Vaccine Ping-Pong: GAVI and MSF’s Advocacy Campaign for Vaccine Access

MSF (Médecins Sans Frontières, also known as Doctors Without Borders) recently posted a set of three animated videos about child vaccines as part of their latest advocacy campaign. The first one, titled “We Need Better Tools to Save Lives” is pretty straightforward – it’s a basic explanation of what is needed to vaccinate children, how MSF struggles to fill that need, and a quirky analogy about what it is like to not have that need filled. Simple enough.

The second video is a lot more direct. The show how the number of vaccines in the standard childhood vaccination battery, as well as the cost of those vaccines, have increased in the last decade. The video then takes a direct shot at pharmaceutical companies for keeping vaccine prices high in order to prioritize profits over saving lives. The debate on drug prices is a heated one, and everyone seems to have their own opinion on what “fair prices” for drugs are, but it is clear where MSF stands.

The last video was the one I personally found to be the most interesting. “Dear GAVI, Please Let Us Access Your Discounted Vaccine Prices” talks about how qualified governments are allowed to access GAVI’s low vaccine prices, but NGOs are not given access to them. MSF provides a more detailed description of their perspective on the issue in this press release:

MSF is also troubled by the fact that non-governmental organizations and humanitarian actors are excluded from accessing the GAVI-negotiated price discounts. MSF is often in a position to vaccinate vulnerable groups, such as refugee children, HIV-positive children, and older unvaccinated children who fall outside of the typical age range for standard vaccination programs. However, MSF has not been able to systematically access the lowest prices negotiated by GAVI, having to resort to lengthy negotiations with Pfizer and GSK over the last four years to access the pneumococcal vaccine. While the companies have offered MSF donations, this is not a sustainable, long-term solution for MSF as we work to respond quickly to needs in the field, and wish to expand vaccination of vulnerable groups in an increasing number of countries.

GAVI responded to the MSF campaign in this statement:

First, we agree with MSF – we do all want the same things. We want all children everywhere to be protected by immunisation. In fact, GAVI is proud to include MSF as a member of the GAVI Alliance. They are an active member of the steering committee of the GAVI Board’s Civil Society Organisation Constituency.

MSF first formally raised the issue of access to the same prices GAVI pays for vaccines at the GAVI Board meeting in December 2012. This issue is currently being discussed through the Alliance’s Governance channels. We find it disappointing that MSF, which knows and is engaged in the GAVI Governance process, has chosen to take on this issue as a public campaign.

MSF then offered this statement in response:

Thank you GAVI for publicly acknowledging our request for access to your vaccine prices. MSF has been frustrated by bilateral discussions, which have been ongoing for a few years now, with vaccine manufacturers and the GAVI Alliance on finding a solution for humanitarian actors to access pneumococcal conjugate vaccine at the GAVI price, and we anticipate that accessing GAVI prices for other new vaccines (for rotavirus, HPV) will also be a challenge. We ask GAVI to fast-track this process so that MSF can vaccinate more kids as soon as possible.

We often talk about issues of coordination (or lack thereof) and collaboration between different aid groups and funding organizations in the wake of natural disasters and humanitarian crises. It is interesting to see this kind of friction between different groups who are trying to do exactly that because of how complicated it can actually be.



To protect children right now, we have to use vaccines that aren’t well suited to the job they have to do. Vaccines can’t take the heat — they have to be kept at between 35 and 46 degrees at all times. But we need to use them in some of the hottest places on earth. For this and other reasons, we need better-adapted vaccines to protect children from life-saving illnesses.



Children are now protected with 11 vaccines; up from six vaccines a decade ago. The price of vaccinating a child has sky-rocketed. It cost $1.37 to vaccinate a child 10 years ago, now it’s $38.80. That’s a whopping 2,700 percent increase. So how do we decide how many vaccines children need? Is it based on how much money you can make, or on how many children’s lives can be saved?



The price to vaccinate a child has risen by 2,700 percent over the last decade. Countries where Doctors Without Borders/Médecins Sans Frontières (MSF) works will lose their donor support to pay for vaccines soon, and will have to decide which killer diseases they can and can’t afford to protect their children against. MSF is asking the GAVI Alliance to open up their discounted vaccine pricing to humanitarian actors that are often best placed to respond to vaccinating people in crisis.

The GAVI Alliance is an international public-private partnership whose stated mission is to increase access to immunization for children in poor countries. GAVI co-finances the cost of vaccines with qualifying countries. Participants include governments of developing and donor countries, the World Health Organization, UNICEF, the World Bank, the vaccine industry, research and technical agencies, the Bill & Melinda Gates Foundation and other philanthropic organizations.

Global Health News Last Week

POLITICS AND POLICY

  • Attacks on aid workers are on the increase and one writer believes this largely due to the current “integrated mission” focus of the UN and other donors.
  • If the Global Fund is to avoid further adverse media coverage and further consequent donor nervousness, it must urgently implement a more effective and fine-tuned approach to the issues of corruption and transparency.
  • The families of two women who died in childbirth are starting a legal action against the government of Uganda, alleging that the inadequate care and facilities provided for pregnant women caused the deaths and violates their country’s constitution and women’s rights to life and health.
  • The results of a recent bombshell study revealing the impact of taking ARVs and the spread of HIV has the Obama administration doing some serious pondering over the impact of a policy change.
  • The elimination of mother-to-child transmission has become the focus of Rwanda’s ministry of health for reducing the rate of HIV.
  • The states in India have been directed by the central government to provide free healthcare to pregnant women and sick neonatal children effective June 1.
  • The Global Fund to Fight AIDS, Tuberculosis and Malaria has frozen payments on hundreds of millions of dollars worth of disease-fighting grants to China, one of the charity’s biggest recipients, in a dispute over China’s management of the grants and its hostility toward involving grass-roots organizations in public health issues.
  • Government think-tanks in China and India have recommended a jointly funded initiative to strengthen traditional medicine innovations in both countries.

PROGRAMS

  • In Ghana, the Oxytocin Initiative Project has begun testing whether community health workers can safely and effectively prevent postpartum hemorrhage.
  • ‘Tupange’ is the name of a new outreach program in Kenya that hopes to increase and sustain contraceptive use among urban women.

RESEARCH

  • Researchers discuss the new developments in vaccines for HIV/AIDS, malaria and TB in the scientific journal Nature.
  • Vuvuzelas – the horns used by football fans celebrating last year’s World Cup – not only cause noise pollution but may also spread diseases, say experts. In crowded venues one person blowing a vuvuzela could infect many others with airborne illness like the flu or TB. Mercifully, organisers are considering whether to ban them at the 2012 London Olympics.
  • Published by the Institute for Economics & Peace, the Global Peace Index tries to measure peace. This year has seen the world become less peaceful for the third year in a row – and highlights what it says is a continuing threat of terrorism.
  • It may be against the law, but wealthier, better-educated families in India are choosing more and more often to abort pregnancies if the child is female, researchers in Canada and India report in the Lancet.
  • Researchers at The University of Texas Health Science Center at Houston find that diabetics have a higher risk of contracting TB.
  • Lancet once called it “potentially the most important medical advance of the 20th century.” But today, oral rehydration therapy (ORT) — a simple treatment often consisting of a home solution of sugar, salt and water — is under-used, causing untold deaths of children.

DISEASES AND DISASTERS

TOTALLY UNRELATED TO ANYTHING ELSE: Apparently, to Nigerians, Bill and Melinda Gates do not look like rich people.