Global Alliance forVaccines and Immunization
WHAT IS GAVI ?
An Alliance Traditional and new partners Public and private sector
Partners have in common: Situation Analysis Vision Set of strategic objectives
What is GAVI ?
Situation analysis: Three Gaps
Stagnation of immunization coverage with decline in certain countries and regional discrepancies
Lack of introduction into the poorer developing countries of newly-developed vaccines against major child killers
Limited investment into vaccine research for diseases with high burden in developing countries
Vision: GAVI Mission
“To save children’s lives and protect people’s health through the widespread use of vaccines with a particular emphasis on developing countries”
Five Strategic Objectives Improve access to sustainable immunization
services Expand use of all existing cost-effective vaccines Accelerate introduction of new vaccines Accelerate R&D on vaccines for developing
countries, (HIV/AIDS, malaria and tuberculosis ) Make immunization coverage a centrepiece in
international development efforts
Milestones By 2002, 80% countries with adequate delivery system
will introduce Hepatitis B vaccine and all countries by 2007
By 2005, 80% developing countries will have routine immunization coverage of at least 80% in all districts
By 2005, 50% of poorest countries with high burden of disease and adequate delivery systems will have introduced Hib vaccine
By 2005, the vaccine efficacy and BOD will be known for all regions for rotavirus and pneumococcal vaccines, and mechanisms identified to make the vaccines available to poorest countries
GAVI and THE VACCINE FUND
Countries (Developing and industrialised) Agencies (UNICEF, WHO) Development Banks (World Bank, ADB, AB) Industry Technical Agencies (CDC, NIH) Foundations (Bill and Melinda Gates,
Rockefeller, Mérieux...) NGOs (Path/CVP, AMP...) Academia
WHO is GAVI?
How does GAVI work ?GAVI Board
15 membersHigh-Level :
Institutional Commitment
Secretariat
Monthly Tele/Video Conferences 3 meetings per year
Weekly Tele/Video Conferences
5-6 Meetings per year
10 members
Joint policy development, Agency
workplans
Small team,
Funded by partner fees
Coordination
Responsive to Alliance needs
Working Group
How does GAVI work ?Task Forces :
Advocacy (UNICEF) Country Coordination (WHO) Financing (World Bank and USAID) R&D (Academia, Industry, WHO)
Regional Groups Africa (2) , East Asia-Pacific, South Asia, Middle East
and ….
Strengthened Immunization Services and Strengthened Immunization Services and New Vaccines Delivered in CountriesNew Vaccines Delivered in Countries
Vaccine procurement
The Vaccine Fund• Independent Board for fundraising &
management
• Working Capital Account (at UNICEF) for vaccine procurement and resource disbursement
• Three Sub-accounts:
Financial Tools: Shares, matching grants
Vaccines & Safe injection
materials
Immunization services
R & D(not active)
GAVI BoardGAVI BoardEstablishes Establishes Principles,Principles,
recommendations recommendations on fund allocationon fund allocation
ContributorsContributorsGates Foundation Gates Foundation USA, UK, Norway, USA, UK, Norway,
Netherlands, DKNetherlands, DK
$$$
The Vaccine Fund
THE VACCINE FUND
Requirements for Vaccine Fund support
Eligibility Countries with < US$ 1,000 GNP / capita
Assessment Criteria Functioning collaborative mechanism (e.g., ICC) Immunization assessment within last three
years Multi-year plan for immunization
Large countries Special arrangements for China, India and
Indonesia
Support for new and under-used vaccines
Support for immunization services and new and under-used vaccines
Support for immunization services
DTP3coverage
>80%
DTP3coverage
50% - 80%
DTP3 coverage
<50%
Basic Conditions
GNP/capita < US$ 1000
ICC or equivalent
Immunization assessmentin last 3 years
Multi-year plan forimmunization
What will the Vaccine Fund finance ?
New and under-used vaccines : Principles Hepatitis B globally Hib vaccine for Africa, Latin America, Middle
East & where evidence exists Yellow fever where recommended in Africa &
South America even when DTP3<50%
Safe injection equipment: auto-disable syringes and safety boxes
‘bundled’ with vaccines shipped to countries Combination vaccines
priority to weakest programmes
Immunization services sub-account: Add to pool of existing funding Invest in advance, on the basis of set targets for the
improvement of the programme Reward progress according to performance Monitor progress by reporting of district
performance, according to standard indicators and annual review to ICC, to GAVI partners
Delegate allocation of funds through government, partner agency, or other ICC mechanism - ‘no strings’, no international input monitoring system.
Functioning coordination mechanism (ICC) Senior Chair from MOH as confirmed by
membership and minutes Broad terms of reference, covering all aspects of
immunization, including polio, general EPI and new vaccines introduction :
Regular meetings (minutes) Broad partnership In many cases, ICCs will require strengthening : staff
budgets, etc..
Recent assessment of immunization programmes
Are recommendations being implemented ? (reflected in the plan)
Surveillance (including AFP surveillance) Safety of immunization (injections, waste
management) Cold chain, logistics, vaccine wastage Financing
Multi-year plan for immunization Reflect recommendations of the assessment Consistent with global polio eradication strategies, measles control and MNT elimination Plan to ensure safety of injections Targets for improving coverage and reaching unreached Disease surveillance New vaccines introduction Budget forecast, financing plan and sustainability strategy
How are applications assessed ? Independent review committee (9 members) Mali, Tunisia, Philippines, Ghana, Tanzania,
Bahamas, USA, Thailand, Slovenia Majority from developing countries Strong immunization programme management
experience Meets for 10 days- 2 weeks for in-depth review each application reviewed by 3 members Members declare any conflict of interest recommendations to the GAVI Board
ROLES AND RESPONSIBILITIES OF
PARTNERS
What is expected of countries ?Increased commitment to strengthen immunization
Establish, strengthen and manage an Inter-Agency Coordination mechanism
Develop,monitor and update a multi-year plan for immunization including: Polio eradication Injection safety Resource mobilization plan
Negotiate and secure financing from National Budgets (including loans) Bilateral and Multi-lateral Partners’ support The Global Fund for Children’s vaccines
What are Partners responsible for?
Increased commitment to immunization Increased coordination of technical and
financial support Procurement of vaccines and goods Consultants, Funding Training (technical, management, financing) Capacity building to develop regional expertise Networking with other countries to learn from
experiences
For re-
submission
12Not approved
2
Conditional approval
4
Not applied
17
Approved36
Status of 74 eligible countries June 2001
* (GNP per capita < US$ 1,000)
June approvals
Approved: Uzbekistan
Approved with clarification: Turkmenistan, Albania, Tajikistan
Conditional Approval: Bosnia & Herz
Financial commitments to GAVI objectives… so far !
• US $ 750 million : Gates Foundation (5 yrs)• US $ 50 Million : USA (FY 2001) • GB £ 3 million : UK• NKr 1 billion : Norway (5 yrs)• NGL 250 million : Netherlands (5 yrs)• Dkr 25 million : Denmark
Next Milestones
Progress report : 1 October 2001Mid term review : 1 October 2002
Next reviews of applications: November 2001 , ….until Spring 2002 All applications approved before Spring 2002
will result in 5 years support