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Korea Herald
4 days ago
- Business
- Korea Herald
[Jeffrey Frankel] Foreign aid, now missed
'Don't it always seem to go, that you don't know what you've got 'til it's gone.' When Joni Mitchell sang that line in 1970, she was lamenting the destruction of the environment, but the sentiment applies to many issues. Today, we can add official development assistance to the list. For some 80 years, the United States spent more on humanitarian assistance, economic development programs and other types of foreign aid than any other government. In the 2023 fiscal year, the US government disbursed $72 billion, with much more coming from private NGOs and individual citizens. But the US does not spend the most as a share of its income: by that measure, the US contributes just 0.24 percent — a quarter of what northern European countries give — putting it in 24th place globally. Moreover, foreign aid accounts for just 1 percent of total US government spending — a far cry from the 25 percent many Americans believe the US allocates. Many Americans, including some prominent scholars, believe that foreign aid has a negligible impact, with some, such as Dambisa Moyo and William Easterly, arguing that it does more harm than good. Critics highlight examples of misguided aid programs falling prey to mismanagement, government overreach, or corruption, including Vietnam in the 1960s, Zaire in the 1980s and Afghanistan in the 2000s. While some economists, such as Paul Collier, insist that foreign aid is useful — especially when certain conditions are met — the dominant message seems to be that foreign aid is suspect. But now foreign aid is gone, or at least going fast. Soon after US President Donald Trump returned to the White House, his administration — and, in particular, his unelected billionaire crony Elon Musk — began frantically dismantling the US Agency for International Development. Almost immediately, reports began flooding in: what was being defunded were often life-saving, high-return projects. Since George W. Bush launched the President's Emergency Plan for AIDS Relief in 2003, the program has saved millions of lives from HIV and AIDS, especially in Africa. The President's Malaria Initiative has prevented two billion cases of malaria over the last 20 years, and halved the mortality rate. Gavi, the Vaccine Alliance, which receives US government support, has vaccinated more than a billion children against measles, diphtheria, tetanus, whooping cough and other potentially fatal diseases, preventing an estimated 19 million deaths. Polio has been eliminated in all but two countries, and smallpox has been eliminated everywhere. These efforts have contributed to a steep decline in child mortality globally: today, 4 percent of children die before their fifth birthday, compared to 40 percent a century ago. Foreign aid also enabled the development and diffusion of improved crop varieties, as well as synthetic fertilizers, new pesticides and modern irrigation, in the second half of the twentieth century. This so-called Green Revolution in agriculture doubled cereal crop yields in Asia; enabled many countries, such as India, to become self-sufficient in food; and raised incomes in many developing economies. This contributed to a reduction in infant mortality by 2-5 percentage points, from a baseline of 18 percent, in the developing world. The US Marshall Plan achieved spectacular success in helping European economies recover from World War II, and in laying the groundwork for 80 years of relative global peace and prosperity. More recently, foreign aid has played a pivotal role in enabling Ukraine to withstand the worst attack on a European country's sovereign territory in the postwar era. The US reaps massive benefits from the aid it provides. One need only recall the COVID-19 pandemic to see that participation in global health initiatives is not pure charity, especially when it comes to infectious diseases like Ebola, HIV/AIDS and Tuberculosis. More fundamentally, international assistance has been a pillar of US soft power. And that soft power has been at least as important as military might in sustaining US global leadership since the Cold War. But now the Trump administration is assiduously undermining it — to China's benefit, no doubt. The effect of foreign aid on economic growth is difficult to quantify because so many other causal factors are involved. Moreover, much of US aid is designed to advance political or military objectives. The top recipients of US foreign aid, after Ukraine, are Israel, Jordan and Egypt. Nonetheless, we know that reduced morbidity and mortality, and improved nutrition, can boost an economy's performance. It thus stands to reason that foreign aid is a contributor to development, even if not the most important one. The US undoubtedly benefits from having more developed, higher-performing trading and commercial partners. Why, then, has the pessimistic view of foreign aid dominated public discourse for so long? One explanation is that the pessimistic view of everything has prevailed for years. A 2018 survey showed that a substantial majority of people in rich countries believed that the child mortality rate in poor countries had either risen or stayed the same over the previous 20 years; in fact, child mortality had been halved. And a whopping 80 percent of people in rich countries believed that the share of people in extreme poverty had either plateaued or risen, even though it fell steeply from 1990 to 2013. If people are so wrong about these trends, how can they possibly know about the role foreign aid played in driving them? Of course, foreign aid has its flaws and limitations, including instances of inefficiency, mismanagement, or unintended side effects. But whatever the limitations of foreign aid in the past, it is clear that Trump's destructive approach is making things far worse. Jeffrey Frankel is a professor of capital formation and growth at Harvard University. The views expressed here are the writer's own. — Ed.
Arabian Post
06-05-2025
- Health
- Arabian Post
Gavi Funding Reductions Pose Challenge for Africa's Vaccine Future
Gavi, the Vaccine Alliance, has been a cornerstone in improving health outcomes in low-income countries, particularly across Africa. Since its inception in 2000, Gavi has facilitated the delivery of vaccines to more than 700 million children, saving millions of lives. However, with Gavi's funding facing reductions, the continent is at a critical juncture that could reshape its approach to vaccine financing and health security. Historically, Gavi has been instrumental in increasing immunisation coverage across Africa, helping governments provide essential vaccines at reduced prices. This partnership has been vital in combatting diseases such as malaria, polio, pneumonia, and rotavirus, which have long plagued the continent. In countries where healthcare systems have struggled to reach the most remote populations, Gavi's initiatives have brought life-saving vaccines to millions who would otherwise have been left behind. However, the alliance's future funding has come under strain, particularly as major donors, including the United States and the United Kingdom, reduce their contributions. These cuts are due to several factors, including global economic uncertainty, shifting political priorities, and the ongoing effects of the COVID-19 pandemic, which has put significant pressure on national budgets worldwide. This financial downturn has led to concerns about Gavi's ability to continue its work at the same scale in Africa, where vaccination rates still lag behind global averages. The implications for African nations are significant. Many African countries rely heavily on external funding to secure vaccines. In places like Nigeria, the Democratic Republic of Congo, and Kenya, Gavi's support has been essential in filling the gap left by insufficient domestic funding for health programmes. Without continued financial assistance, these countries risk seeing setbacks in immunisation progress, leading to a potential resurgence of preventable diseases that could overwhelm already fragile healthcare systems. See also Ghana Centralises Gold Trade Under New Licensing Regime In response to the potential shortfall, African governments are under increasing pressure to find alternative sources of funding for vaccination programmes. Some experts suggest that African nations may need to bolster their own domestic health financing efforts, increasing public investment in immunisation and health infrastructure. However, the ability of many African nations to self-finance these initiatives is limited by economic challenges, including low GDP per capita, high levels of debt, and ongoing socio-political instability. Several African countries have begun exploring innovative financing mechanisms to address these gaps. The African Union's African Vaccine Acquisition Trust , for instance, was launched to secure vaccines through collective purchasing. While this initiative has shown promise, it has been hampered by funding shortages and logistical challenges in distributing vaccines across the continent. Furthermore, AVAT's long-term sustainability is uncertain, given that many African nations are still grappling with the economic fallout from the pandemic. Another avenue being explored is the expansion of public-private partnerships. Global pharmaceutical companies and philanthropic organisations such as the Gates Foundation have stepped in to fill some of the funding gaps. These partnerships could provide critical resources, but they also bring about concerns related to equity and access. There is the risk that vaccine procurement becomes increasingly driven by market dynamics rather than public health needs, potentially putting vulnerable populations at a disadvantage. The cuts to Gavi's funding come at a time when Africa faces a heightened need for vaccines, especially in the context of emerging health threats. Malaria remains a top priority, with the World Health Organisation identifying Africa as the epicentre of the disease. In 2021, 95% of global malaria cases occurred on the continent, highlighting the ongoing vulnerability of African populations. As the continent continues to battle malaria, new vaccine candidates, such as the RTS,S/AS01 malaria vaccine, are showing promise, but only if they can be scaled up quickly and effectively. Similarly, there is growing concern over the threat of a new wave of vaccine-preventable diseases. Routine vaccination programmes, such as those for measles, diphtheria, and polio, have seen significant disruptions due to the COVID-19 pandemic. These disruptions have led to a decline in vaccination coverage across Africa, with the WHO warning that the world is facing a 'backslide' in immunisation rates. The disruption of essential services has left millions of children unprotected, and without Gavi's continued support, many African countries may struggle to recover ground. Gavi's role as a leader in global vaccine financing is now under intense scrutiny. Its funding model, which has been reliant on donations from high-income countries, is increasingly seen as unsustainable in the face of shrinking budgets and the changing priorities of international donors. For Africa, this is a moment of reckoning, where the continent must decide whether to continue depending on external aid or take control of its own vaccine financing future. As the global health landscape evolves, there is a growing call for greater investment in Africa's health systems, with a focus on building domestic capacity for vaccine production, distribution, and financing. Local vaccine production has the potential to reduce reliance on external donors and ensure that African countries are better equipped to respond to future health crises. Several countries, including South Africa and Rwanda, are already taking steps to boost vaccine manufacturing capacity, with the hope of creating a more self-sufficient health system.
Hindustan Times
05-05-2025
- Health
- Hindustan Times
Cut to Gavi's funding to impact our ability to protect children: Professor José Manuel Barroso
Professor José Manuel Barroso, chair of the board of Gavi, the Vaccine Alliance, spoke to HT about his India visit and the nature of India-Gavi partnership. He also looked back at Gavi's 25-year-old journey; and the changes he foresees in Gavi's role in helping countries in the future; and the impact of US threatening to pull out as a contributor. What was the agenda behind your recent India visit? My recent visit to India reinforced the strong Gavi-India partnership and celebrated immunization progress since 2002. The current India-Gavi partnership represents a strong example of immunization collaboration within Gavi-supported countries. We are developing a roadmap for our collaboration beyond 2026, shifting towards targeted technical assistance, innovation partnerships, and knowledge sharing as India strengthens its global health leadership and Gavi donor role. Also, as part of our strategic partnership we will be supporting the Government of India to roll-out the HPV vaccine, in a push to eliminate cervical cancer in the country. How would you rate Gavi's journey so far? Over the past 25 years, Gavi has been highly impactful, immunizing over 1.1 billion children, preventing 18.8 million deaths, and halving child mortality in 78 lower-income countries. We also bolster global health security through health system support and vaccine stockpiles for Ebola, cholera, meningococcal and yellow fever vaccines. Our model relies on co-financing, with countries progressively contributing to their vaccine costs. We aim to expand our impact in the 2026-2030 period, protecting more people against more diseases faster. How easy or difficult is it to sustain multilateral partnerships given Gavi is all about public-private global partnerships? Maintaining political engagement and alignment across our diverse partners — governments, international organizations, manufacturers, civil society, and the private sector — is crucial for long-term sustainability, especially amid a complex funding environment. What impact do you see of US pulling out as a contributor on Gavi's functioning? While Gavi has not received any official notification regarding changes in US funding, recent reports are certainly extremely concerning. The US has been a long-standing partner with strong bipartisan support for over 25 years, including during the previous administration, and Congress recently approved $300 million for Gavi in the FY 2025 budget. Any cut to Gavi's funding would have a devastating impact on our ability to protect children and keep our world safe. Gavi operates as an incredibly lean and efficient organisation, spending 97 cents of every dollar directly on life-saving programmes and delivering an estimated return of $54 in broader economic benefits for every $1 invested. If you could specifically talk about some of the projects/initiatives that are likely to get disrupted. The US currently contributes roughly 15% of Gavi's funding. A cut of this magnitude could translate, in rough terms, to 75 million fewer children protected during our 2026-2030 strategic period, leading potentially to 1.3 million more deaths from preventable illnesses. It would directly and negatively impact our capacity to protect the world against infectious disease threats through our global vaccine stockpiles (covering diseases like Ebola, cholera, meningitis, yellow fever) and our emergency response funds, which have proven crucial in recent events like the mpox outbreak. Are there any alternatives that Gavi members are looking at to meet the overall funding requirement? Gavi is focused on securing its target of at least $ 9 billion for the 2026-2030 period through contributions from its diverse range of partners. However, we recognize the current global funding environment is very complex and constrained. We have a broad base of sovereign donors, foundations, and private sector partners. Critically, implementing countries themselves are co-financing vaccine programmes at increasing levels, contributing nearly half of the costs in the upcoming strategic period. So far, 19 countries have already graduated entirely from Gavi support, and some, like India and Indonesia, have transitioned to become Gavi donors. Given this broad existing base and the significant contributions already being made by implementing countries, it would be extremely difficult for other partners to make up a major shortfall should one occur. Going forward, do you see any changes in the role that Gavi will be playing while helping needy countries? Doing more, faster; enhanced health security (expanding stockpiles (such as adding mpox, in addition to Ebola, cholera, meningococcal and yellow fever vaccines); addressing climate change (nearly half our vaccine portfolio addresses diseases sensitive to climate shifts); tailored support (Adapting our support for countries as they develop); and leveraging innovation (Continuing to embrace AI, predictive analytics, and digital tools).
Zawya
25-04-2025
- Health
- Zawya
African Vaccination Week 2025: Big Catch-Up and vaccine introduction to boost South Sudan's health
Mrs. Lavina Mariba, today, celebrated the launch of the African vaccination week as a proud mother, with all her three children fully vaccinated and every family member up to date with their shots. 'All my children are fully vaccinated, my husband and I as well,' said Mariba 'my children have not fallen ill for the past eight months, and I believe this is the work of vaccine, I am proud of it.' Narrated Mariba. Mrs. Mariba, a 32-year-old resident of —a suburb of Juba—has joined the rest of her community in the official celebration of African Vaccination Week 2025 at a nearby Kator Primary Health Care Centre in Juba. From 24 to 30 April, South Sudan will celebrate African Vaccination Week (AVW) under the theme 'Immunization for All is Humanly Possible'. This year's commemoration coincides with the 50th anniversary of the Expanded Programme on Immunization (EPI), which, over the past five decades, has driven progress in combating vaccine-preventable diseases, saving lives and promoting health. In South Sudan, the country's national immunization programme has progressively introduced life-saving vaccines, expanding coverage with lifesaving vaccines. BCG (tuberculosis vaccine), Oral Polio Vaccine (OPV), DTP (diphtheria, tetanus, pertussis), measles (first dose), and Tetanus Toxoid (TT) vaccines were first introduced in 1976. This was followed by the introduction of the Pentavalent vaccine in 2015 and the Inactivated Polio Vaccine (IPV) in 2016. Subsequently, the tetanus-diphtheria booster (Td) and second dose of IPV were introduced in 2021. Most recently, the malaria vaccine was added to the routine immunization schedule in 2024. This year, with the support of Gavi, the Vaccine Alliance, the country is introducing additional vaccines, including the Pneumococcal Conjugate vaccine (PCV), the Rotavirus vaccine, and the second dose of Measles-Containing Vaccine (MCV2) to its routine immunization programme, keeping children safe from pneumonia, measles and diarrhea. South Sudan's Ministry of Health highlighted the progress that has been driven by the Expanded programme on Immunization and called on the people of South Sudan to take an active role by getting vaccinated. 'As we observe African Vaccination Week, we celebrate progress while passing an important message to our communities that individual health is a personal responsibility. It starts with you. While the Government, through its health entities, is working to ensure protection from vaccine-preventable diseases by introducing these new vaccines, the responsibility to make use of them to protect yourself and your family is in your hand,' said Dr Anin Ngot Mou, Under-Secretary of South Sudan's Ministry of Health. Data from the WHO Regional Office for Africa shows that since the celebration of the first African Vaccination Week in 2011, countries in the region have used the occasion to conduct a wide range of activities including advocacy, communications, vaccination campaigns, and other high impact health interventions. As a result, over the past 14 years, more than 180 million individuals of all age groups were reached with different vaccines; an estimated 120 million were reached with Vitamin A supplementation and 100 million children with deworming tablets. The World Health Organization continues to advocate for immunization as a cornerstone of global initiatives aiming to rid the world of vaccine preventable diseases and achieve global health goals. 'Vaccination is the most cost-effective tool to save lives and the first line of defense for protection against disease. WHO commends the Government's efforts and support by partners to ensure the successful introduction of new vaccines into South Sudan's routine immunization programme. 'Prioritizing pregnant women and children will be key to building a safer and healthier population, helping us to save lives and build a robust health system,' said Dr Humphrey Karamagi, WHO Representative for South Sudan. Over the past five decades, immunization has saved more than 154 million lives—an average of over 3 million lives each year. In Africa, immunization has saved over 50 million lives and data modelling shows that in 2024, a child under age 10 in Africa had a 50 per cent higher chance of surviving to their next birthday than they would have had in the absence of vaccination programmes. "The introduction of these new vaccines marks a major milestone in South Sudan's efforts to ensure no child dies or becomes sick because of a vaccine-preventable disease. As we commemorate African Vaccination Week and 50 years of immunization progress, we are reminded of the extraordinary power of vaccines to give every child a fighting chance. UNICEF remains committed to working with the Government and partners to ensure every child, no matter where he or she lives, is reached with life-saving immunization services," said Noala Skinner, UNICEF Representative in South Sudan. Despite ongoing routine vaccination efforts, the program has faced numerous challenges during the reporting year, including outbreaks of measles, yellow fever, cholera, and cVDPV2. Additionally, the influx of returnees and refugees fleeing the Sudan crisis, coupled with severe flooding and consequent internal displacement, has strained health systems. These challenges have, nevertheless, not halted the delivery of immunization services, which continue, both within and outside health facilities, even in affected areas. To address the significant immunization backlog accumulated between 2019 and 2022, as well as to reach children who defaulted on routine vaccinations in 2023 and 2024, the Government of South Sudan has also launched the 'Big Catch-Up' vaccination initiative. This national effort is aimed at identifying and reaching all children under the age of five (0–59 months) who have either missed one or more antigens or have never received any routine immunization doses. Through this initiative, South Sudan is intensifying efforts to close immunity gaps and prevent outbreaks of vaccine-preventable diseases, which remain a persistent threat due to low routine coverage in many parts of the country. As part of the campaign, the Ministry of Health—working in close coordination with key partners such as WHO and UNICEF—is rolling out catch-up vaccination activities in 30 counties across the nation. These efforts specifically target 146,054 zero-dose children those who have not received a single dose of any routine vaccine with the full schedule of routine Expanded Programme on Immunization vaccines. It is in this regards that this year the AVW celebrates and recognizes the collective efforts to save and improve countless lives from vaccine-preventable diseases and underscores that immunization for all is an achievable goal. Distributed by APO Group on behalf of World Health Organization (WHO) - South Sudan.
Zawya
25-04-2025
- Health
- Zawya
Vaccination progress helps save millions of lives in African region
An increase in vaccine coverage in Africa is helping protect millions of people from life-threatening diseases such as measles, polio and cervical cancer. In 2023, vaccination saved at least 1.8 million lives in the African region, nearly half the global figure of 4.2 million. These advancements have been possible thanks to government efforts and the support from partners including Gavi, the Vaccine Alliance (Gavi), UNICEF, World Health Organization (WHO) and others. More than 5 million 'zero-dose' children – children who have not received a single dose of an essential routine vaccine – in the African region have been vaccinated since 2024 through the 'Big Catch-Up' initiative launched in 2023 in 24 priority countries to protect communities from vaccine-preventable outbreaks, save children's lives and strengthen national health systems. Despite a growing birth cohort between 2022 and 2023, the region recorded a two-percentage-point increase in the diphtheria-tetanus-pertussis (DTP3) immunization coverage among 1-year-olds, from 72% to 74%, an important sign of recovery in routine immunization services post-COVID-19. This progress means that amid a rising number of births, governments are vaccinating more children each year than ever before. Notable gains were seen in Cameroon, Chad, Côte d'Ivoire, Ethiopia, Madagascar, Malawi, Mozambique and Uganda. In addition, more girls than ever are being protected against cervical cancer, a disease that kills a woman every two minutes worldwide. Human papillomavirus (HPV) vaccination coverage (one dose) has increased to 40% in 2023 up from 28% the year before – making Africa the region with the second highest coverage rate globally, empowering millions of girls to fulfil their potential. Africa has also made tremendous progress in the fight against polio, recording a 93% decline in circulating variant poliovirus type 1 cases from 2023 to 2024 and a 65% decrease in variant poliovirus type 1 cases in just the past year. This year, World Immunization Week/African Vaccination Week, which is being marked under the theme Immunization For All is Humanly Possible, aims to promote the life-saving power of immunization to protect people of all ages against vaccine-preventable diseases. 'We have made great progress in expanding vaccination and saving lives, thanks to the dedication of governments and partners. But we still have more ground to cover. We must sustain and expand these life-saving efforts to build a stronger, healthier future for all,' said Dr Chikwe Ihekweazu, Acting WHO Regional Director for Africa. Despite the progress, challenges persist in reaching children in the region. One in four children remain under-vaccinated (missing out on key routine vaccines) and one out of five children are unvaccinated, with many countries facing recurring outbreaks, particularly of measles – a highly contagious and potentially fatal disease. These gaps, which leave the region vulnerable, can be attributed to persistent barriers including limited access to healthcare in remote areas often due to conflict and instability, logistical and cold chain constraints, vaccine hesitancy driven by misinformation, and insufficient funding for immunization programs. These challenges are further compounded by disruptions caused by public health emergencies. 'The progress seen across African countries—bolstered by an unprecedented record of co-financing toward vaccine programmes in 2024 by African governments—demonstrates the tangible impact of sustained commitment,' said Thabani Maphosa, Chief Country Delivery Officer at Gavi, the Vaccine Alliance. 'However, this momentum must not stall. Conflict, population growth, displacement, and natural disasters are creating ideal conditions for outbreaks to emerge and spread. Investing in immunization and securing sufficient funding for Gavi to carry out its mission over the next five years is essential to protect our collective future.' Building on the gains in Africa, Gavi has launched an ambitious five year strategy, 'Gavi 6.0' which is anchored on three key pillars: protecting the world against pandemics and disease outbreaks; protecting people by vaccinating more children against more diseases than ever before - including reaching 50 million children with the malaria vaccine by 2030; and protecting communities by reducing the number of zero-dose children. A successful replenishment for Gavi will enable the Vaccine Alliance –a coalition of partners that includes 39 African governments - to implement this impactful 6.0 strategy and will enable countries to protect and advance the progress that has been made to date. Full engagement across the Alliance to obtain the necessary funding over the next few months will be critical. 2025 also marks the mid-point of the Immunization Agenda 2030, which aims to prevent diseases, promote equity and build strong immunization programmes. To achieve these goals, African governments and partners are encouraged to accelerate progress towards reducing zero-dose children, increase routine immunisation coverage, accelerate malaria vaccine introductions and expand access to HPV vaccines. Maintaining the progress achieved in immunization over the years will also require regional commitment to implement key strategies. These include increasing investment in health systems and infrastructure for effective vaccine delivery; enhancing surveillance systems to respond swiftly to outbreaks; addressing vaccine hesitancy and misinformation; bolstering domestic funding for immunization programmes; increasing the use of innovation and technology for better vaccine delivery; and investing in research and development for vaccine development. In 2024, Gavi and partners launched the African Vaccine Manufacturing Accelerator (AVMA), a financing mechanism established to make up to US$ 1.2 billion available over ten years to accelerate the expansion of commercially viable vaccine manufacturing in Africa. Two new collaborations under this initiative were signed earlier this year, in a positive step towards enhanced regional health security. Distributed by APO Group on behalf of WHO Regional Office for Africa.
