DFC’s Nisha Biswal and Nafisa Jiwani met with DFC partners from GAVI and Institute Pasteur de Dakar during the Global forum for Vaccine Sovereignty.

How DFC is addressing urgent global health challenges: A conversation with Nafisa Jiwani

DFC
4 min readJul 31, 2024

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Last month, DFC joined world leaders at the Global Forum for Vaccine Sovereignty to celebrate the launch of GAVI’s African Vaccine Manufacturing Accelerator (AVMA), which is enabling sustainable production of lifesaving vaccines for the continent.

This week, DFC is at the Global Pandemic Preparedness Summit hosted by the Coalition for Epidemic Preparedness Innovations (CEPI) and the Government of Brazil. DFC highlighted how the G7 DFI-led surge financing for medical countermeasures initiative will advance more equitable vaccine access in a future health emergency. This initiative aligns with CEPI’s mission to develop a vaccine for the next novel health outbreak in 100 days as well as the Regional Vaccine Manufacturing Collaborative (RVMC) goal to advance vaccine equity and health security.

During the COVID-19 pandemic, developing countries in Africa and other parts of the world experienced significant delays accessing vaccines and diagnostic tests. Similar inequities persist today as many of the world’s poorest countries face some of the highest burdens of infectious and noncommunicable diseases and rely on fragile supply chains for essential medicines.

As a leader in healthcare investing in emerging markets, DFC has a robust portfolio of private- sector-led projects that are strengthening health manufacturing and supply chains around the world. DFC has partnered with Gavi, the Vaccine Alliance, to provide liquidity to accelerate the purchase of COVID-19, routine childhood, and future outbreak vaccines.

“Health security is economic security. Outbreaks know no borders. Health security cannot be robust anywhere unless health systems and supply chains are strengthened everywhere.”

Nafisa Jiwani, Associate Vice President for Global Health, who has played a leading role in building DFC’s healthcare portfolio, details some of the specific challenges DFC is working to address and explains how investments in global health are critical to stability and prosperity.

Explain the challenges developing countries face accessing healthcare.
Today, only 1 percent of all vaccines administered in Africa are produced locally. That includes COVID-19 vaccines but also routine childhood vaccines and those that protect against infectious diseases.

Right now, multiple African countries are experiencing outbreaks of cholera, dengue fever, and Mpox. In addition to, limited local vaccine manufacturing, there is insufficient capacity to manufacture drugs and diagnostics, and for lab capacity to analyze test results.

We saw how this impacted the response to COVID-19. There was a 100-day gap between the first COVID-19 vaccination administered in low-income and high-income countries, and testing rates were also much higher in high-income countries.

DFC is committed to ensuring that the world never again faces a health crisis with these vulnerabilities.

How is DFC working to address these challenges?
We are looking at the entire spectrum of care, from diagnosis to treatment. The first pillar of this approach is to invest in more health services including clinics and hospitals. The second is manufacturing capacity, and it encompasses vaccines, therapeutics, and diagnostics, including everything that is needed to use the finished product such as syringes and glass vials. A lot of these components are imported as well, which compounds the problem. The third is innovation and new technology, including cutting-edge research and development. This whole ecosystem needs to be strengthened to ensure the world is prepared to respond to a health emergency.

As we saw during the pandemic, DFC and other development finance institutions (DFIs) play an important role in investing in these areas that struggle to attract commercial investment given the risks and long project -development timelines. Early in the pandemic, our financing alongside a group of DFIs helped South Africa’s Aspen Pharmacare significantly expand its capacity for COVID-19 vaccine production. That ultimately helped Aspen enter a partnership with the Serum Institute of India to expand capacity for other routine childhood vaccines.

Finally, we are looking at the intersection of health and technology to use data to improve efficiencies. Our investment in Kasha, a platform for last -mile access to health products and household goods in East and South Africa, is an example of how investments in technology can help us reach women and other underserved populations.

What impact are these investments having?
A subset of clients that reported impact results last year showed a massive impact. Collectively, DFC support provided 52 million patients access to healthcare products and services and procured 790 COVID-19 vaccines and booster doses.

More broadly, we’ve established an architecture for DFIs to work together on surge financing for medical countermeasures — that is, all the products such as vaccines, drugs, and diagnostic tests that will be critical in the event of a public health emergency. Last year, the G7 DFIs, European Investment Bank, and International Finance Corporation agreed to collaborate on surge financing to more rapidly respond to future health emergencies. This year, these DFIs are building on this first -of -its -kind framework to develop a memorandum of understanding and design working capital and other innovative financing mechanisms to help ensure that we will never again face a global health crisis in the position we found ourselves in four years ago.

It has been almost five years since COVID-19 first appeared. What have we learned?
I think we all learned that the way we were doing business, where manufacturing was concentrated in one or two different regions, came with a downfall. Even if that model lowered the cost per dose, it failed from a health equity standpoint and showed that we need to establish regional manufacturing capacity worldwide and strengthen supply chains.

DFC aims to invest where American values and interests intersect. How do investments in global health advance that mission?
Health security is economic security. Outbreaks know no borders. Health security cannot be robust anywhere unless health systems and supply chains are strengthened everywhere.

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DFC
DFC

Written by DFC

U.S. International Development Finance Corporation. Investing in development and advancing U.S. foreign policy.

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