Results campaigners pressing UK Parliamentarians to support global vaccine programmes.
David Lammy stands behind the podium and the room waits to hear what it knows he is about to say. Speaking in Brussels, at the Global Summit for Gavi, the Vaccine Alliance – the world’s biggest multilateral vaccine fund – the Foreign Secretary is here to announce the UK Government’s financial commitment to Gavi for the next five years.
Fronted by the slogan ‘Health & Prosperity through Immunisation’, he talks about stepping up, about taking a modernised approach, about investing, not donating. But above all, he is here to talk about a figure – a figure that has been fought for by campaigners in the months leading up to this moment, and whose significance can be counted in the millions of children vaccinated and lives saved.
That figure is £1.25 billion. It makes the UK the largest single country donor to Gavi, and it is seen as a win for all those who advocated for it by dedicating their time and effort into making the UK’s pledge as big as it could possibly be.
The work done by campaigners in the build up to the Gavi replenishment this June provides a good example of the advocacy we do at Results. Through our grassroots network, our parliamentary and our policy team, we pressed the UK Government to commit money to a multilateral global health organisation that, since its inception in 2000, has helped to save almost 19 million lives.
However, understanding what multilateral bodies are and what they do can be difficult. With replenishments of other multilateral institutions coming up this year and at the start of the next, it’s important to know how they work, why we advocate for them, and the role organisations like Results play in holding them to account.
multilateralism and multilaterals
A common understanding of aid is that of an A-B relationship between one country that is giving money and another that is receiving it; a direct transfer of wealth. Headlines about the UK sending numerous billions of pounds to another country perpetuate this view. This is not how multilaterals work.
A multilateral approach is one when two or more parties work in partnership to solve a problem. This is compared to unilateralism, acting alone, and bilateralism, having one other partner.
At Results, a lot of the work we do involves encouraging the UK Government to support multilateral bodies whose work we believe plays a role in creating a world without poverty. These organisations include Gavi, a child vaccination initiative; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the Global Partnership for Education (GPE). These multilaterals go through funding cycles and at the start of each cycle, governments, individuals and private sector organisations pledge money so that they can continue their work. At June’s Global Summit, Gavi secured US $9 billion in funding for the next five years (almost US $3 billion short of its $11.9 billion target).
But what happens to that money? How does it get spent and who spends it? And why do we think this is a good investment?
investment to implementation
Above all, multilaterals are useful for tackling global development challenges because of their ability to work at scale, and their expertise, making them often more efficient and effective than bilateral development relationships.
Education Cannot Wait (ECW), for example, is the world-leading multilateral organisation for ensuring that children have access to quality education in crisis-affected areas.
In these circumstances, like after the Russian invasion of Ukraine in 2022, ECW is able to quickly mobilise the money it has received from its donors to respond to the education and wellbeing needs of conflict-affected children.
This is attractive to investors. Even though donors often put quite problematic stipulations on where money should be spent, multilaterals offer the opportunity to contribute to international development efforts without having to take time researching and deciding how best to spend the money.
The Global Fund is looking for US $18 billion for the next three years.
It is the role of multilateral bodies and the organisations that advocate for them to highlight this in the run-up to a replenishment.
The most recent ‘Investment Case’ for the Global Fund outlines that with US $18 billion funding for the next three years it can save 23 million lives by developing and delivering vaccines, strengthening health systems, and tackling inequality to fight HIV/AIDS, tuberculosis and malaria.
This is because the Global Fund can pull together governments, communities, technical agencies, the private sector, and those affected by the diseases to create large-scale impact; combining local leadership with global expertise to provide efficiency, effectiveness, and adaptability. The efficiency of this approach is clear: every one dollar invested in the Global Fund leads to $19 in economic and health gains. This is a big reason why at Results we advocate for multilateral bodies.
Results and multilaterals
In June, we published an ‘action’ on our website – ‘support the Global Fund’s live-saving work’. Here, we asked grassroots campaigners – people from around the UK, from all walks of life – to press the UK Government to maintain its commitment to the Global Fund at its replenishment at the end of this year.
In doing so, Results, and our network of committed volunteers were actively advocating for the Global Fund, pinpointing it as a worthwhile recipient of the UK’s Official Development Assistance budget.
We also carry out what’s called ‘high level’ advocacy. In May, alongside the International Parliamentary Network for Education (IPNEd), we hosted a meeting between Ministers for Education from seven African countries alongside UK parliamentarians and Government officials, as they made the case for investing in global education, including multilateral bodies such as the GPE.
But financial efficiency isn’t the only reason we support the multilateral approach. The broad coalitions multilaterals convene means that there is more room for voices from civil society.
In Gavi’s next spending cycle, they have continued their commitment that 10% of all country funds will go towards civil society organisations (CSOs). This bottom-up strategy increases accountability, utilises local expertise, and shifts the power imbalances present at the core of the international development sector – an imbalance even more stark in bilateral arrangements.
No multilateral is perfect, however, and there is a danger that when you advocate for something, you become simply a supporter. Being a critical friend is important, both for the organisation and the people it aims to support.
money talks – but it shouldn’t deafen
There is a difference between working with and for people. When working for, inequity is baked into the relationship – either as a servant or a saviour. Working with people, on the other hand, creates the idea of partnership.
This is a significant distinction, and ensuring that there is an awareness of occasions when there may be power imbalances in relationships is very important. We must remember there is no panacea that will solve all global health and development challenges, such as reaching all ‘zero-dose’ children with vaccines; a multilateral approach is a good but imperfect solution.
While at Results we spend a lot of our time trying to ensure multilaterals meet their funding targets and are sufficiently supported, ensuring their effective practice is also our role and responsibility.
At our most recent Grassroots Monthly Conference Call, our volunteer network heard from Dr Bvudzai Magadzire, Director of Partnerships at VillageReach and the CSO representative on the Gavi board. There, the role of CSOs when working with multilaterals was made clear: we don’t just assume the money is being spent well – we check.
There are ways to do this. For example, our CEO, Kitty Arie, played a key role in amplifying youth voices from implementing countries in the build up to the Gavi Summit – first attempting to organise visas for them to attend, then recording a video to be shown at the Summit after those visas were denied – to ensure that their needs were heard by donors. We also advocate to the Global Fund to challenge the amount of money they allocate to tackling TB alongside HIV/AIDS and malaria.
How would you organise a multilateral?
Accountability is important because running a multilateral organisation is filled with challenges. Recently, at an all-staff away day, we took part in a thought experiment. We were broken into groups and each group was tasked with creating the perfect multilateral. All aspects were up for consideration: governance, funding streams, cause, scale and scope.
While every presentation was well thought out and insightful, the most interesting aspect of the activity was that each ‘organisation’ was entirely unique. For a group of people who spend a lot of their time thinking about multilateral organisations to have very little consensus on how one should be structured highlights just how difficult it is to get these things right.
So, then. Figures are important. £1.25 billion is a lot of money, and a lot more than it could have been without organised advocacy and campaigning – it’s important to remember that and to celebrate it.
But we shouldn’t get lost in the numbers, and we must be careful that this doesn’t just turn into a game about who can secure the biggest number for their cause. Ensuring that money is spent effectively and fairly, in order to help those that need it most, is a vital part of political advocacy.
If we can work with multilaterals to make sure they work with the people they aim to support, then these principles of collaboration and expertise sharing across a broad coalition does offer hope for lasting change, where the most important figures tally lives saved and futures transformed.