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