Foundations Race to Save Vaccine Progress

Medscape

07-07-2025

devastating diseases, rewriting childhood illnesses, and pushing the boundaries of what medicine can prevent.
Much of the development of vaccines has been thanks to both private and federal grants. But that progress is under threat.
The federal government has proposed deep cuts to vaccine development funding — nearly halving the CDC's budget, shuttering its Global Health Center, and slashing spending on the National Institutes of Health by 43% — while continuing to phase out the US Agency for International Development.
That's where foundations come in. One of the biggest players is the Seattle-based Gates Foundation, founded by Bill Gates and Melinda French Gates. It is among the largest funders of global healthcare initiatives, dipping into its endowment as it enacts a spend-down plan that will double its charitable investments over the next two decades.
In 2000, the Gates Foundation made a landmark $750 million pledge to Gavi, the Vaccine Alliance: a Geneva-based global health partnership that, according to the World Health Organization, has since delivered vaccines to more than a billion children.
'But even as our organization raises spending to $9 billion a year,' Gates Foundation CEO Mark Suzman notes, 'it is unrealistic to think that private giving can make up the shortfall as public giving shrinks.'
Yet foundations are determined to try. In March, the nonprofit Council on Foundations in Washington, DC, polled 183 of its members and found that most (80%) were considering or planning a change of approach in light of expected government cuts, with 70% contemplating multiple changes. Some 44% were looking at shifting grantmaking priorities with an eye toward filling funding gaps, and 27% said they planned to increase their overall grantmaking budget or were at least considering it.
The Michelson Medical Research Foundation reports a surge of interest in its Michelson Prizes, which have helped finance early-career researchers in the fields of immunology and vaccine discovery since 2017. This year, as federal money dries up, the Los Angeles-based foundation has received a record number of applications.
'We're committed to bridging those immediate funding gaps, given what's happening with the loss of federal grants,' says program manager Michele Morris. 'At the same time, we're looking for lasting solutions that can safeguard scientific progress and cultivate the next generation of biomedical leaders.'
Foundation leaders, meanwhile, appear to be lying low as the current budget bill wends its way through Congress. Many declined to go on the record for this article or simply didn't reply to interview requests. Still, they've made their positions clear. In April, Suzman wrote an op-ed piece for The Economist in which he noted that assistance to poor countries had already fallen 'off a cliff,' with affluent nations like France, the Netherlands, and the United Kingdom planning to reduce their aid budgets by 'around a third.'
Even as many remain quiet publicly, behind the scenes, collaboration is gaining traction. One of the most widely supported ideas was to join forces with fellow funders: 54% of those surveyed said they would seek 'new opportunities to collaborate' with other foundations, much the way Gates works with Gavi.
Not all foundations are rethinking their strategies. The Novo Nordisk Foundation, with its Initiative for Vaccines and Immunity (NIVI), is staying on course. In 2023, in partnership with the University of Copenhagen, it established a limited liability company now known as NIVI-Development, or NIVI-D. Its aim is to complement and accelerate the work of NIVI-Research, initially focused on tuberculosis, influenza, and group A streptococcus. 'The gap between basic research and vaccine development is often difficult to bridge,' notes a foundation spokesperson. 'But NIVI-D is set up to do exactly that, boosting the chances of success.'
Chicago's MacArthur Foundation, best known for its no-strings-attached 'genius' grants, isn't usually associated with the health field. But in 2021, in the thick of the COVID-19 pandemic, it made headlines with a grant to the Vaccine Confidence Project (VCP), a London-based research group that tracks attitudes toward vaccines worldwide. Also funded by foundations linked to pharmaceutical companies such as AstraZeneca and Merck, the VCP helps implement immunization programs that have addressed outbreaks ranging from Ebola in West Africa to the Zika virus in Brazil.
Founded in 2010 to fight vaccine myths — such as those that prompted resistance to an earlier polio eradication effort in Nigeria — the VCP received fresh support during the pandemic that began a decade later. But vaccine hesitancy remains a tough nut. Earlier this year, a KFF tracking poll found that at least moderate faith in the FDA had dropped to 53%, compared to 65% in June 2023, with a third of respondents maintaining that vaccines' risks outweigh their benefits. General trust in public health has also eroded over the years. In short, vaccine initiatives have been hit with a double whammy: mounting skepticism plus deep budget cuts in the name of government efficiency.
Ironically, one thing that attracted the data-driven Gates Foundation to Gavi is that its immunization efforts are so cost-effective. A 2020 study of 73 countries showed that $1 spent on vaccine programs resulted in savings of $21 in medical costs, as well as lost wages and productivity. Factoring in the broader societal value of lives saved, Gavi claims an even more impressive return on investment: $54 for each dollar spent.
Whatever the precise ROI, it's a point that health-sector foundations grasp — even as government support wanes. As the Michelson Foundation's Morris says, 'It's less expensive to safeguard the community than it is to care for the community once it becomes ill.'