Malcolm Bruce MP writes: How UK Aid is being spent in the developing world

Malcolm Bruce MP in Bangladesh
Photo courtesy of The Gavi Alliance.

I have just returned from Dhaka, Bangladesh, where I was part of a parliamentary delegation looking at Bangladesh’s rapidly improving healthcare system and in particular their immunisation programmes, which the UK Government through bilateral aid and the GAVI Alliance is helping to support.

Pneumonia and diarrhoea together account for about 40% of all under 5 mortality in the world and yet most of these cases could be prevented through the use of vaccines.

The GAVI Alliance was established in 2000 to help developing world countries like Bangladesh gain access to these life-saving vaccines. They are a public-private global health partnership that funds the roll out of life-saving vaccines in developing countries where 85% of the world’s unvaccinated children live. Since their creation, they have immunised 288 million children and saved 5 million lives and are aiming to save more than 4 million more by 2015.

The UK Government has shown their support for GAVI’s work, GAVI received one of the highest commendations in the DFID Multi-Lateral Aid Review and in June the Government pledged £814 million to help them expand their projects. And our trip has shown what this money is delivering in countries like Bangladesh. Health system strengthening has been supported since 2008, GAVI rolled out the pentavalent vaccine in 2009, which saves an estimated 20,000 children’s lives a year and have approved the introduction of the measles second dose and ‘conditionally approved’ the pneumococcal conjugate vaccine. With the work of Unicef, GAVI’s partner on the ground, this support has undoubtedly helped Bangladesh to develop impressive vaccination services. These vaccines will help to reduce the 55,000 childhood deaths from pneumonia in Bangladesh every year.

I travelled to Bangladesh in 2009 with the Select Committee on International Development and saw then that they had an increasing focus on vaccination. This trip has confirmed the success that this success has continued. Immunisation coverage for basic vaccines such as DTP3 (against diphtheria, tetanus, whooping cough) has risen from 69% in 1990 to 95% in 2010 and when I visited the main children’s hospital in Dhaka, an immunisation and maternal health centre in an urban slum and the headquarters of the Bangladesh Expanded Programme of Immunisation I saw improved delivery of healthcare services, greater health education and greater access to immunisation for new and underused vaccines. A great deal of this is down to the drive of medical staff, organisations on the ground like BRAC and Unicef, as well as Government programmes. But, it is clear that the UK’s increased international development funding is playing a vital role in helping Bangladesh to fund and rollout successful vaccination programmes.

Also, one of the issues that is particularly close to me is that vaccines not only protect against death, but also help to prevent lifelong handicaps. I met with a woman whose child had been left deaf because of meningitis. These injuries have a devastating cost for families, both in terms of the price of healthcare, but also the social exclusion and incapacity to bring in revenue.

But there are challenges, especially the capacity of Bangladesh to store and distribute vaccines at the right temperature (known as the cold chain). But this challenge is being met and we visited the team in charge of cold chain development and it is clear that they are working with GAVI and Unicef to make the necessary changes to ensure that this can be scaled up in time to roll out the pneumococcal and rotavirus vaccines in 2012 and 2013 respectively.

It is therefore an encouraging picture in Bangladesh. I have seen that UK money is going to the people who matter and is having concrete results. The results are impressive and should continue to get even better.

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2 Comments

  • Jonathan Webber 17th Nov '11 - 8:00am

    Through the course of my work I encounter UK Aid / DFID all over the world. There should be no doubt that the Department is held in very high esteeem and the report posted here by Malcolm Bruce serves to underline and illustrate that fact.
    I’ve listened to DFID Minister Andrew Mitchell (local Sutton Coldfield MP) on a number of occasions and have always been impressed by his commitment to the Development agenda. I’ve also considered the Overseas Development agenda to be an intrinsically Liberal Democrat issue and believe that we have missed a trick in not having a strong, visible presence attached to and working with UK Aid / DFID.

  • William Wilberforce 18th Nov '11 - 5:20pm

    Dear Mr. Bruce,
    Most would agree that the various vacination programs you describe has been very successful, however, I think it is important to highlight some critical issues raised by respected healthcare professionals that have not been addressed.

    A new campaign has been launched by the GAVI Alliance to vaccinate up to 2 million women and girls with either GlaxoSmithKline’s Cervarix or Merck’s Gardasil by the year 2015. These two HPV shots have been shown to be very dangerous, with Gardasil linked to death, countless adverse reactions, and Cervarix recently outed as similarly threatening (Evidence -see links http://naturalsociety.com/gardail-timeline-history-corruption-negative-reactions/ and http://naturalsociety.com/merck-gardasil-cervarix-dangerous/.

    Nine countries are candidates for the HPV vaccine campaign, though they are not listed at this time. In addition, the price of the campaign is not being disclosed due to the “sensitive nature” of the price talks.

    Why would an organization supposedly dedicated to enhancing health worldwide push either HPV shot on up to 2 million women and young girls? Considering HPV results in only 1% of cancers, and has a 90% chance to resolve itself within two years, it does not seem worth the dangerous side effects and countless millions that will be spent on the upcoming campaign.
    The GAVI Alliance, a name relatively unknown to many, is a Geneva-based public-private partnership set up in the year 2000 with financial backing from organizations such as the World Bank, The Bill & Melinda Gates Foundation, the vaccine industry, UNICEF, and many other unidentified philanthropists. It is important to note that a public-private partnership is a government and private industry merger or partnership, meaning that these corporate interests can intertwine with big government.
    Even more concerning is the link between GAVI and the vaccine industry. In the past Merck has used bribery and other forms of corruption to push Gardasil on patients through government legislation and policy. In fact, it was revealed that Merck paid key legislators to pass the Gardasil bill that would enable the state to administer Gardasil to girls as young as 12 without parental permissions.

    Without much surprise, the bill ended up passing and being signed into law. The sales boost that Merck will receive from this law is not yet known, however Merck’s profits have recently exploded due in part to the skyrocketing sales of Gardasil. Merck may also manage to establish Gardasil as the primary HPV shot used in the GAVI alliance campaign, which would generate them countless millions.

    Merck is offering GAVI a deep discount on Gardasil, down to $5 per vaccine from $15 per three-dose course. While this may seem thoughtful, as GAVI appears to make 0 profit from their ‘generous’ act of dishing out the deadly Gardasil vaccine on poor nations, Merck stands to make a substantial profit.

    Thanks to a GAVI co-financing policy, recipient countries are required to contribute toward the cost of the vaccines. This guarantees that not only Merck, but Gavi as well, will receive considerable amounts of cash from the 9 unknown countries in which the HPV shots are being administered. Furthermore, the UN World Bank is actually issuing bonds to fund the HPV shot campaign.

    The International Finance Facility for Immunisation (IFFIm) is an organization integral in the funding of the campaign. Created to accelerate funding for vaccination campaigns, the IFFIm generates funds through the issuing of bonds in the capital markets, using long-term government pledges as a guarantee to pay back interest. Since it launched in 2006, the IIFIm has raised more than $3 billion by tapping into capital markets. This has doubled the funds available for GAVI’s immunization programs.

    Shockingly, GAVI’s Tax Form 990 for 2009 shows that GAVI has net assets of $2.5 billion — ($2,505,336,042 -page 1).

    Not only is the IFFIm generating billions in cash from governments, but Merck or GlaxoSmithKline may soon be getting a chunk of it for the HPV shot campaign. The IFFIm is funded by France, Italy, the Netherlands, Norway, South Africa, Spain, Sweden, the United Kingdom and Australia. All of this information is available through GAVI fact sheets, available on their website.

    In a 2007 article on the World Bank’s website, it was revealed that the International Finance Facility for Immunisation hoped to raise $4 billion over the next 10 years to fund the vaccination of 500 million children. Among the first buyers were the Pope, the Archbishop of Canterbury, and three other British religious leaders at the IFFIm’s launch event in London.

    Other investors included North American investors (35%), UK investors (12%), Swiss investors (8%), and investors in the rest of Europe (21%). The remainder was placed with investors in the Middle East and Asia, according to the IFFIm. Interestingly enough, Goldman Sachs and Deutsche Bank lead-managed the inaugural bond issue.

    Notes were also placed with North American investors (35 percent), UK investors (12 percent), Swiss investors (8 percent) and investors in the rest of Europe (21 percent). The remainder was placed with investors in the Middle East and Asia, according to IFFIm, the World Bank, Goldman Sachs and Deutsche Bank; the latter two lead-managed the inaugural bond issue
    The article also mentions that the bonds will be repaid over 20 years by the UK, France, Italy, Spain, Sweden and Norway under the terms of ‘legally binding’ agreements.

    The report states :

    It’s a good way to fund immunization programs because the benefits—lives saved—are realized more quickly as future donor contributions are used to provide funding now, she says
    As women take legal action against Merck for Gardasil-induced abortions and severe side effects, it seems quite outlandish for GAVI to launch a global HPV shot initiative. The HPV shot led to 3,589 harmful reactions and 16 deaths between May 2009 and September 2010 alone. Of the 3,589 adverse reactions, many were debilitating. Permanent disability was the result of 213 cases; 25 resulted in the diagnosis of Guillain-Barre Syndrome; there were 789 other “serious” reports according to FDA documents.

    It was also revealed that the FDA was hiding 26 additional Gardasil deaths until Judicial Watch filed a Freedom of Information act on the information.

    Organisations and governments around the globe should be banning Gardasil, not unleashing it on poor countries. It seems that GAVI, a multi-billion dollar merger of government and corporation, is not truly interested in improving the health of 3rd world inhabitants (or simply hides behind the benefits it does provide, as described in your article, only because of unquestioned ‘paybacks’ as I describe.).

    I hope our Government & democracy is mature enough to ask some awkward questions.

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