Funding Update: 2013 – 2015

September 10, 2013

1

China 2013 2

OVERVIEW • MR Initiative Annual Expenditure 2001-2013 • MR Initiative Annual Donations 2001-2013; Financial Resource Requirements through 2015 • MR Initiative Financial Resource Requirements - detail • MR Initiative donors, 2001 - 2013 • measles & rubella moving ahead • Challenges to implementation for MR Initiative 3

180

MR Initiative Annual Expenditure, 2001-2013

Total expenditure 2001-2013 = $1,008 million

160 140 120 100 80 60 40 20 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Donations Series2

4 * Excluding country contributions

Measles & Rubella Initiative Annual Donations 2001-2015 and Financial Resource Requirements, Projections, Funding Gap 2013-2015*

350 300 250 200 150 11 59 36 100 50 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 38 44 Donations Funds Projected or Pledged

* Excludes all country contributions and direct social mobilization funding from partners

Funding gap (includes PSC) 94

5

Measles & Rubella Initiative Financial Resource Requirements, Projections, Funding Gap 2013-2015 47

Total Funding Gap 2014-2015: US $65 million

400 350 32 300 250 200 150 100 50 0 31 18 2013 2014 2015 Anticipated Country Contributions Donor Funds Projected/Pledged/Received Anticipated GAVI Contribution (Rubella) Funding Gap (includes PSC)

6

Resource Requirements by Major Category of Activity, 2014-2015

Total Cost 2014-2015: US $557 million

400 350 300 250 200 150 100 50 0 Measles SIAs Surveillance / Lab 2014 2015 Measles Rubella SIAs Technical Assistance Coverage Surveys Research Outbreak Response Communication

7

MR Initiative Donors, 2001-2013

CDC JICA Norway DFID

Civil Society

ARC* LDS Lions

UN

UNICEF UNF*

Foundations

Gates

Private Sector

BD Merck Vodaphone

Other

GAVI/IFFIm * Includes ARC/UNF and other partners 8

Where is the Measles & Rubella Initiative Headed?

Toward regional achievement of Measles Rubella Elimination Goals by or before 2020 Improvement of routine coverage and timely and high quality SIAs Expanded use of accurate data for decision making

• • • •

2012

measles goals: AFRO (pre-elimination) and WPRO (elimination) - missed

2013

potential SEARO elimination goal set (waiting), begin MR introduction campaigns with GAVI support (done)

2015

GIVS (95% mortality reduction) and MDG 4 goals; measles goal in EMRO and EURO (elimination); rubella goal in EURO (elimination); continue to set regional rubella elimination goals as appropriate

2020

Measles goal in AFRO (elimination) • • • •

Critical Elements for Success

Political leadership Timely funding (donor and national governments) Adequate time for planning and social mobilization (9 months) Well performing surveillance, analysis & use of data to improve coverage 9

Challenges to Implementation for MR Initiative

• Lack of timely and sufficient funding: few multiyear grants • Ensuring high quality SIA’s (increased training and social mobilization cost, increased technical assistance request) • Providing strategic support for non-GAVI eligible countries (TA, Surveillance) • Increased surveillance cost (including lab, coverage surveys) • Projecting target age range for SIA’s several years in advance • Projecting cost to MR Initiative for target populations above 59 months for GAVI funded measles SIA’s in 6 large countries • Routine immunization: scale up of MCV1, increased MCV2 introduction and coverage, other routine strengthening immunization activities 10

Anne Ray Charitable Trust 11