Geneva, 05 Oct 2009 - WHO declared more than six decades ago that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being".1 Nowadays, most countries have ratified international treaties that make the right to health an international legal obligation that has to be progressively realised nationally.
Yet inequalities in basic health services remain intolerably wide, even in many high-income countries. This is despite the fact that health is the fundamental basis of any successful nation: for social cohesion, economic prosperity, and even political stability.
Fortunately, we are seeing a renewed commitment to making access to health care a reality for all. This commitment is evident through the creation of global initiatives that aim to generate broad access to essential health services. One such public-private initiative, the GAVI Alliance (formerly the Global Alliance for Vaccines and Immunisation), was launched in 2000 to finance new and underused vaccines for developing countries that otherwise have no access to these life-saving technologies.
In just under a decade, GAVI Alliance partners have collectively achieved impressive results in 72 of the poorest countries worldwide: vaccines such as those to prevent hepatitis B and Haemophilus influenzae type B infections have now been widely introduced, and hundreds of millions of children have been protected. WHO estimates that, as a result of GAVI Alliance programmes, more than 3·4 million deaths have been averted.2
The case for immunisation is as compelling as ever. Governments worldwide continue to invest in immunisation programmes as a powerful means to protect their populations from disease and save on future health-care expenditures. For developing countries, investment in immunisation is regarded as one of the most cost-effective contributions to their economic development, and an essential way to help realise the right to health for millions of people (figure).
Yet these signs of progress draw attention to further challenges that remain to be addressed. To secure long-term success, more should clearly be done to strengthen the foundations of health systems within countries-eg, by ensuring that health workers with the right training and experience are available in all countries. Realisation of this aim means supporting efforts to make primary and secondary care more accessible, and improving logistics and supply systems so that money, drugs, equipment, and fuel can be made available in the right place at the right time.
With the support of its donors, the GAVI Alliance is contributing to such efforts. It is asking countries to identify restrictions to achieving sustained high immunisation coverage. This goes beyond supply of vaccines and syringes to addressing systemic constraints that are restricting the effectiveness of national health plans. The GAVI Alliance recently welcomed a further commitment to funding for health-system strengthening through an expansion of the International Finance Facility for Immunisation, thanks to support from the UK, Australia, Norway, and the Netherlands.3 The intended use for the additional funds will be to help to address wider maternal and child health issues.
Providing life-saving vaccines to all children worldwide, irrespective of where they live, is fundamental to ensuring the right to health. Global health initiatives such as the GAVI Alliance are crucially important if we are serious about our collective promise. We face many challenges, but must not lose sight of the great opportunities that are within our reach. Only through committed leadership and effective partnerships between the global north and south, between the public and private sectors, and between human rights advocates and health professionals, will we see real progress towards the goal of universal access to health.
I am Chair of the GAVI Alliance Board and President of Realizing Rights: The Ethical Globalization Initiative.
<IFPMA Press Review 5 October 2009>