III 

118TH CONGRESS 

2D SESSION S. RES. 684 

Supporting the role of the United States in helping save the lives of children 

and protecting the health of people in low-income countries with vaccines 

and immunization through Gavi, the Vaccine Alliance (‘‘Gavi’’). 

IN THE SENATE OF THE UNITED STATES 

MAY 14, 2024 

Mr. WICKER (for himself and Mr. CARDIN) submitted the following resolution; 

which was referred to the Committee on Foreign Relations 

RESOLUTION 

Supporting the role of the United States in helping save 

the lives of children and protecting the health of people 

in low-income countries with vaccines and immunization 

through Gavi, the Vaccine Alliance (‘‘Gavi’’). 

Whereas, prior to 2000, the distribution of and the resources 

for vaccines for children in the developing world were declining, immunization rates were stagnant or decreasing, 

and nearly 10,000,000 children died each year before 

reaching their 5th birthday; 

Whereas, prior to 2000, it was common for new lifesaving 

vaccines to take up to 15 years to be introduced in the 

world’s most impoverished countries; 

Whereas access to routine immunization and vaccines protects children from deadly but preventable diseases and 


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contributes to national economic growth and poverty reduction by ensuring people live longer, healthier, and 

more productive lives; 

Whereas, in 2000, the United States, the United Nations 

Children’s Fund (UNICEF), the World Health Organization (WHO), the World Bank, government donors, lowerincome country governments, foundations (including the 

Bill & Melinda Gates Foundation), the private sector (including the vaccine industry), faith-based organizations, 

civil society, and other partners joined forces to create a 

public-private partnership now known as Gavi, the Vaccine Alliance, in order to expand access to new and 

underused vaccines and support the introduction and 

scaleup of these vaccines into routine immunization systems in the world’s most impoverished countries; 

Whereas, from 2000 through 2022, with support from the 

United States, and other donors and partners, Gavi has 

supported country-led vaccine initiatives in 78 countries 

to support the immunization of more than 1,000,000,000 

additional children and averted an estimated 17,300,000 

deaths in the world’s most impoverished countries; 

Whereas Gavi has been a major contributor in reducing the 

number of childhood deaths in lower-income countries 

due to vaccine-preventable disease by 70 percent since 

2000; 

Whereas country ownership and sustainability are at the core 

of the Gavi model, which requires Gavi-eligible countries 

to contribute to a portion of vaccine costs and directly invest in immunizing children, and Gavi-supported countries contributed more than $1,500,000,000 to immunization campaigns between 2008 and 2022; 


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Whereas 78 low-income countries currently provide co-financing for new and underused vaccines supported by Gavi, 

more than 19 countries have transitioned from Gavi support by the end of 2022, and an additional 10 countries 

may transition by 2040, moving toward fully funding 

their immunization programs; 

Whereas Gavi has transformed the market for vaccines by 

matching pooled demand from low-income countries with 

secure, predictable financing to make vaccines more affordable and supply more reliable, reducing the price of 

the most common vaccines by 24 percent from 2015 to 

2020 and increasing the number of global vaccine manufacturers selling pre-qualified Gavi-supported vaccines to 

the world’s most impoverished countries from 5 in 2001 

to 18 in 2018; 

Whereas Gavi estimates that its market shaping efforts will 

result in savings of over $900,000,000 from 2021 to 

2025 and may encourage research and development of 

new vaccines; 

Whereas Gavi is poised to provide the most comprehensive 

package of support in the 2021 to 2025 period by financing and delivering 18 vaccines to the world’s most impoverished countries; 

Whereas Gavi, the African Union, and the Africa Centers for 

Disease Control (Africa CDC) have jointly established the 

African Vaccine Manufacturing Accelerator (AVMA) to 

provide innovative financing to expand sustainably vaccine manufacturing capacity in Africa and improve the 

region’s resilience in the face of pandemics, outbreaks, 

and other health emergencies, while preserving the health 

of vaccine markets globally; 


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Whereas Gavi is collaborating with the Global Polio Eradication Initiative on the final push to end polio, and expanding the integration of the inactivated polio vaccine 

into routine immunization programs; 

Whereas Gavi has made significant progress in supporting 

the development and stockpiling of effective vaccines to 

combat cholera, measles, meningococcal, yellow fever, and 

Ebola, which could also protect Americans in the event 

of an outbreak on United States soil; 

Whereas malaria is one of most long-standing and deadliest 

diseases in Africa, and in 2022, malaria killed an estimated 580,000 children in Africa, 78 percent of whom 

were children under five; 

Whereas Gavi has begun deliveries of new malaria vaccines 

and will expand the program to dozens of countries as 

vaccine supply becomes available; 

Whereas Gavi recently allocated 18,000,000 doses of the malaria vaccine RTS,S in 2023 and 2024, the World Health 

Organization estimates that at least 40,000,000 to 

60,000,000 doses will be needed annually by 2026 and 

80,000,000 to 100,000,000 doses will be needed by 2030; 

Whereas Gavi is supporting expanded procurement, access, 

and implementation of new malaria vaccine programs to 

help meet rising demand; 

Whereas data from malaria vaccine trials indicate that these 

vaccines can save one life for every 200 children vaccinated, with the potential for significantly impacting 

public health and saving tens of thousands of lives annually; 

Whereas Gavi supports the strengthening of health systems 

to ensure effective immunization and health services, inVerDate Sep 11 2014 23:49 May 14, 2024 Jkt 049200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6300 E:\BILLS\SR684.IS SR684

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cluding through the provision of cold chain equipment 

that can also be effectively repurposed for emergency response, as was demonstrated during the COVID–19 pandemic; 

Whereas, through COVAX, Gavi and global partners delivered nearly 2,000,000,000 doses of COVID–19 vaccines 

to 146 economies, and averted an estimated 2,700,000 

deaths in Advance Market Commitment lower-income 

participating economies; 

Whereas Gavi is providing additional vaccine support to address health service interruptions that occurred during 

the COVID–19 pandemic and contributed to the largest 

backslide in routine childhood immunization in 30 years, 

and is also focusing on the 14,000,000 ‘‘zero-dose’’ children in Gavi-supported countries who had not received a 

single vaccine; 

Whereas vaccines programs are widely regarded as high-impact, evidence-based interventions and are among the 

most efficient, cost-effective, and successful health initiatives in history, returning over $50 in health and economic savings for every $1 invested in Gavi-supported 

countries; 

Whereas the prevention of infectious disease through immunization in Gavi-eligible countries provides protection and 

health security in the United States by reducing the prevalence of infectious diseases and stemming outbreaks at 

their source; 

Whereas United States investment in Gavi complements and 

enhances the effectiveness of other United States investments in global health, particularly in maternal and child 

health and nutrition; 


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Whereas Gavi is committed to working with partners, including United States bilateral programs administrated by 

the United States Agency for International Development 

(USAID) and the Centers for Disease Control and Prevention (CDC), to ensure children in developing nations 

have access to lifesaving vaccines and immunizations; 

Whereas Gavi’s next strategic cycle will cover the strategic 

period of 2026 to 2030, which will include the expansion 

of Gavi’s malaria program; 

Whereas the launches of the Gavi’s Investment Opportunity 

for 2026 through 2030 and AVMA will be held in June 

2024 and co-hosted by the Government of France, African Union, and Africa CDC to obtain funding commitments; 

Whereas the United States has consistently supported the 

goal of saving lives by contributing annually to Gavi to 

meet its projected replenishment and program goals; 

Whereas with this support and support from other donors, 

Gavi will have contributed $220,500,000,000 in economic 

benefits in Gavi countries as of 2022, with each $1 invested yielding $54 return on investment; and 

Whereas an increased commitment from the United States 

remains necessary to ensure predictability and stability to 

the vaccine market, to enable strong global health security efforts, spur confidence in Gavi-eligible countries, 

and encourage continued innovative vaccine-related approaches: Now, therefore, be it 

1 Resolved, That the Senate— 

2 (1) affirms the continued support of the United 

3 States Government for the purchase of vaccines for 


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1 low-income countries through Gavi as a cost-effec2 tive, efficient means to reduce mortality and as a 

3 critical component of meeting the United States goal 

4 to end preventable child and maternal deaths; 

5 (2) supports the principles and goals of Gavi 

6 to— 

7 (A) introduce and scale up new and rou8 tine immunizations in low-income countries; 

9 (B) improve sustainability of immunization 

10 programs; 

11 (C) ensure healthy markets for vaccines 

12 and related products; and 

13 (D) strengthen health systems to increase 

14 equity in immunization; 

15 (3) recognizes that United States Government 

16 support for Gavi is a critical component to ensuring 

17 health security in the United States; 

18 (4) encourages the continued use of USAID 

19 maternal and child health and CDC global immuni20 zation resources to strengthen local public health ca21 pacity to introduce and sustain new and underuti22 lized vaccines supported by Gavi through routine im23 munization systems; 

24 (5) recognizes the need for multiyear pledges 

25 from the United States to allow Gavi to maximize its 


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1 impact to provide lifesaving vaccines and to leverage 

2 contributions from other countries and donors; and 

3 (6) encourages continued increased commitment 

4 and investment by the United States Government to 

5 Gavi in the 2026 to 2030 strategic period in order 

6 to ensure that lives are protected and saved through 

7 access to vaccines and immunizations. 

Æ 


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