Funding Gavi is the simplest financial decision facing Keir Starmer. He must get it right

Telegraph

a day ago

When he announced he was cutting international cooperation and aid to its lowest level on record, Keir Starmer promised he would protect global health. He is now about to take a decision that will show how serious he was. Will he maintain the UK's support for the global vaccine alliance, Gavi, which has prevented an estimated 18 million deaths since its inception in 2000? In the view of Save the Children and more than 150 other organisations around the world, it is critical that he does.
Gavi has been one of the most effective investments in public health in modern history. In the last 25 years, the alliance has helped immunise more than a billion children. Gavi supports the rollout of vaccines for everything from measles to polio to Ebola. In doing so, it not only saves lives but builds up national health systems, strengthens pandemic preparedness and helps protect us all – everywhere including Britain – from the spread of infectious disease.
Five years ago, through the Covid-19 pandemic, we witnessed that when it comes to health, nobody is safe until everyone is safe. Gavi's purpose is to shield us from the re-emergence of pandemics and lethal but preventable diseases. The fact that it is struggling to secure enough money to continue its critical mission tells us a lot about the geo-political climate today and the false instinct to draw back from international cooperation to solve global problems.
Vaccination is one of the most cost-effective health interventions known to mankind. The World Health Organization (WHO) estimates the return on routine vaccinations at $54 for every $1 invested. You'll be hard-pressed to find a more attractive investment proposition; and that's before you take account of the human factor. Anyone who has met a mother mourning a child who could have been saved by a routine jab or seen toddlers gasping for breath because their measles has turned into pneumonia, will know what I mean.
I understand it can feel difficult to back aid in times of economic crisis, budget deficits and a struggling NHS here at home. When it comes to Gavi and global health security, however, the benefits so outweigh the costs that any vacillation seems incomprehensible.
Infectious diseases know no borders, and the cost comes home to Britain. In 2023-24, more than 20 per cent of secondary care bed days in the NHS were attributable to infectious disease or infections. The cost to the NHS was £5.9 billion. Gavi's role in supporting routine vaccination and its stockpiles of vaccines against killers such as Ebola, cholera and yellow fever represent our first line of defence against future pandemics and the terrible costs counted in ruined lives and devastating economic damage.
Some say governments in the Global South could, and maybe should, buy their own vaccines. They ask why British taxpayers should pay for jabs for African arms. This misses an important point: vaccine markets, like many essential commodities, are global. If every country did its own procurement, the poorest – those with the lowest bargaining power – would immediately be priced out of essential, life saving vaccines.
Perhaps the most important thing Gavi has done in the last 30 years is to shape this market. By guaranteeing the purchase of hundreds of millions of vaccines over many years, Gavi has enabled pharma companies to manufacture many more doses and, through economies of scale, do it much more cheaply than would otherwise be the case.
It has also enticed other firms to enter the fray and compete. Witness the Serum Institute of India, which played a major role in supplying Covid-19 vaccines during the pandemic and has now become a vaccine manufacturing giant.
And Gavi works with countries to 'graduate' so that they pay for an increasingly large share of their own vaccines as they become richer, thereby ensuring that aid-funded doses go to the poorest and most vulnerable countries.
The UK, as a founding member, has helped Gavi become the world-changing alliance it is today. Our partnership has put British scientific leadership in the global spotlight. From 18 million doses of ground-breaking malaria vaccines that are already saving lives in Africa to digital biometric identification and record-keeping that are transforming health systems in Ghana, Gavi links UK scientists and innovators with partner governments in the global South.
At Save the Children, we're working with national governments and local communities – for example in Malawi where a recent cholera outbreak killed more than 1,700 people – to make sure children are protected from deadly and debilitating illness. With our private sector partner GSK, we are targeting millions of 'zero-dose' children who are completely unvaccinated in Nigeria and Ethiopia. In war-torn Sudan, we are transporting vials into a country whose health services are shattered.
All this would be immeasurably harder to do without Gavi ensuring that vaccines are made affordably in large enough quantities for the most vulnerable populations.
To keep up UK funding of Gavi is one of the most straightforward decisions this government must make. I know a bargain when I see one. I hope Keir Starmer will too.