The New Bottom Billion: Implications for GAVI?

The New Bottom Billion: Implications for GAVI?

Global Health Policy, Center for Global Development

Our new visiting fellow Andy Sumner has drawn attention to the fact that most of the world’s poor now live in middle-income countries, not low-income countries. As it turns out, most of the world’s unvaccinated one-year olds also live in middle-income countries, specifically the lower middle-income countries. It’s actually been this way for the past decade. Although, on average, vaccination rates are higher in the LMICs than the LICs (86% vs. 76%), the sheer numbers of unvaccinated children may explain why we see frequent vaccine-preventable disease outbreaks in LMICs and why it has been difficult to eliminate polio in some of these countries, for example.

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