A Call to Action: An Interview with Dr. Rajeev Venkayya

On January 29th, Bill and Melinda Gates announced a new ten billion dollar vaccine initiative.  UN Dispatch interviewed Dr. Rajeev Venkayya, Director of Global Health Vaccine Delivery for the Gates Foundation, to find out more about it. 

Can you tell us a little more about the Gates Foundation’s current work on global health vaccine delivery?

We’ve been investing in vaccine delivery for quite some time, beginning with a commitment to GAVI. GAVI is the principal partner for vaccine delivery. Beyond GAVI we have selected investments in efforts to improve decision-making around vaccine introduction, address barriers to vaccine delivery, such as improving supply chain, and to improve our understanding of the environment vaccines are intended for. Our principal investment is through GAVI.

Our readers at UN Dispatch recently had a discussion about the rotavirus vaccine. Specially, some people questioned the value on investing in a vaccine as opposed to investing in water and sanitation. What would your response be to that?

There is no question that the ideal way to prevent diarrheal disease is to ensure that every child has access to clean water. We believe strongly in the importance of clean water. However, the challenges in getting clean water to most poor children around the globe mean that it will take a long time. Clean water should be a priority for donors and national governments, but in the meantime – we have tools such as rotavirus to use while we work to improve he infrastructure. We can improve a lot of lives in process. We agree in the long term the ideal way to address diarrhea is through clean water.

Is the ten billion dollars announced all new money on top of existing vaccine funding from the Gates Foundation, or was some of it already committed?

We have to date spent about 4.5 billion dollars on vaccines, so the ten billion represents the amount we will spend going forward over the next ten years. It’s all future money; it does not represent current investments.

What is the ten billion dollars most likely to support?

We have made commitments to certain vaccine programs which we will continue. These include malaria vaccines, tuberculosis vaccines, additional vaccines for diarrhea beyond rotavirus, and additional vaccines against pneumonia to include influenza. That is one significant area of investment.

The next category is new types of vaccines, just as UN Dispatch alluded to in your post. This would include efforts like the development of vaccinations that don’t require refrigeration. Finally we will support basic science investments to improve deliverability.

We do anticipate some new investments, but it is difficult to predict what they will be. The landscape is changing fast, and we need to be responsive. For example, if we need new disease burden data on malaria to support vaccine development, we might make targeted investments in data collection.

Why was this initiative launched now? Are we facing special difficulties or special opportunity?

That’s a great question. One reason for launching it now is we are ten years into GAVI and this was a good occasion for us to celebrate the successes of that investment. We also wanted to call for the world to redouble attention and resources to vaccines. Major programs facing critical budget shortfalls include GAVI, global polio eradication, and global funding for measles control. If those efforts don’t get funding we risk a resurgence of measles in Africa.

In poor countries, 79% of children are receiving the full set of childhood vaccinations. This is up from 66%, which is good. But a substantial proportion are still not receiving vaccinations despite our efforts to date. That’s something people need to pay attention to. It is an excellent time to send the message that vaccines are the best bargains you can buy in global health, and they should be a spending priority.

This announcement is a call to action. We can’t do it alone and we don’t plan to.  By laying out a vision of success, we’re hoping to motivate national governments who are responsible for administering vaccine programs, donors who are responsible for funding and procurement, and the companies we rely on to make vaccines affordable. We’re counting on all of them to achieve this vision. 10 billion dollars over ten years is just a drop in the bucket to achieve that vision of success.

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