 "Seth Berkley")
GAVI, a global vaccine alliance funded by several governments and private organisations, says India's poor districts need better immunisation cover. Seth Berkley, chief executive officer of GAVI, tells Deepak Patel 60 per cent of the vaccines they purchase are made in India. Excerpts:
You have been in India since 2002 and spent almost $400 million till date. You have promised to spend another $500 mn by 2021. How do you plan to spend it?
India is due to transition out of GAVI support. It will start its transition around 2017 and depending on the economics of the country, the project will be over by 2021. This is a unique opportunity to use GAVI's support to help introduce new vaccines and strengthen the indigenisation of the system. Interestingly, India is provider of vaccines for most of the world. Around 60 per cent of vaccines that GAVI purchases are made in India. And, in a funny sense, India was making the vaccines for children of other parts of the world but did not use these for sufficiently for its own children. This is one of the things we are trying to fix.
In India, some states have high per capita income and others have a really low one. We want to see that immunisation coverage in the weaker districts comes up to the level of the wealthier ones.
What is the one achievement you are proud of in India?
India's engagement in the vaccine market has probably been a transformational process. When GAVI started, five companies provided vaccines for us. Now, there are 16. With that, we have seen a two-third reduction in prices and development of healthy competition. Of this change has come with India becoming more engaged. The five-in-one vaccine rolled out across India was later rolled out across all GAVI countries. Today, there are seven manufacturers of this product and four or five of them are in India. So, if one stops supply, others can take its place and this has completely changed the marketplace. This is what we hope to happen for all the vaccines we are supporting. In the long run, this ensures a really good system.
Sixty per cent of your vaccines are sourced from India. Do you expect it to increase?
There are many countries looking at India with envy. I put China at the top of the list, which until recently did not have a pre-qualified manufacturer. Now, they have one which makes vaccines for Japanese encephalitis which we purchase from them. India has a first-comer advantage and if it continues to innovate and grow its facilities, it can stay at this position and maybe even grow from here. But, there will be others who would like to be in that role.
Apart from vaccines, what are you looking to procure from Indian companies in the coming years? What business opportunities do they have?
We see huge opportunity in India to help meet the need for modernising the cold-chain equipment and information systems, in managing vaccine supply chains. India currently has a massive push on innovation and the current administration has shown a lot of promise by promoting several interesting initiatives like Make in India and Digital India. The technology adopted in India as a pilot, like the SMS-based monitoring system and Electronic Vaccine Intelligence Network are two examples of technologies that could help improve vaccine supply chains, increasing immunisation coverage and equity, which would benefit countries across the world. India has already changed the face of the global vaccine market; now, it has the opportunity to do so with supply chains.
In 2011-2015, you aimed at immunising 250 mn children and preventing 3.9 mn deaths. Have you succeeded in this and what target would you like to put now?
Yes, we have succeeded in both. The area where we have done well is in rolling out new vaccines and protecting children's lives. In the next period of 2016-2020, we aim to immunise an additional three million children and prevent five-six million deaths. It depends on which vaccines get rolled out. The areas where we have lagged are on some of the health systems weaknesses and the issue of equal access. This is why we have redoubled our focus. We want to work harder with a smaller number of countries.
We are in 73 countries, but we will work in 20 countries on priority in order to provide equal coverage and reach where we have not reached.
You have said 100 new vaccine introductions would occur by 2015. What is your next target?
We launched around 200 vaccines during 2011-2015 and we will launch 215-220 vaccines by 2020.
The new vaccine launches are quite certain. We had a successful replenishment in our fundraising efforts. We raised $7.5 billion against a $10-billion budget for 2016-2020. We are fully funded to roll out these vaccines. Assuming everything goes well, we will stick to our schedule.
