Gates Package — page 1087

combating a pandemic like COVID, but looking back, it now seems obvious: Gavi was a fantastic investment for saving children that was also a fantastic investment for dealing with COVID. Having spent the better part of two decades helping poor countries improve their systems for delivering vaccines, Gavi had skills and experience to help when global disaster struck. Gavi is one of three partners running COVAX, the program designed to get COVID vaccines to people in developing countries. COVAX has missed its volume goals for getting vaccines out, but it deserves credit for two important things. It delivered hundreds of millions of doses of a vaccine that had not even existed a year before, and it accomplished this feat faster than anything like it had ever been done before. (This was even more complex than it sounds: Although Gavi and UNICEF have built lots of infrastructure for delivering vaccines, their job is to immunize children and, in some cases, teenagers. They had to retool their systems to reach adults during COVID.) It's not just global vaccination programs that are paying off for COVID. Countries that made a point of improving their own immunization efforts were also well positioned to respond. Let's look at one of them. Beginning after it won independence from the U.K. in 1947, India undertook a massive campaign to eliminate smallpox--a project that required improving its health system, training vaccinators, buying cold chain equipment, reaching even the most remote parts of the country, and creating a surveillance network for vaccine-preventable diseases. It took decades, but it worked. India's last case of smallpox was reported in 1975.15 Then, in the early 1980s, India turned to another problem: low rates of routine childhood immunizations. At the time, the percentage of children born in India who received these basic