Over the past week and a half I've had the privilege of touring Laos to see the impact of aid investments in improving immunization coverage. This is my final blog, but you can catch my earlier oneshere and here.
Our final few days in Laos were spent meeting the Minister for Health and the President of the National Assembly as well as visiting Sethathirath Hospital, Vientiane’s university hospital. Our delegation took away a number of key insights from these meetings.
Firstly, the support that the Government of Laos is receiving through Gavi, the Vaccine Alliance, should not be seen as a handout.Through Gavi’s co-financing requirement, the Laos Government also contributes funding towards its vaccination activities. And as Laos’ economy continues to grow at levels of at least 6% p.a, it is expected that the Government will gradually cover more of the costs associated with its immunization program. This element of sustainability – ensuring that the Government’s capacity is strengthened over time and does not become dependent on aid – is one of the hallmarks of the Gavi model.
Nonetheless, the Health Ministry stressed that at least over the course of the next few years Laos will continue to require Gavi funding in order to scale up its immunsation coverage. Roughly 1 in 5 children continue to go without access to basic vaccines and the country as a whole still has one of the highest child mortality rates in the region. Yet, Laos has also been able to achieve some incredible results in recent years as well. It has introduced a wide range of new vaccines (such as the DTP-HepB-Hib and Measles-Rubella vaccines), making incredible inroads into its relatively high child mortality rate. Continued support from countries like Australia and the United States, via Gavi, will help ensure this progress does not stall.
After our visit to Sethathirath Hospital, I don’t think there would be a single member in our group who would not subscribe to the argument that vaccines are one of the best buys in public health. That is, if you want to get best bang for your aid buck, invest in delivering basic vaccines in remote, vulnerable and marginalized communities. Not only do vaccines help ensure more children grow up to be healthy and productive citizens, but they also help reduce pressure on the health system overall. For instance, we were told that the cost of treating cervical cancer for women in Laos is estimated at USD $20,000 plus per person; an extravagant amount that unfortunately many are unable to afford. Compare this to the cost of delivering the relatively inexpensive HPV vaccine and the case for investing in vaccines speaks for itself. Although even after being vaccinated women should still get screened for cervical cancer as a safety measure, if the current pilot of HPV in Vientiane proves effective then imagine how many lives (and dollars!) could potentially be saved if it is able to be rolled out across the whole country through the backing of Gavi?
As our parliamentarians flew back to Australia – and I begun the lengthy trip back to New York – I reflected on the one key take away from the past week. Too often we hear reports about aid being misspent or wasted. While bad aid certainly exists however, as the work of Gavi in Laos demonstrates there is also no shortage of life-saving, meaningful and sustainable aid programs. My hope is that the MPs who accompanied us on this trip will share these insights with their colleagues in Parliament and also with the people they represent, making the case for Australian aid as an effective investment in producing better health outcomes, more inclusive economic growth and improved living standards.
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Michael Sheldrick