Abstract

Innovative finance is now considered essential to mobilize the trillions projected as required to meet the sustainable development goals. The International Finance Facility for Immunisation (IFFIm), which issues vaccine bonds, is an emblematic example of innovative finance in global health and development. Since its launch in 2006, IFFIm has played a leading role in developing social bonds and funding global health, securing over $8 billion in donor commitments, and disbursing over $3 billion to date to Gavi, the Vaccine Alliance. Adopting a follow the money approach, we set out a significant, evidence-based challenge to some of the dominant development claims around innovative development finance more widely and IFFIm in particular. We find evidence of nontrivial private profit making, hiding in plain sight, at the expense of beneficiaries and donors. Through advanced critical financial analysis, we reveal precisely who benefits and by how much. Furthermore, our analysis shows in detail how financialization reduces political control over aid, and the uneven spatial distribution of material rewards and political power. While IFFIm delivers on its claim to front-load aid commitments and makes a significant contribution to global health, the article asks whether the economic and political costs of innovative financing mechanisms are worth it. We finish by showing that alternative models for vaccine finance are possible. A postscript provides a brief account of how IFFIm has responded to the COVID-19 pandemic.

摘要

现在，创新融资被认为是动员数万亿美元以实现可持续发展目标所必需的。发行疫苗债券的国际免疫融资机制 (IFFIm) 是全球卫生和发展领域创新融资的标志性例子。自 2006 年成立以来，IFFIm 在发展社会纽带和资助全球健康方面发挥了主导作用，获得了超过 80 亿美元的捐助承诺，迄今已向疫苗联盟 Gavi 支付了超过 30 亿美元。采用跟随金钱方法，我们对围绕更广泛的创新发展融资，特别是 IFFIm 的一些主要发展主张提出了重大的、基于证据的挑战。我们发现了以受益者和捐赠者为代价的不平凡的私人获利的证据，这些证据隐藏在众目睽睽之下。通过先进的批判性财务分析，我们准确揭示谁受益以及受益多少。此外，我们的分析详细显示了金融化如何减少对援助的政治控制，以及物质奖励和政治权力的空间分布不均。虽然 IFFIm 兑现了其对前期援助承诺的要求，并为全球健康做出了重大贡献，但本文质疑创新融资机制的经济和政治成本是否值得。最后，我们展示了疫苗融资的替代模型是可能的。后记简要介绍了 IFFIm 如何应对 COVID-19 大流行。