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Step up to the global vaccine plate

Step up to the global vaccine plate

Agencies Representational The Modi government is under pressure from the domestic vaccine industry to substantially increase its financial investment in Gavi (formerly, Global Alliance for Vaccines and Immunisation), the Vaccine Alliance, threatened by the prospect of its largest-by-far donor, the US, under Trump 2.0 pulling the plug on the PPP that helps vaccinate half the world's children against some of the deadliest diseases. Gavi is now desperately looking at large emerging economies like China and India, along with Gulf states, to make up the shortfall. For New Delhi, it's an opportunity to help local vaccine manufacturers heavily involved in Gavi, and also boost India's role as a major global player.Gavi's current fiscal predicament is an outcome of Trump, ironically a champion of the alliance in his first term when he pledged a generous $1.1 bn for 2020-23. But in an extraordinary somersault, Trump 2.0 has suspended all external funding, including for global health, pulled out of WHO, and appears to be reneging on an earlier pledge to Gavi by the Biden administration one year ago of $1.58 bn over a period of five years.
Significantly, the Trump regime's FY26 budget request to Congress and senate now being debated indicates drastic reductions in funding for global health. It does not even include funding for Gavi. To make matters worse, US secretary of health Robert F Kennedy Jr is a vaccine-sceptic who has questioned the efficacy and safety of vaccines. A vocal critic of Gavi, Kennedy has made numerous public statements and written articles expressing concerns about the organisation's transparency, accountability and impact on global health. India has had a special relationship with Gavi for long. In 2014, it was the first recipient country to become a donor to the alliance formed at the start of the new millennium with the help of core partners WHO, Unicef, World Bank, and the Bill and Melinda Gates Foundation, along with solemn pledges of support from a host of developed nations led by the US. As the Indian vaccine industry grew in leaps and bounds over the past decade, local manufacturers today represent over 50% of Gavi's vaccine procurement by volume. In terms of value, Gavi has procured 3 bn doses worth $3 bn from Indian manufacturers during 2016-24.
Worried at the impact on India by Gavi's financial crisis, Indian Vaccine Manufacturers Association (IVMA) appealed to the PM, FM and health minister, among others, urging GoI to come to Gavi's aid. 'India has long benefited from Gavi's programmes, both in terms of access to life-saving vaccines and through support for the export of vaccines manufactured by Indian companies. A reduction in Gavi's funding would, therefore, adversely impact our export ecosystem, restrict market access, and challenge our shared mission to advance global health equity,' their letter said. It urged GoI to consider a 'financial contribution of $260 mn annually for the next 5 years to bridge the impending funding gap and support Gavi's continued efforts'. Such a commitment, IVMA believes, would reinforce India's global leadership in health diplomacy, and its image as a champion of multilateral institutions and 'global south-south' cooperation. This, along with sustaining the global reach of Indian vaccines that is crucial for the domestic manufacturing ecosystem.
Such an increase in financial commitment to Gavi from the current $15 mn - although quadrupled in less than a decade from India's contribution when it first became a donor - may be difficult for GoI. This is particularly so when it's dealing with financial challenges posed by the burden of importing expensive military hardware and Donald Trump's tariff demands. A more realistic financial commitment expected from India would be around $100 mn. Over the past decade, one area India has gained considerable respect in is the global health space, particularly during the pandemic when the country significantly contributed with its vaccine manufacturing abilities to the worldwide effort to cope with an unparalleled health crisis. India recently became the world's third-largest economy, surpassing Japan. But the latter gives as much as $1.54 bn in total contributions and pledges, while China's contribution is $120 mn.With China poised to fill the vacuum left in global health and other development initiatives by an increasingly isolationist US, India would do well to weigh the gains of protecting a vital domestic industry, as well as promoting strategic global outreach against the financial burden. Health minister J P Nadda, a former Gavi board member, will be India's representative at the organisation's pledging summit in Brussels next week. It could be an opportune moment for India to punch its weight on the global healthcare front.
The writer is an independent journalist
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