As part of World Immunization Week 2022, News Medical speaks to Thabani Maphosa, the Managing Director of Country Programmes at Gavi, The Vaccine Alliance, about their work to increase equitable and sustainable use of vaccines by maximizing financial investments, bringing the best partners to the table and driving innovation.
Please can you introduce yourself and tell us about your role at Gavi, The Vaccine Alliance?
My name is Thabani Maphosa, I am Gavi's Managing Director of Country Programmes, overseeing Gavi's operations in the countries we support. The Country Programmes Department's role is to harness the power of the Vaccine Alliance to increase equitable and sustainable use of vaccines and help countries protect as many children as possible against vaccine-preventable diseases.
Gavi aims to save lives and protect people's health by increasing the equitable and sustainable use of vaccines. Can you tell us more about how your alliance works towards this goal?
Gavi, the Vaccine Alliance, seeks to increase equitable and sustainable use of vaccines by maximizing financial investments, bringing the best partners to the table and driving innovation. Gavi now vaccinates almost half of the world's children, giving it tremendous "market-shaping" power to negotiate vaccines at prices that are affordable for the lowest-income countries. As a result of this, the cost of fully immunizing a child against 11 infectious diseases is now less than US$ 30 in Gavi-supported countries compared with more than US$ 1,000 in the US.
Gavi shares the cost that implementing countries pay for vaccines. Thanks to our support, more than 521 vaccine introductions and campaigns have been implemented since 2000, dramatically boosting immunization against virulent diseases.
Gavi hosts an online platform "VaccinesWork" for the dissemination of global health and immunology news. How important is it to provide well-researched, accurate information not only on the science of vaccines but also on the more cultural/societal impacts vaccination can have?
We developed VaccinesWork because we believe it is extremely important to provide readers with fact-based yet accessible content on all matters regarding immunization, vaccines, COVID-19, and global health in general. By using experienced journalists from across the world and drawing on an in-house expert review team, we believe we are shining a light on the work of Gavi, the critical issues it tackles on a daily basis, and providing a high-quality antidote to the high volumes of disinformation we see in the world.
What is the current state of the vaccine and immunization product market, and what improvements need to be made to the market to help facilitate vaccine availability in lower-income countries?
Over the last two decades, much has changed: in lower-income countries, 78% of children now receive routine vaccines, up from 59% in 2000. The number of children dying from vaccine-preventable diseases in these countries has dropped by 70%. Millions more children are now growing up protected against debilitating diseases.
Gavi, the Vaccine Alliance, has played an important role in this turnaround. So far, we have protected over 888 million children globally with life-saving vaccines. However, millions of children are still being left behind despite this progress. COVID-19-related disruptions led to a 4-percentage point drop in coverage in 2020.
Gavi has launched a global movement to bring an end to this inequity, making reaching zero-dose children – defined as children who don't receive a single dose of diphtheria, tetanus and pertussis-containing vaccine – with immunization its key priority for the next five years. The goal: to reduce the number of zero-dose children by 25% by 2025 and by 50% by 2030, which will also mark the closing of the Sustainable Development Goals.
Gavi has already protected a generation of children. What do you foresee the challenges being when protecting the next generation?
It's clear that we need to get routine immunizations back on track after the shock of the pandemic, which is still sending shock waves through health systems. Some countries have fared better than others. However, data shows that for the 68 lower-income countries Gavi supported between 2016 and 2020, there was an average 4 percentage-point drop in routine immunization coverage over the course of 2020, from 82% of children to 78%, for a full course of basic diphtheria, tetanus and pertussis-containing vaccines (DTP3) – the key yardstick used for vaccination coverage worldwide.
We did see the beginnings of a recovery in 2021 but also reasons for concern. We continue to see outbreaks of vaccine-preventable diseases like yellow fever and polio, which underlines the importance of continued investment in routine immunization. Countries must continue to be supported in their efforts to prioritize and sequence COVID-19 vaccination and emergency response alongside routine immunization and other essential health systems activities – this is a critical area of focus for Gavi and the Alliance partners.
Given that Gavi is co-leading COVAX, how have you seen attitudes towards vaccination change over the course of the COVID-19 pandemic?
Vaccines are one of the most impactful scientific innovations of all time and have helped protect generations of people against infectious diseases throughout their lives. The level of scientific collaboration in this pandemic has been unprecedented, and we have seen an incredible pace of vaccine development. Yet, amid the COVID-19 pandemic, we have also faced an "infodemic" that has made this health crisis more dangerous than many others we have faced. The misinformation around COVID and COVID-19 has impacted people's attitudes towards vaccination, and it might be having an impact on other life-saving immunization programmes.
This is why Gavi works closely with its Alliance partners UNICEF and WHO to develop a globally coordinated approach to social listening and engagement, leveraging our growing relationships with social media companies and content developers to undertake sentiment analysis, as well as scaling up efforts to collect behaviourally focused demand-side data in country-level surveys systematically. The Gavi COVAX AMC is also investing in key strategic initiatives that are country- and community-owned to generate demand for vaccines.
How have you seen vaccine technology change over the last few years, and how have these technological advances translated into change in people's lives?
Vaccines for common diseases like measles, diarrheal diseases, and pneumonia allow more children worldwide to live longer and more fulfilling lives. Thanks to vaccines against diseases from COVID-19 to Ebola and cholera, we have the tools to keep our loved ones safe from health crises. However, we must ensure everyone, everywhere, has access to these life-saving tools.
The theme of this year's World Immunization Week is a "Long Life for All." As a society, how can we work towards global vaccine equity and strive towards a "Long Life for All"?
While much progress has been made in vaccine technology, not everyone has the same access to vaccines. For instance, about 12.4 million children in lower-income countries did not receive a single vaccine shot in 2020, leaving them vulnerable to some of the world's deadliest diseases. COVID-19 has also made the challenge of reaching these zero-dose children even harder, as the fiscal space, populations move, and trust in health authorities – as well as demand for vaccines – is impacted.
We move closer to a healthier, more resilient, and prosperous world by reaching these children with vaccines and ensuring none are left behind.
However, it is important to note that there is no one way of reaching these missed communities. Approaches will vary from country to country and within countries, contexts, and settings. It will require flexibility, innovation, and the expertise of organizations working in a range of fields.
It will mean working with new partners and new ways of working, particularly in fragile, conflict, and cross-border settings outside government reach.
Gavi will focus on reaching the most marginalized by strengthening primary healthcare systems, building and sustaining community demand, addressing gender barriers, and using innovation to ensure that immunization services reach these children.
What is next for Gavi, and what are your hopes for the future of vaccination?
In 2021, Gavi launched a new strategy to guide the Alliance's work over the 2021–2025 period, prioritizing reaching communities with immunization that are currently missed, such as those in urban slums, remote areas and conflict settings.
The strategy is anchored in the Sustainable Development Goals, echoing its driving mission to leave no one behind. In the strategic plan, Gavi will look to introduce and scale-up vaccines, strengthen health systems to increase equity in immunization, improve the sustainability of immunization programmes, and ensure healthy markets for vaccines and related products.
Where can readers find more information?
About Thabani Maphosa
Thabani Maphosa is Gavi’s Managing Director of Country Programmes, overseeing Gavi’s operations in 73 countries. The Country Programmes Department’s raison d'être is to harness the power of the Vaccine Alliance for countries to save the maximum number of lives through immunisation. This is achieved through maximising financial investments (donor and domestic), bringing the best partners to the table and driving innovative solutions. The Country Programmes Department manages Gavi’s relationships with governments and provides grant management oversight for all in-country resources.
Prior to joining Gavi, Thabani held several leadership roles in World Vision International for over 16 years. Thabani is a seasoned humanitarian who has led disaster preparedness and response efforts globally. He is also recognised for introducing the use of technology in the last mile and not least for scaling up cash transfers in stable and fragile contexts.
With a Master of Philosophy degree in Science, Thabani has worked in academia as a lecturer in physiology and microbiology.