF the vaccines. I think the Price Is Right activity. Hi, I didn't leave you on the strength of international cooperation. So two interventions as such as the one provided like I'm Hayden, I think what we need to do is to Half Price is going down. So that countries are in a position to be able to procure.

I'm cooperation between different states said that this will be achievable pasta to be the champion in central Africa or blood oxygenation and I accepted on the 18th of every hour and a half to be involved in. So I'm coming from the area to mobilize and I think that we need to go from a vaccination rates are which in Congo is about 35% and I figured I'd like to see the figure rise to 70% I say we wanted to implement opening job all by universal mean that we will be able to reach out on to administer Primary

Health Gap Services. I provide those services but I will be able to have vaccinations are vaccines real there which will be administered Those Who coming on with the various illnesses as we speak now can address them of the points that the president has raised as well, but maybe I could ask you a crisp. What do you think in today's world of the fourth Industrial Revolution? How can technology actually help us to get to the next levels of challenges that we have both you and said to mention some of them I think

you Sarita. I think that Journey like any race to do anything important the last miles harder than the first Mile and you know, we said we've reached at least 90% of children with some vaccines we've reached about 80% of children with a full course. We still have dropouts kids who get their first coast and don't get the doses 2 and 3 and I think we need to take what has made davia success in the last 20 years that is innovation and continue to apply because those last ten to twenty percent of children are not like the first eighty to

ninety percent. They may be in a slum. They may be in a highly mobile family fleeing. What conflict they may be in a very remote area they may be in places where seasonal interruptions of the road Network prevent the vaccines from getting this is where Technologies from the fourth Industrial Revolution came out Agape started 20 years ago. We naturally work with the vaccine industry. But if you look at gavi partnership list today, it includes I met yesterday with the chairman of the NEC company in in Japan. They have a fingerprint ID technology that is being

used in a partnership with David to help track children so that we can find children who may be moving from one place to another from their first dose to their final dose of a vaccine. We work with a range of supply chain and logistics companies UPS others who are helping to bring their cutting-edge expertise and Tech tracking Technologies to understand. What's the best route to get around the flood that took out the bridge. How do we get the vaccines to the places? They're drone companies now involved in helping LeapFrog Geographic barriers to get vaccines into a

critical places a whole range of refrigeration and cold chain companies that are Are developing solar powered off grid long hold a Time Refrigeration to their vaccines which are perishable right there. They often need to be kept between 3 and 7 degrees Centigrade from the factory to the child. And if that was last children are in very difficult to place work places. We're going to need all of that technological. So it's not just increasingly working with the vaccine industry to capture The Cutting Edge of

science and technology for heat sensitivity excetera, but also working with a vast array of Corporations who can bring their expertise to solving this last mile challenge reaching those iradosa, Lauren and making sure that every child is reach gets the full dose in the full benefit of agave model and I would like to ask about this conversation around universal health coverage and how you think about that and the linkage of that and what you're trying to do and Gabi first of all, I meant the president because Chris and I are visited him last year and he brought all of the

provincial Governors and said you are responsible in a decentralized system. You have to make sure that we move forward in the fact that he's just said publicly again. I'm going to hold them accountable is really important. Of course, he needs technology. He has a very difficult geographic area issue. He talks about and pricing is important that the if you look at the 11 vaccines the WHL recommends they cost around $1,300. It's not exactly the same say in the US but similar vaccine right now, they're about $27 in Garvey and that's because we buy vaccines for

60% of the world's children and because we've been Go to work with the pharmaceutical sector to help us we have to make sure they're still profitable. And so the challenge has been to expand the number of Manufacturers. We've gone from a small number 512 now 17 different manufacturers creating healthy competition. And so that process needs to continue to go on but I'm excited about is has new diseases appear. The vaccine industry is on it and and brings us new vaccine. And that's one of the important issues. We're this year moving into our replenishment. We have to

raise at least to 7.4 billion dollars and that's to bring these new vaccines forward but to do this type of work and that's important, but they just quickly answer your question or belief is if you build that system out that Primary Health Care system, which is responsible for 85% of Health. There's some stuff that you needed tertiary centers for most of it can be done on the Primary Healthcare System if we can bring that Talk to every person in the DRC that is where we'll get the traumatic benefit and in a way as and cozy said by doing it with vaccine. We can actually

measure width of that system is really delivering adjust in change using the technology. Chris talked about to make sure that we're able to do it and that's how we can get towards success. Next event Coming Back To You Paul. I know you had a few things in mind that you wanted to discuss with specifically. Maybe you can also talk about where is the industry going from the future standpoint what Innovation and investment is the industry looking to make So I think we continue to push what we can in terms of breaking ground on

you science with challenge by Gabbie with challenge ride me so frosted sanofi, of course, we have a few things. I'd hourly in front of us. We have the process to help us with yellow fever which we think will bring benefits across the board and we have a hexavalent 6 in one of which one is an injectable polio vaccine which we know how critical that's going to be a cult. We also have a preventative the respiratory syncytial virus, which again is a worldwide epidemic of sorts and and we're

proud to be behind those things. I think the panel and others are right to say what are you doing next to where does it go does Excellency also raises the question on pricing which I think is very valid question. Continue in like I said to vaccines I'm struck by this very delicate balance and it is a delicate balance in ecosystem. How do we make sure that we are there when you need us with the volumes of the inventory that is ready to go to validate a new manufacturing facility

and then start to build inventory. And in this case you really at 6 she has enough if you have an outbreak of a Resurgence or a mutation of some form and that's a huge big investment. There's a bunch of course for lower prices and in some cases APUSH to hold $2 even to see what we get to and it's fine lines between building capacity for the long-term and getting the appropriate price of what I think is special about the Gabby relationship. But it does require long-term planning long-term thinking

to maintain the system because if you're not planning ahead and if you're not building a you lose that ability to move and help support and not because long-term pain during friend sample in long-term thinking we may see that as a big open question as we get to the polio coming up. So I think we'll check completely committed. I think Seth mentioned the the number of Manufacturers we know because of the way at 10 bring and price and volumes of gone. There's only really one manufacturer for measles and rubella now remaining

patients to that is acceptable over the long-term have to get that ecosystem. Right? So there are multiple players long-term long very long time thinking. To pull through the R&D. I'm from the industry and it's not easy right? I'm used to it, but I'm excited about how we can we can buy those things together. Yeah, I think the industry is critical obviously and they are new brakes coming out. So suddenly you have your challenge there ahead of you as an industry to be able to provide that Innovation. That is so needed ngozi. Maybe we can just take the learnings from Garvey and

from your inside and you know how might we be able to take this in a flight to the broader development contacts. There's a lot of conversation here at Davos as well as all year round that we are talking about we have the sdg goals. We have the 20 30 Milestone other earnings here that we can take and apply to other sectors and how might we go about it. Thank you very much. I think that you know that Godly model was a bit ahead of its time. It was something that you know, what set up at that time. I know it's

become kind of the type of model that the whole world is seeking to go. We should be seeking to emulate this multi-stakeholder approach to problems with recognize that none of this sustainable development goals can be attained without a multi-stakeholder approach working in silos a one sector without partnership can do is so Gabby and bodies this partnership with the private sector with civil society with governments both developing and developed countries. Everybody is it is in there and I think this is a big lesson for development. But what is good about garbage that

has shown that it can work just to give you an example this multi-stakeholder approach is that Lexi at mr. President spoke about the fact that they had the Ebola crisis and they were able to deal with it much faster. That was because we had been able to stop file this working with with with the private sector with the Pharmaceuticals. And so when that happened there was a stockpile ready to go if we we're not doing this partnership approach the Smokies pickle that type of thinking we wouldn't be able to do it till he has shown that it can still one

of the big problems we have in development is the lack of skill. We have lots of good pilot projects and examples everywhere. But how many times can we talk of reaching a billion people? That's what God is doing in the next 5 years will reach a billion children and we will save you no more than 20 million lives. So those two things are very applicable. The last point I want to make Gazi has a financial instrument called the international finance facility for immunization where we actually with government guarantees go to the market and we raise money on the

markets to help Finance. This is no spell applicable. Everybody's looking for Innovative approaches to financing options are going to do those three grounds is really got a model ahead of its time that we can use Yeah, I was also thinking of Education when I was thinking if we took some other like this and applied it to education. That would be a good foundation for the brother development. So we have a few minutes left and maybe since it is the celebration of the 20

years that I would come back to you to talk about. You know, we've talked about what God has done huge accomplishment. And what do you hope to do and what would be your ask of the stakeholders that I hear in. Was due help you get to that mission and what might be some specific areas that you want to go to sleep behind as pots that we could all take back. Such a one thing I want to say just before I answer that is in a we're celebrating us and the Forum it was here in 2015 at the event purchase commitment. Another Innovative financing was set up to make sure they'd be in a bowl of vaccine just

in case there was an outbreak and so when there was an outbreak and multiple in DRC, we were able to bring that vaccine forward. So important thing is people think about Garvey as a as a vertical initiative. We're about vaccines. That's it. But of course that's not true about health systems and Supply chains and you know, refrigeration and data systems and identity. And so the real question is how does the rest of the world help us get to these goals. These are noble goals. We have to work with industry sign about charity. How do we open new markets for industry?

How do we get to the bottom of the pyramid and be able to bring them in and I think to me this is what I'm excited about because the more we Can bring in the best technology from different sectors the more we can move forward in Rwanda today or blood is being delivered by drone if a woman goes and is hemorrhaging in a clinic in rainy season, how many units of blood there they are for her. There's no wasted and they're doing it for the price of a motorcycle delivery beginning to experiment with Thrones in the DRC in Ghana and other countries. These are examples of how technology

like the cell phone has LeapFrog. And what I need is help from all of the corporate Partners as well as the political leaders to move us forward in the movement. Great. It is interesting to hear the panel here because this is truly an example of a very good example of the multi-stakeholder approaching the public-private partnership and it's not just the business from the health sector, but it's really businesses across the sectors. You said from supply chain Industries those who can read The Last Mile and there many many Industries in

sectors who are actually providing all sorts of products in The Last Mile. So there's opportunity there for them to engage. I think the date of his that you talk about because he's very very critical to drive actually date. That didn't help us make the right decisions and know where the interventions need to come in. So it's that I want to thank the panel because the president has you know laid out very good explanations of way. You have sold some of the situations that you have faced you have others. You've got some great targets to double the Penetration of the vaccination and

we have here for you. The people who can make that happen. I think on the industry side suddenly the industry has been critical and delivered on the vaccination. Unfortunately, we do seen you without breaks coming out even this week. We've had some use item. So we do see challenges ahead of us and I think together we can really make all this happen. So I do want to congratulate Garvey on its 20th anniversary certainly for the world economic Forum, which is a very special moment having launched it on our platform 20 years ago, as you said ngozi. This may be ahead of its time, but this is

really showing us the way but which weekend do not only in the vaccination Arena, but also in other development goals, so thank you for your time and thank you very much.