In sickness and in health

When did you last meet someone with polio? It's possible that you never have. Although there are an estimated 120,000 people who have had polio living in the UK, the most recent natural infection with the virus happened in 1982. Such is the power of vaccination.

Vaccination puts a weakened version of a virus or bacterium into your bloodstream, and your body does the rest. The immune system senses the presence of foreign organisms, and develops antibodies that destroy them. The antibodies are then ready if you come into contact with the full-strength organisms.

Thanks to vaccination, the world has been smallpox-free for three decades now. Polio is all but eradicated, too. But there is still work to do, which is why it's a disgrace that the Global Alliance for Vaccines and Immunisation (Gavi) is faltering. On 25-26 March, Gavi's partner organisations, drawn from governments, industry and philanthropic organisations, are meeting in The Hague to seek solutions to the alliance's financial woes.

In many ways, Gavi is a victim of its own success. Since its formation ten years ago, it has gathered vaccine manufacturers, teams that can administer them and those that can pay the bill. The result has been more than 250 million children immunised, five million deaths averted and
a huge demand for more.

It's a demand that Gavi can't meet: current campaigns will leave the alliance $4.3bn short by 2015. Gavi raises funds by obtaining public financing commitments from governments, the European Commission and the private sector. It can then use these to raise capital.

Although its founding partner, the Bill and Melinda Gates Foundation, has promised to invest $10bn more in vaccine programmes over the next ten years, it's not yet known how much of that will go to Gavi. The hole in the alliance's finances is gaping wide.

Not that Gavi is planning to pass round a begging bowl at The Hague. The meeting is a motivator for its current partners: a chance to refocus on how its vaccination programmes provide the easiest route to meeting the UN's Millennium Development Goals. The hope is that the existing partners will leave The Hague inspired to recruit more nations to the cause. Of the 20 richest nations, 12 are not yet involved. That includes China
and Japan, numbers two and three on the GDP chart.

Science has provided the tools to save millions of lives with relatively little effort. There can be no excuse for not putting those tools to work.

Michael Brooks is a consultant to the New Scientist