Global health security

Vaccines: central to global health security

Outbreaks of vaccine-preventable diseases are becoming more likely, more frequent and more far-reaching across the globe – driven by factors such as climate change, mass migration, urbanisation and antimicrobial resistance (AMR). In addition to the direct health impact, outbreaks cause numerous disruptions to health service delivery, including routine immunisation programmes. This may jeopardise coverage rates and put individuals and communities at risk of disease beyond the outbreak pathogen itself. The world’s ability to respond to outbreaks is a bellwether of its ability to respond to future pandemics.

Vaccines are a central tool in the global health security toolkit and are critical for the prevention of, and response to, outbreaks, epidemics and pandemics. All but one Public Health Emergency of International Concern (PHEIC) – a formal declaration by the World Health Organization constituting a public health risk through international spread of disease and which may require a coordinated international response – has relied on vaccines as part of the response. The COVID-19 pandemic showed that countries with strong immunisation programmes were better able to implement a vaccine response to the pandemic. Achieving equitable access to vaccines is critical during a pandemic and requires an end-to-end approach centred on the needs of the most vulnerable.

Gavi’s role

Building on its more than two decades of work on disease prevention and outbreak response, its expertise as a co-lead for COVAX and the lessons learned from the COVID-19 response, Gavi is meeting the new challenges to global health security to enhance countries’ capabilities to sustain strong immunisation programmes, and to further Gavi’s mission of saving lives and protecting people’s health by increasing equitable and sustainable use of vaccines. This includes:

• working with Vaccine Alliance and other partners to prepare for and respond to outbreaks, epidemics and pandemics of vaccine-preventable diseases to ensure equity and inclusivity in decision-making for prevention, preparedness and response;
• building on existing mechanisms for outbreak prevention, preparedness, and response – such as vaccine stockpiles for Ebola and cholera, and diagnostics for yellow fever – and long-term health system and immunisation strengthening (HSIS) investments;
• working with Gavi implementing country partners to support resilient routine immunisation programmes that can quickly pivot to outbreak response; and
• leveraging innovative finance tools; and ensuring early and at-risk funding for critical response activities from day zero of a future pandemic through the First Response Fund and the Day Zero Financing Facility for Pandemics (DZF).

Priority areas

Several global efforts are underway to strengthen and shape the global health architecture, with the goal of better addressing countries’ needs in preparing for and responding to outbreaks, epidemics and pandemics – as well as coordinating roles and responsibilities to enable a more timely response. Gavi is contributing to these efforts, focusing on areas where the Alliance has a clear comparative advantage and alignment with existing programmatic priorities. These efforts include:

• negotiations of a Pandemic Accord through the Intergovernmental Negotiating Body (INB) on pandemic prevention, preparedness and response;
• amendments to the International Health Regulations (2005) under the framework of strengthening health emergency preparedness, response and resilience (HEPR);
• engagement with national, regional, and civil society partners to support the United Nations General Assembly’s September 2023 adoption of the first Political Declaration on Pandemic Prevention, Preparedness and Response (PPPR); and
• actively working alongside key vaccine partners to contribute to the processes initiated by the G7, G20, and the WHO to shape the future architecture of global health, including establishing an interim coordination mechanism on medical countermeasures (e.g. vaccines, therapeutics, devices, diagnostics).

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