So who is paying attention to medical distribution systems and more specifically to the innovation pile-up we highlighted in the last post?
There are 4 main categories of players: Governments, NGOs, multi-lateral organizations (WHO, UNICEF) and public-private alliances. While there are many, many important and interesting stakeholders in the field, the most interesting evolution over the last decade has been the ways these groups cross boundaries to find creative ways to work together.
When Global Alliance for Vaccines and Immunization (GAVI) was established in 2000, it had an enormous impact on the field of vaccines. GAVI refocused attention on vaccine-preventable diseases which waned in the 90’s after the highly successful immunization campaigns of the 70’s and 80’s. 
And as a public-private partnership funded by donor governments and private organizations such as the Bill & Melinda Gates Foundation, it brought serious financial resources to the table (over $2 billion of net assets in 2007). Currently, GAVI supports 72 low and middle-income countries in vaccine financing and procuring. While considerable resources at GAVI have been directed towards augmenting the supply of existing vaccines and developing new vaccines, GAVI and its stakeholders are increasingly beginning to consider the inadequacies of the health systems into which these vaccines must enter.
One particularly interesting initiative is The Optimize Project, a joint collaboration between the WHO and PATH. The Optimize Project seeks to identify and advocate for the “immunization systems and technologies for tomorrow.” Funded by the Gates Foundation, the Optimize Project is a recognition that discovery and development of vaccines is only half the battle.
Here at VillageReach, it has been exciting to see the development of enthusiastic recognition and articulation of the problems of logistics at theLast Mile.