(Bloomberg Business) -- The measles outbreak has shone a light on the growing number of parents opting not to vaccinate their children, despite overwhelming medical reasons to do so. Amid the often-vicious debate between anti-vaxxers and their critics, it's gone largely unnoticed that when it comes to vaccination rates, the United States is out of step with the rest of the world.

Last week, a group of donors that included the United States, the United Kingdom, and the Gates Foundation met in Germany to pledge $7.5 billion to Gavi, the vaccine alliance, to pay for its operations to 2020. Gavi is a global organization that buys vaccines to immunize children in low-income countries. The alliance has provided billions of dollars’ worth of new vaccines over the past decade for such conditions as haemophilus influenza and pneumococcal disease, both of which can cause pneumonia and meningitis, as well as rotavirus—the leading global cause of death due to diarrhea under age 5. Gavi support has translated into more kids being protected against catching and spreading these killer illnesses.

Some Gavi resources have gone toward buying vaccines that even the poorest countries were already providing before they got donor support—including immunizations against diphtheria, whooping cough, and tetanus. The very fact that many of the world’s poorest countries are already immunizing against a number of diseases, including measles, and that "middle income" countries are providing a growing spectrum of vaccines without any donor support at all, is a demonstration of the level of global commitment against infectious disease that should shame America. Average health expenditures per person per year—public and private combined—are as low as $20 in some of the poorest countries that receive Gavi support and remain below $100 in such countries as Nigeria and India. Despite tight resource constraints, those countries are providing the staff and equipment to run national vaccination programs at a cost of $20 a child or more—mostly with minimal donor assistance (which is focused on providing the vaccines themselves).