IndiaPost.com - GAVI earmarks $350m to immunize poor children in India

India Post News Service

NEW YORK: For a country that manufactures and delivers the largest number of life-saving vaccines in the world, India, ironically, is home to over 40 percent of the world's unimmunized children.

To tackle this staggering problem, GAVI Alliance, a unique, multi-dimensional global partnership, has reached out with philanthropic funds to supplement the Indian governmental initiatives in this direction. GAVI has earmarked $350 million to be spent in India over the next four years, as part of its commitment of $3.2 billion towards vaccines, immunization, and health system strengthening initiatives in more than 72 countries, since its inception in 2000.

And trying to strengthen GAVI's commitment to India by encouraging corporate philanthropic funding is Boston-based Karun Rishi, President of the USA-India Chamber of Commerce (UICC), and a 'Friend' of GAVI Alliance.

Through the UICC, Rishi has been working closely with the Indian biopharma and healthcare industry for the last couple of years by organizing high profile summits, attracting participation from top industry executives, policy makers and academia. Recognizing that India presents a challenge and an opportunity for philanthropic investment, and the willingness among the Indian American business community to give back to their native country, Rishi has joined hands with GAVI Alliance.

"At GAVI, they fully support and believe in what they are doing," Rishi told India Post, explaining the reason for his involvement with GAVI. "In terms of results they are phenomenal." So far, GAVI has vaccinated up to 180 million children worldwide. "There are people who simply talk of planning to do such things, but with GAVI this has already been done," says Rishi.

"Net result is the 180m children that they have vaccinated, has actually prevented close to 3 million premature deaths so far. That's a lot of lives saved." Rishi says that in a developing country like India, which boasts of 8-9% GDP growth, revolutionary growth in hi-tech sector, etc., it's shocking that almost 40 percent unimmunized children in the world are in India.

Rishi is involved with GAVI in his individual capacity and puts the UICC to good use for encouraging Indian and Indian American corporate houses to contribute to GAVI. "At the last Bio-pharma summit, GAVI had a strong presence.

We had 42 top-tier companies and their senior-most executives participating including the chairman of Dr Reddy Labs. As UICC, when we liaise between such senior level executives and GAVI, it makes a lot of difference." Although there are numerous well-intentioned organizations working in the healthcare sector in India, Rishi says the problem of child immunization in the country is too huge to be tackled on a small scale.

"When we talk about 40% unimmunized children globally living in India, you need an institutional approach. It has to be tackled in a structured manner and GAVI does have a very robust management structure to take care of such a situation like in India. They have very strong partners they work with in India."

Significantly, the Serum Institute of India, the world's largest producer of measles and DTP group of vaccines, partners with GAVI Alliance. It is estimated that two out of every three children immunized in the world is vaccinated by a vaccine manufactured by Serum Institute of India. Its products are used in 140 countries across the globe.

Despite the mammoth scope of GAVI's operations, Susan Drake Swift, Senior Director, Strategic Marketing and Communications for GAVI Fund's Private Philanthropy Team assures India is a huge priority for the organization. "India has got more than 10 million unimmunized children and most of those are in the states of Bihar and Uttar Pradesh," she told India Post.

"Our Board last November decided to spend $350m in India. It's a big investment for us." In each of the 72 countries that it works in, GAVI supports programs already designed by the respective governments. "It's very much a country-led effort, but the effort is informed by what we have learned in other countries about what works," explains Swift. "For instance, when GAVI talks to the Indian health minister, it knows that India is a much bigger player than GAVI is.

The $350m GAVI funding is perhaps small change to India's entire budget, but it is catalytic funding to help them get basic immunization particularly in those two states. It's for India to decide on how they help those two states and on what kinds of support within $350m cap to seek from us."

In addition to the government being in the driver's seat, around the table is a group that combines inter-agency, civil society, business community, local world health officials, UNICEF, etc. "It's a very GAVI-like organization, its not top down," she explains.

Talking about how he approaches corporate houses to contribute to GAVI, Rishi says, "End of the day there is a common goal -- whether you are talking corporate Indian Americans or corporate America or corporate India -- you want to make sure that the benefit actually goes to the person who needs it. It's not like just giving money, there are many such mom & pop shows.

Anyone giving money to GAVI is ensured that it's going for the right cause." Rationalizing the ever increasing divide between the rich and poor in India, Rishi says, "India is not a socialistic country, it's a capitalistic country on a socialist platform, so rich become richer and poor poorer. But if you see, research, education and healthcare budgets in the last 5 years have gone up tremendously.

In science and technology, which is funding biotechnology and life sciences, budgets have gone up three or two times in last 3 years, which means those benefits will actually percolate to the common man.

The biggest problem in India, however, is population -- whatever infrastructure you create, or try to put in money, by the time you implement those very exhaustive and huge projects, the population just grows.

How do you control that?" Charity, therefore, says Rishi, is never enough. Further on the population issue, Swift says, "Research shows that because immunization increases the likelihood of children who live, in areas where there's strong immunization, there is lower birth rate, which supports a better society over all." Swift feels this is the "most right moment" for GAVI to be involved with India. "There is a great deal that can be accomplished in India.

One key accomplishment in India has been to use GAVI funding to ensure that any vaccinations that have been provided are conducted safely. "It may look small, but it's very significant. They use disposable syringes and use boxes for proper disposal.

This has been a huge success in India." India's challenges in this will continue to require huge funds - not just government funds, but from private philanthropists, and that's where Rishi is helping out, Swift adds. As for the Indian government prioritizing healthcare in its budgets, Swift says, "Right now it's not so much as the willingness to commit funds, but the willingness to take this on as a government priority to get kids vaccinated.

There's money there, but it needs to get these programs up and running. The Indian government has been fighting very hard to cut back polio, so some basic vaccination has gone unattended. I think they recognize that and there is a big opportunity to fix that." Both Rishi and Swift stress that there's tremendous leadership available in India.

"The Chairman and MD of the Serum Institute, Cyrus Poonwalla has done great work," says Rishi. "He talks about the aim and the challenges of how he could produce a vaccine at the cost of a cup of tea or coffee... that's where you produce high quality vaccines at a very low cost.

These are the kind of people in India, who are working globally, not just for India." Still, the problem in India is of execution and follow-up, as also a crying need for basic infrastructure like primary care centers. "Work has to happen in a concurrent manner," says Rishi. "Immunization of children cannot wait while the government struggles with developing the infrastructure."

Swift adds that India is now qualified to apply to all of GAVI's windows of funding including for health system strengthening. For future goals, GAVI is setting aggressive and tangible goals to reduce child mortality. It's working toward a 66% reduction in child mortality rates in 36 countries by 2015 and introducing hepatitis vaccine in 72 countries by 2010.