Lancet World Report examines the challenges ahead for the GAVI Alliance, which after a decade of “steadily increasing financing” is now “facing a funding shortfall for the next decade that could hamper the roll-out of new vaccines.” GAVI leaders attribute the funding challenges to the global economic crisis, which has kept government aid budgets from increasing, according to the Lancet.

In order to cover the cost of “a huge expansion of its programmes” over the next five years, “GAVI will have to raise up to US$4 billion – an amount equivalent to its total spending during the past decade,” the journal writes. The article reviews the cost associated with GAVI’s new programs – including the introduction of a pentavalent vaccine and new pneumonia and rotavirus vaccines – and the growing concern among GAVI executives and bilateral donors over GAVI’s financial situation.

“The question for GAVI as it enters its second decade is how will the shortfall be met? It remains to be seen whether GAVI’s main bilateral donors – the USA, Norway, Canada, the Netherlands, and the U.K. – are willing to increase further their levels of support,” the Lancet writes.  In light of GAVI’s funding gap, the article also examines the Bill & Melinda Gates Foundation’s recent pledge of $10 billion for vaccines and other bilateral donors efforts.

The piece includes comments from leaders at GAVI, the Swedish Development Minister and a Gates Foundation spokesperson (Danaiya Usher, 3/6).