When the United States abruptly withdrew nearly $8 billion in support for Gavi, the global vaccine alliance, it put millions of the world’s most vulnerable at risk. For over two decades, U.S. funding was central to Gavi’s mission, helping immunise over 1.1 billion children and avert nearly 19 million deaths. But Washington’s decision to walk away from its pledged $1.58 billion for the 2026–30 cycle has left a massive shortfall.
At the centre of this crisis is India. Once a major beneficiary of Gavi, India is now the world’s leading vaccine manufacturer — and finds itself in a position of both influence and responsibility. As global immunisation efforts hang in the balance, the question is whether India will rise to fill the financial void and lead with purpose.
Gavi and India: A shared journey
Historically, Gavi has relied on a few major donors. Between 2016 and 2020, over half of its $9.3 billion budget came from the UK, U.S., and the Bill & Melinda Gates Foundation. The U.S., formerly its second-largest donor, contributed around $300 million annually. Its exit leaves Gavi’s 2026–30 plan short by at least $1.5–2 billion of its $11.9 billion goal.
India has been one of the biggest beneficiaries of Gavi support, especially given its large child population. It was among the first recipients of Gavi-funded vaccines like pentavalent, rotavirus, PCV, and measles-rubella. Between 2000 and 2019, the number of “zero-dose” children in India dropped dramatically from 6.8 million to 1.6 million.
Yet, at the recent Brussels summit, India pledged only $20 million for the next cycle — a figure seen as modest for the world’s fourth-largest economy. Gavi has now turned to emerging powers like India, China, and Gulf nations to step up. The Indian Vaccine Manufacturers’ Association (IVMA) has also urged the government to act, citing risks to both global health and India’s $2 billion vaccine export market. They’ve proposed an annual contribution of $260 million — 17 times India’s current pledge — or at least $100 million per year to signal serious intent.
Why it makes strategic sense
Increasing India’s contribution offers strong returns across three dimensions:
1. Health Security: By funding immunisation globally, India reduces the risk of infectious disease outbreaks that could eventually reach its own borders. Vaccines offer excellent return on investment — every $1 spent saves up to $44 in healthcare and productivity costs. A strong Gavi acts as a global insurance policy.
2. Economic Gains: Indian pharmaceutical companies supply over half of Gavi’s vaccine volumes. Continued funding would support jobs, research, exports, and India’s pharma leadership. Globally, Gavi’s immunisation programs have generated over $250 billion in economic benefits, much of which flows through Indian channels.
3. Soft Power and Global Leadership: A larger contribution would enhance India’s global standing, especially as the “pharmacy of the world.” It aligns with India’s G20 vision and its ambition to be a “Vishwa Guru.” Increased goodwill from developing nations and stronger influence in global health governance are added benefits.
Critics may argue that the funds could be used elsewhere, but even $200 million annually is just 1.66% of India’s $12.03 billion health budget. Compared to its $82 billion defence allocation, this would be a high-impact, low-cost investment. India could also explore in-kind support or innovative financing to maximise its role without burdening the exchequer.
Alternatively, India could complement its financial commitment with stronger investments in vaccine R&D, supply chains, and global partnerships — positioning itself as a manufacturing and innovation hub for future immunisation programs.
As Martin Luther King Jr. said, “Life’s most persistent and urgent question is, ‘What are you doing for others?’” India now has a rare opportunity to answer — not just with vaccines, but with vision.
(The author, Dr Sabine Kapasi, is the MD & CEO and Dr Hardik Sankhla, is the Partner, at ENIRA Consulting.)
