PAHO's revolving fund for immunization

Today, thanks to the PAHO Revolving Fund for Vaccine Procurement, all the countries in the Americas are prepared for Vaccination Week in the Americas, a hemispheric immunization effort that starts April 24 with the aim of vaccinating some 40 million persons.

The creation of the revolving fund in 1977 allowed participating countries to use a common fund to buy vaccines at cheaper prices. Through the fund, PAHO acts as a purchasing agent on behalf of the member countries, charging them a 3 percent fee. This service charge has made it possible for the capitalization of the Fund to grow from the original $1 million to nearly $24 million by 2003. The largest individual contributor is the United States with nearly $1.7 million last year. The number of countries participating in the Fund has increased from 19 in 1977 to 35 in 2002.

Through the years, the Fund has assured a constant supply of vaccines as countries duly repay the sums borrowed. This has enabled them to benefit from the lower cost of wholesale orders. The savings have been substantial - up to 80 percent of the price of the vaccines ordered by a given country.

By using bulk purchasing, the Fund has secured high-quality vaccines for national immunization programs at affordable prices, making possible the orderly planning of immunization activities. This means they can be vital to the success and continuity of country immunization programs.

By allowing countries to acquire high-quality vaccines at affordable prices, the Fund played a major role in the introduction of new vaccines in routine immunization schedules against vaccine-preventable diseases of public health importance. These include rubella and congenital rubella syndrome, hepatitis B, Haemophilus influenzae type b and yellow fever.

When the Expanded Program on Immunization began, six vaccines were included: measles, pertussis, tetanus, diphtheria, polio and tuberculosis. Since then, polio has been eradicated, transmission of indigenous measles has been eliminated from the Americas, and countries are now targeting the elimination of rubella, though vaccination against these diseases must continue until their worldwide eradication.

A PAHO briefing paper on the Fund's aims and objectives makes clear that the challenge to the immunization situation in the Americas "remains the same as it was 25 years ago – immunization programs must continue to drive the efforts to correct issues of inequity."

"Safe, effective and affordable vaccines must be made available to people who need them," the paper says.

Experience gained by the organization's management of the Fund could benefit other regions of the world, the PAHO paper says, "This would be a catalyst to ensuring the sustainability of the vaccine supply worldwide."

In sum, the Fund's objectives are to:

• Provide countries with a continuous supply of vaccines that meet PAHO and World Health Organization (WHO) standards at affordable prices.
• Enable countries to procure the required supplies of vaccines and syringes for immunization activities. This prevents interruptions due to lack of vaccines or immediate funds.
• Facilitate the use of local currency for the reimbursement of invoices.
• Consolidate vaccine and syringe contracts for bulk purchasing, which results in more advantageous prices and improved delivery.
• Assure quality of vaccines being used in national immunization programs.
• Establish procedures with suppliers to permit urgent orders to be placed and delivered on short notice.

Vaccination Week events from April 24-30, coordinated by PAHO, will focus on the children normally left behind, those living in rural border regions, and the most vulnerable groups, including women and the elderly. The joint effort, which coincides with National Infant Immunization Week in the U.S., highlights the need for routine vaccinations and promotes access to health services. According to the CDC, 1 million U.S. children are not adequately immunized. The targets for the immunization effort in Latin America and the Caribbean include some 15 million children, 10 million adults, 10 million people over 60 years old, 1.4 million women of childbearing age, and 1.7 million people in other risk groups.

PAHO was established in 1902 and is the world’s oldest public health organization. PAHO works with all the countries of the Americas to improve the health and the quality of life of people of the Americas. It also serves as the Regional Office for the Americas of the World Health Organization (WHO). PAHO Member States today include all 35 countries in the Americas. France, the Kingdom of the Netherlands, and the United Kingdom of Great Britain and Northern Ireland are Participating States. Portugal and Spain are Observer States, and Puerto Rico is an Associate Member.