IV 113th CONGRESS 2d Session H. RES. 688 IN THE HOUSE OF REPRESENTATIVES July 25, 2014 Ms. McCollum (for herself, Mr. Reichert , Mr. Engel , Mr. Crenshaw , Ms. Bass , Mr. Diaz-Balart , Ms. Lee of California , Mr. Fitzpatrick , Mr. Smith of Washington , Mr. McCaul , Ms. Esty , Mr. McHenry , Ms. Speier , Mr. Ross , Mr. McDermott , Mr. Hall , Mr. Levin , Mr. Schock , and Ms. Roybal-Allard ) submitted the following resolution; which was referred to the Committee on Foreign Affairs RESOLUTION Supporting the role of the United States in ensuring children in poor countries have access to vaccines and immunization through the GAVI Alliance.

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 30,000,000 children born in the developing world each year were not fully immunized; Whereas prior to 2000, it was common for new life-saving vaccines to take up to 15 years to be introduced in the world’s poorest countries; Whereas access to routine immunization and vaccines protect children from deadly but preventable disease and contribute to national economic growth and poverty reduction by ensuring people live longer, healthier, and more productive lives; Whereas in 2000, the Bill & Melinda Gates Foundation, the United States, the United Nations Children's Emergency Fund (UNICEF), the World Health Organization, the World Bank, bilateral partners, developing countries, the private sector, including the vaccine industry, civil society, and other partners joined forces to create a public-private partnership called the Global Fund for Children’s Vaccine (now the GAVI Alliance) in order to expand access to new and underused vaccines and support the introduction and scale-up of these vaccines into routine immunization systems in the world’s poorest countries; Whereas partnership and sustainability are at the core of the GAVI Alliance model by requiring GAVI-eligible countries to contribute financing to some portion of their vaccine costs and directly invest in immunizing their children; Whereas by 2012, more than 65 developing countries working with the GAVI Alliance were co-financing new and underused vaccines funded by the GAVI Alliance and more than 20 countries are projected to graduate between 2016 and 2020, moving toward fully funding their national immunization programs; Whereas the GAVI Alliance has transformed the market for vaccines by pooling demand from developing countries matched with secure, predictable financing to make vaccines more affordable and supply more reliable, and encouraging research and development of new vaccines; Whereas as a result, the GAVI Alliance has played a critical role in increasing the number of global vaccine manufacturers selling to the world’s poorest countries from 5 in 2001 to 13 in 2014; Whereas the price for the pneumococcal vaccine, which prevents pneumonia, is now more than 90 percent lower for GAVI-eligible countries, and the price of rotavirus vaccines, which prevents diarrhea, is 67 percent lower in GAVI-eligible countries; Whereas with innovative financing mechanisms like the Advance Market Commitment and International Finance Facility for Immunisation (IFFIm), the GAVI Alliance ensures that appropriate and affordable vaccines are available throughout the developing world; Whereas the GAVI Alliance supports the financing and delivery of 11 vaccines, including those against pneumococcal disease and rotavirus, the leading vaccine-preventable causes of pneumonia and diarrhea, which kill more children under the age of 5 than any other disease; Whereas the GAVI Alliance collaborates closely with the Global Polio Eradication Initiative on the final push to end polio, strengthening and bringing the inactivated polio vaccine into routine immunization programs; Whereas strong immunization systems are critical to ensuring continuous coverage and sustainability of polio, new and routine immunization programs in implementing countries; Whereas the GAVI Alliance supports the strengthening of health systems and local civil society organizations to ensure effective immunization and health services; Whereas since 2000, with support from the United States, the Bill & Melinda Gates Foundation, UNICEF, the World Health Organization, the World Bank, implementing countries, donor governments, the private sector, and other donors and partners, the GAVI Alliance has supported country-led vaccine roll outs in 77 countries to support the immunization of an additional 440,000,000 children and will avert an estimated 6,000,000 deaths in the world’s poorest countries; Whereas in 2013, the GAVI Alliance was ranked the second most transparent aid program in the Aid Transparency Index, behind only the Millennium Challenge Corporation; Whereas even with significant contributions by the GAVI Alliance, only a small percentage of young children worldwide receive all 11 life-saving vaccines universally recommended by the World Health Organization; Whereas vaccines are widely regarded as one of the “best buys” in global health and recognized as one of the most efficient, cost-effective, and successful health initiatives in history; Whereas in 2012, leading experts on health economics ranked childhood immunization as 1 of the 3 most cost-effective solutions to advance global health; Whereas as one of the initial 6 donors, the United States has been an important supporter of the GAVI Alliance and through the generosity of the people of the United States has contributed almost $1,200,000,000 for the acquisition of life saving vaccines; Whereas at the GAVI Alliance’s first pledging conference in June 2011, the United States increased its support and pledged $450,000,000 for fiscal years 2012 through 2014 to increase access to new and underused vaccines, including pneumococcal and rotavirus vaccines; Whereas in addition to this 3-year pledge, the United States contributed an additional $90,000,000 to the GAVI Alliance in fiscal year 2011; Whereas United States investment in the GAVI Alliance complements and enhances the effectiveness of other bilateral and multilateral United States investments in global health, particularly in child survival; Whereas the GAVI Alliance is committed to working with partners, including United States bilateral programs run 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 vaccines and immunizations; Whereas in June 2012, the United States Government, together with the Governments of Ethiopia and India as well as UNICEF, mobilized the world around the goal of ending preventable child deaths by 2035; Whereas access to immunizations is a key component of reaching that goal; Whereas in May 2014, at the World Economic Forum meeting in Abuja, Nigeria, African leaders pledged to increase investment in their countries’ immunization programs by endorsing the Immunise Africa 2020 leaders declaration; Whereas, on May 20, 2014, the GAVI Alliance called on donors to support an ambitious plan to immunize an additional 300,000,000 children against potentially fatal diseases and save an additional 5,000,000 to 6,000,000 lives between 2016 and 2020; Whereas the GAVI Alliance needs donors to invest an additional $7,500,000,000 to support developing countries’ immunization programs from 2016 to 2020; Whereas at the same time, implementing countries are expected to co-finance an additional $1,200,000,000, an increase from almost $500,000,000 in 2011 through 2015; and Whereas with this support from donors and the global vaccine community, the GAVI Alliance can reach its 1,000,000,000th child with critical vaccines by the early 2020s, nearly double the number of lives saved since its founding and unlock between $80,000,000,000 to $100,000,000,000 in economic benefits through health care savings and productivity gains: Now, therefore, be it

That the House of Representatives— (1) commends the GAVI Alliance, the Bill and Melinda Gates Foundation, the United Nations Children's Emergency Fund (UNICEF), the World Health Organization, the World Bank, civil society, the private sector, faith-based organizations, the international community, and implementing countries on the progress that has been made on reducing child mortality through the increased availability and distribution of vaccines; (2) affirms the United States continued support for the purchase of vaccines for poor countries through the GAVI Alliance as a cost-effective, efficient means to reduce child mortality and as a critical component of meeting the United States goal to end preventable maternal and child deaths; (3) supports the ideals and goals of the GAVI Alliance— (A) accelerate equitable uptake and coverage of vaccines; (B) improve the effectiveness and efficiency of immunization delivery; (C) improve sustainability of national immunization programs; and (D) shape markets for vaccines and other immunization products; (4) upholds that the United States is a critical donor in its work with other donors to perform diplomatic outreach in seeking additional funding for the GAVI Alliance in order to leverage its commitment; (5) recognizes that the United States, in addition to being an important donor, is a critical technical partner to the GAVI Alliance and the impact of United States investments to the GAVI Alliance is leveraged by providing direct technical assistance to implementing countries and global bodies; (6) encourages the continued use of United States Agency for International Development (USAID) maternal and child health and Centers for Disease Control and Prevention (CDC) global immunization resources to strengthen local public health capacity to introduce and sustain new and underutilized vaccines, that are supported by the GAVI Alliance, through routine immunization systems; and (7) encourages continued commitment and investment by the United States Government and international donors, through the GAVI Alliance, to the global effort to ensure that children in developing nations have access to vaccines and immunizations.