Dagfinn with-baby Bangladesh GAVI 2011 Saiful-Huq-OmiIt is unfair and unjust that every 20 seconds, a child still dies of a vaccine-preventable disease. The GAVI Alliance is committed to saving children's lives by increasing access to immunization in developing countries. Since 2000, GAVI has prevented more than five million children from dying of vaccine-preventable diseases. It should be noted 1.3 million of the five million children lived in Islamic states.

GAVI's mandate is clear:, to create a world where life-saving vaccines are available to everyone who needs them, regardless of where they live. Historically, there has been a 15-20 year delay before a new vaccine reaches the poor in developing countries. The role of the GAVI Alliance, which consists of WHO, UNICEF, developing and donor countries, vaccine manufacturers and all the other partners, is to bridge that gap.

By the end of 2011, GAVI had supported over 70 countries in immunising an additional 326 million children, who might not otherwise have had access to vaccines. Of these, 143 million children were in 33 of the Organisation of Islamic Cooperation (OIC) member states. The five OIC countries that have received the most GAVI support to date are Pakistan, Bangladesh, Uganda, Nigeria and Afghanistan.

When I visited Bangladesh for GAVI's Board meeting in 2011, I met Rabbi, a female health worker who delivers vaccines in her living room in Bara Goan, a village 55 kilometers south of Dhaka near the Padma river. She fulfills GAVI's mission every day.

I watched as mothers waited patiently for Rabbi to register the weight, height, and health of their newborn babies. She then pulled life-saving vaccines out of a cold box. It took her five minutes to administer the vaccines against the biggest child killers in Bangladesh—pneumonia and diarrhoea.

Immunisation sessions like these are held once a week at Rabbi's house. In between, the health worker makes daily calls on the community's young babies to check on progress and ensure mothers do not forget immunisation schedules. During the monsoon season, when the rivers overflow, Rabbi uses a small paddleboat to reach her patients.

It is health workers like Rabbi who need GAVI support to continue to do their job on the frontline of immunisation. In addition to funding immunisation programmes, GAVI supports health systems strengthening programmes in countries (e.g. the training of health workers such as Rabbi) to ensure that vaccines are delivered where they are needed most.

Pakistan is the single largest recipient of GAVI funds worldwide, with US$316 million disbursed to date (2000-2011). With GAVI support, more than 36 million Pakistani children have been vaccinated and more than 320,000 future deaths prevented. Pakistan is expected to roll out the pneumococcal vaccine in September 2012. Between 2012 and 2020, GAVI support will help Pakistan immunise an additional 43 million children and prevent more than 800,000 future deaths.

Afghanistan is a country in transition. As the Afghans resume more and more responsibility for their own security, they will still need strong support and cooperation to build services for their people. Civil society organisations do much of the work of providing basic health services—as is the case in many fragile states.

I was inspired when I met Suraya Dalil, the recently appointed Minister of Public Health, in Kabul earlier this year. She is committed to strengthening health systems so that health workers can be trained to administer the childhood vaccines, even in remote areas.

Many of Afghanistan's children are difficult to reach in this war-torn mountainous country. Between 15 and 25 percent do not have access to immunisation services. Two thirds of the vaccinations are carried out through outreach and mobile services. However, DTP3 (three doses of diphtheria-tetanus-pertussis vaccine) coverage has been increasing substantially over the last 10 years thanks to a close partnership with civil society organisations and funding from GAVI. DTP3 coverage increased from 24 percent in 2000 to 66 percent in 2011, and child mortality dropped by 10 percent over the same period.

In 2011, GAVI extended its civil society support to Afghanistan and Pakistan to ensure that health system strengthening activities, and thereby service delivery, could continue uninterrupted.

Following GAVI's successful resource mobilisation meeting in London in June 2011—where donors pledged an additional US$4.3 billion - GAVI is now well-positioned to achieve an ambitious immunisation agenda. Its aim is to assist developing countries to immunise 250 million children by 2015 and potentially save four million more lives.

Middle East engagement

In 2011, His Highness General Sheikh Mohamed bin Zayed al Nahyan, the Crown Prince of Abu Dhabi, made a private donation of US$33 million to GAVI for 2011-2014. The funds, to be used to purchase the five-in-one pentavalent and pneumococcal vaccines in Afghanistan, were matched by an additional generous contribution from the Bill & Melinda Gates Foundation. I sincerely hope that other potential donors in the region will recognise the Crown Prince's inspired investment as a call to action. If one wants to ensure children lead a healthy life and become productive members of society, then immunisation is one of the most cost-effective investments one can make.

There is a growing need, from Islamic states, to introduce new vaccines to combat the two biggest killers of children under five in the developing world—pneumonia and diarrhoea. Given that Kuwait, Qatar, Saudi Arabia and the United Arab Emirates are the largest contributors for foreign humanitarian/health assistance in the region, they can each play a key role in expanding access to life-saving childhood vaccines in Islamic countries. The reality is that one in five children worldwide still misses out on life-saving vaccines each year. New funding contributions from the Middle East, both governments and the private sector, could really help GAVI fulfil its mission of reaching that fifth child.

Between 2012 and 2020, GAVI plans to more than double its previous investments to 3.4 billion U.S. dollars in OIC member states and immunise 400 million children with the support of existing and potential new donors from the public and private sectors.

GAVI's largest donors to date include the United Kingdom, the Bill & Melinda Gates Foundation, Norway, the United States of America, France, Italy, Austria, The Netherlands, Sweden and Canada. GHD