U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. has announced that the U.S. government has cut off funding to GAVI the Vaccine Alliance, an organization founded and largely funded by the Gates Foundation.
Kennedy claimed that GAVI has “ignored the key issue of vaccine safety” and promoted censorship of debate about vaccines, thus undermining public confidence on issues related to public health. He said it has sometimes ignored science to focus on public relations.
U.S. taxpayers have provided 13 percent of GAVI’s funding since its inception – some $8 billion – and the Biden administration had pledged some $1.67 billion between now and 2030.
Kennedy made the announcement in a video address to a “pledging summit” sponsored by GAVI and the European Union, a gathering to secure funding for the program.
“We’re living now in a time of upheaval, a time of popular revolt against established institutions that have lost the public trust, and that includes medicine. President Trump and I are committed to earning it back,” Kennedy said. “We will do that by preserving what is honest, what serves our country and the world, and we will sweep away that which is not.
“A major concern that I share with the President is how the World Health Organization and GAVI partnered together during the COVID-19 pandemic to recommend best practices for social media companies to silence dissenting views, to stifle free speech and legitimate questions during that period.
“In addition, GAVI has continued to make questionable recommendations, encouraging pregnant women to receive COVID-19 vaccines. Having said that, there’s much that I admire about GAVI, especially its commitment to making medicine affordable to all the world’s people. GAVI has done that part of its job very well.
“Unfortunately, in its zeal to promote universal vaccination, it has neglected the key issue of vaccine safety. When vaccine safety issues have come before GAVI, GAVI has treated them not as a patient health problem, but as a public relations problem.”
He added: “When the science was inconvenient, GAVI ignored the science.
“GAVI should consider the best science available, even when that science contradicts established paradigms. It should define success not just in terms of the number of vaccines delivered, but on their rigorously measured overall impacts. I call on GAVI to re-earn the public trust and to justify the $8 billion dollars that America has provided in funding since 2001. Until that happens the United States won’t contribute more to GAVI.
“Business as usual is over. Unaccountable and opaque policymaking is over. I invite all of you to join us in a new era of evidence-based medicine, old-standard science and integrity.”
Some of Kennedy’s criticism was based on GAVI’s choice of a combined vaccine for diphtheria, tetanus, and pertussis (whooping cough). GAVI uses a whole-cell pertussis vaccine in less-developed countries, rather than the acellular pertussis vaccine (DTaP) used in higher-income nations.
He cited research suggesting a link between the whole-cell pertussis vaccine and increased infant mortality in girls. Researchers examined healthcare records involving 4,000 children, ages six weeks to four months, admitted to a pediatric hospital in Guinea-Bissau between 2001 and 2008. Among those who had not received the DTP vaccine, girls and boys had similar death rates, but among those who had received the vaccine, more girls died.
As noted by the HistoryOfVaccines blog, researchers searched for alternative explanations. “They adjusted their analysis to account for factors such as the child’s age, the mother’s education level, and whether the child had also received other vaccines, like BCG (a vaccine against tuberculosis not used in the United States). But even with those adjustments, the pattern of higher mortality among vaccinated girls remained. It wasn’t a huge difference, but it was enough to prompt them to call for further research.”
HISTORY
GAVI, originally the Global Alliance for Vaccines and Immunization, is the world’s largest organization that spends donations on vaccines. According to one study, a third of donor money for vaccinations in 1996-2016 went through GAVI.
The watchdog website Influence Watch describes GAVI as “a public–private global health partnership consisting of large NGOs, drug companies, and private foundations.” Its stated mission is “providing access to vaccines and immunizations to individuals in poor and developing countries, with an emphasis on child vaccination.”
It was founded in 1999 by the Bill and Melinda Gates Foundation, which provided $750 million in seed money. Its founding partners included the World Bank, UNICEF, and the World Health Organization. To this day, GAVI is by far the largest single recipient of Gates Foundation money. In addition, organizations connected to Bill Gates lobby heavily for taxpayers’ money for GAVI.
GAVI pools money from donors to buy vaccines from pharmaceutical manufacturers, then distributes those vaccines. It negotiates bulk prices with the manufacturers while, in effect, ensuring companies against the risks of operating in poor countries. It also supports the training of healthcare workers and “health system strengthening” (HHS), or efforts to improve the performance and capacity of countries’ healthcare systems.
The largest GAVI vaccine purchase, half its budget at some times, has been for pneumonia vaccines. Pneumonia is the most frequent cause of preventable death in children (some 400,000 preventable deaths per year).
Diseases targeted in GAVI’s immunization campaigns have included Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), yellow fever, hepatitis B, cholera, meningitis, tuberculosis, measles, and polio, along with the Wuhan coronavirus (“COVID”). GAVI has vaccinated a reported four million children, particularly in Africa, for human papillomavirus (HPV). (HPV can cause cancer, and the vaccine is most effective at stopping the spread of the virus if given before a person is sexually active.)
In its 2016-20 strategic plan, GAVI focused on Haiti, Yemen, Afghanistan, Pakistan, India, Myanmar (Burma), Indonesia, and Papua New Guinea, and, in Africa, Chad, the Democratic Republic of the Congo, Ethiopia, Kenya, Nigeria, Uganda, the Central African Republic, Madagascar, Mozambique, Niger, Somalia, and South Sudan. Prices are heavily subsidized, with the price breaks phased out once nations reach a certain income level (about five dollars a day per person).
GAVI claims to have provided nearly a billion vaccinations. For public-relations purposes, advocates for vaccination programs claim that such vaccinations save one life for every 58-62 vaccinations. GAVI’s claim is to have saved 15 million lives – perhaps the most frequent claim noted by Bill Gates to demonstrate the effectiveness of his philanthropic work.
Excluding money from U.S. taxpayers, GAVI said it has secured $9 billion in funding toward its goal of $11.9 billion for 2026-2030. The Gates Foundation has pledged $1.6 billion, which will bring the total Gates donation since 2000 to $7.7 billion.
More than half of the money for GAVI in recent years has come from the governments of the United Kingdom and the United States and from the Gates Foundation. In 2016, the numbers were $2.08 billion from the U.K., $1.552 billion from Gates, and $1.38 billion from the U.S., out of a total of $8.8 billion.
CRITICISM
GAVI has been the subject of criticism for its approach, sometimes termed the “Gates approach,” to public health matters, a business- and market-oriented approach that relies on technology and quantifiable results. Some critics liken its approach to Robert McNamara’s strategy for the Vietnam War – saying, in essence, that it focuses on measurable details while missing the big picture. Critics say that, under Bill Gates’s influence, it overprioritizes vaccines over the above-mentioned HSS (health system strengthening); they point to reports that, lest Gates be offended, staffers hid pro-HSS materials when he visited GAVI offices.
GAVI critics have alleged conflicts-of-interest involving pharmaceutical manufacturers on the governance board and of sweetheart deals (including subsidies) for those companies. In his 2023 book The Bill Gates Problem, Washington journalist Tim Schwab wrote that “the vast majority of GAVI’s budget actually comes from taxpayers in Europe and the United States, which have pledged billions of dollars to the project. Do we simply trust that the deals GAVI negotiates with Big Pharma are a good, just, and efficient use of taxpayer dollars?”
As Schwab notes, Gates commented in a 2011 Wired magazine interview that “When you get this problem of these diseases – this sounds like an awful thing to say – but when diseases affect both rich and poor countries, trickle-down will eventually work for the poorest, because the high cost of development is recovered in the rich world, and then as they go off patent, they’re sold for marginal cost to the poor and everybody benefits.” That’s certainly true, but when governments and politically connected billionaires and mega-nonprofits are involved in that process, those with great political clout such as Big Pharma always seem to do well.
Other criticisms of GAVI include allegations that private donors wield excessive influence, that local healthcare systems are dominated and weakened by GAVI efforts, and that GAVI prioritizes new, expensive vaccines over older ones (supposedly in order to maximize pharma profits).
In addition, there are criticisms that apply to foreign aid in general. As British economist Peter Thomas Bauer noted – a sentiment popularized by U.S. politician Ron Paul – “Foreign aid is a system of taking money from poor people in rich countries and giving it to rich people in poor countries.” Foreign aid is often diverted to corrupt officials and their friends, or it helps prop up regimes that keep their people poor, or the aid fosters dependency, or the aid pumps up the value of the currency and makes exports less competitive, or the aid subverts the development of the homegrown economy.
And, as is illustrated by what’s called the Preston Curve, higher incomes in a country are strongly associated with longer life expectancy. The poorer the country, the greater the increase in life expectancy as incomes rise. This raises the question of whether any given dollar in aid might be better spent on changing a country’s economic system, to move it away from systems such as socialism that cause poverty.
The cutoff of funding for GAVI, at least until it implements reforms, will give critics of GAVI an opportunity to make their case. One hopes that the outcome of Kennedy’s action will be an improvement in global public health and a lessening of the burden that such programs put on the American taxpayer.
Dr. Steven J. Allen is a Senior Fellow of the National Legal and Policy Center.
