Hyderabad: GAVI Alliance, formerly known as the Global Alliance for Vaccines and Immunisation, is a public-private partnership that focuses on saving children’s lives and protecting human health by increasing access to immunization in developing nations. In June, it raised $3.8 billion and received pledges for $7.3 billion of funding from donors to fund immunization programmes; it influences the vaccine market by providing an incentive for drug makers, especially generic drug makers in emerging markets such as India, to develop urgently needed vaccines at affordable prices for public health programmes. GAVI Alliance includes developing countries, donor governments, the World Health Organization, Unicef, the World Bank, the vaccine industry and research institutions as well as philanthropic organizations such as the Bill and Melinda Gates Foundation.

Seth Berkley, the chief executive officer of GAVI Alliance, a medical doctor by training, the founder of the International AIDS Vaccine Initiative in 1996 and recognized by the Time magazine as one of the “100 Most Influential People in the World” in 2009, spoke to Mint during a recent visit to Hyderabad. Edited excerpts:

GAVI has set an ambitious goal to prevent 3.9 million future deaths by 2015. How are you going to achieve this goal?

We are trying to save 3.9 million future lives by immunizing a quarter of a billion children with new vaccines. We are also supporting immunization programmes which have a far larger number of people. The aspiration in the end is to try to reduce diseases in these populations (by tackling the) most important childhood diseases.

Checks and balances: Dr Berkley says the government of India and its national regulatory agency have to play an important role in ensuring quality of vaccines. Kumar/Mint

(Pneumococcal vaccines are aimed at protecting children against diseases such as meningitis and ear infection. Rotavirus vaccines protect children against rotavirus, the cause of severe diarrhoea.)

What is your funding requirement to meet this target and how do you raise the money?

We calculated that we would need an additional $3.8 billion; we had a replenishment conference last June and were able to raise that money plus an additional amount. Interestingly, because there is so much excitement about new vaccines, we actually had increased demand from countries trying to get these vaccines out. So all of the money we raised now is accounted for by countries wanting to introduce these vaccines for their population.

Do you think you need to raise more funds going forward?

It is enough to do what we said we wanted to do, but, of course, we are very ambitious and would like to make sure we get the vaccines out to everybody who wants them. So countries have to step forward and roll these out more quickly; of course, we will like to be able to accommodate them.

One of the critical issues is going to be how pricing changes occur over time. Because there are three components in how we think about vaccines: One is price of the vaccines, second is what countries pay, third is donor funds. But we don’t want to rely only on donor funds. Long-term sustainability means more countries have to pay for them.

What is the reason for you to be able to get such a large commitment from donors, given the tough global economic situation?

What GAVI does is measurable. Vaccines are the most cost-effective intervention. In times of fiscal tightening what you know is (that) if you buy a vaccine and get it injected in a child, you will be able to prevent a disease and save a life. It is a very good and clear equation—it’s something that can be measured. So, in times like these when people are worried about value for money, it is value for money.

We have seen vaccine manufacturers announcing voluntary price cuts; do you see further price erosion of vaccines supplied to the immunization programmes?

We expect the prices will come down, but the issue here is we want (vaccine makers) to have enough of a margin so that companies can invest on quality assurance and control. We want it to be a good business for them, but the really important thing about what GAVI has been able to do by its stand in the market is that one dramatically increases the volume over time, this increases efficiency and drives down the cost of every product.

So companies can reduce the price of the product. Normally in pharmaceuticals or any product, over a life cycle, the prices drop. Our goal has been to get new products quickly to the people who need them and try to accelerate that curve. So by going to companies in India, we want to purchase 100 million of these vaccines. You allow a company to grow at a rate at which it might not have grown relying on the private market and, therefore, drive the cost down.

Vaccine manufacturers from the emerging world, especially India, have already started work on new vaccines. But many of them complain that funding is a problem. Does GAVI help such companies?

We are willing to talk about anything. We are willing to talk about funding upfront. We are willing to talk about different ways to help them scale up. We are working with some of our partners in technology transfers. That is what GAVI does. Given our partners, which include the World Health Organization, the Bill and Melinda Gates Foundation, Unicef and bilateral donors, there are many possibilities to help such companies raise funds.

In recent times, there has been an increase in the number of vaccines supplied by Indian manufacturers getting delisted from WHO pre-qualification on grounds of quality and safety. Do you see it as a concern, given that the supply from Indian manufacturers is critical for global immunization programmes?

That is certainly a worry, and one of the reasons to have high quality is because you want people to know that India produces (vaccines) not only in large quantity and inexpensive but also of global quality. Of course, nobody has been harmed by any of these vaccines; these (problems) were actually due to quality control procedures and not (because of) a problem with the product.

In the field of vaccines, I think all of us agree, including the manufacturers in India, that quality is key. One of the challenges of having a healthy vaccine market is to have an adequate investment in quality. So the pricing has to be at good enough levels so that companies can invest in quality assurance and quality control. Also, the government of India and its national regulatory agency have to play an important role in ensuring quality.