Immunization Independence

During the last couple of decades, international donors have invested billions of dollars in national disease-control programs and health systems, saving millions of lives. But now some of the countries that have benefited from such investments face a new challenge: how to sustain their gains after external support is withdrawn.

WASHINGTON, DC – The first years of this century have been heady ones for global health. International donors – whether national governments, such as the United States, through its PEPFAR program, or new international funding initiatives, such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria and Gavi, the Vaccine Alliance – have invested billions of dollars in national disease-control programs and health systems, saving millions of lives.

But now some of the countries that have benefited from these programs face a new challenge: sustaining the gains they have made once external support is withdrawn. Ultimately, it is on the basis of this transition that donors’ initiatives – and the health aid enterprise as a whole – will be judged.

Consider Gavi, the Vaccine Alliance. Founded in 2000 by a partnership of major donors, international agencies, and vaccine industry leaders, Gavi’s goal is to help the world’s poorest countries introduce new lifesaving vaccines and strengthen their immunization programs. When a country’s annual per capita income rises above a certain threshold – currently $1,580 – it becomes ineligible for Gavi support.

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