Transcript GAVI

Global Alliance for
Vaccines and Immunization
WHAT IS GAVI ?
What is GAVI ?
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An Alliance
Traditional and new partners
Public and private sector
Partners have in common:
Situation Analysis
Vision
Set of strategic objectives
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
WHO is GAVI?
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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
How does GAVI work ?
GAVI Board
Working Group
15 members
High-Level :
Institutional
Commitment
10 members
Joint policy
development, Agency
workplans
Monthly Tele/Video
Conferences 3 meetings
per year
Weekly Tele/Video
Conferences
5-6 Meetings per
year
Small team,
Secretariat
Funded by partner
fees
Coordination
Responsive to
Alliance needs
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 ….
The Vaccine Fund
GAVI Board
The Vaccine Fund
Establishes
Principles,
recommendations
on fund allocation
• Independent Board for fundraising &
management
• Working Capital Account (at UNICEF) for
vaccine procurement and resource disbursement
• Three Sub-accounts:
Contributors
Gates Foundation
USA, UK, Norway,
Netherlands, DK
$$$
Immunization
services
Vaccines &
Safe injection
materials
Vaccine
Financial Tools:
Shares, matching grants procurement
Strengthened Immunization Services and
New Vaccines Delivered in Countries
R&D
(not active)
THE VACCINE FUND
Requirements for Vaccine Fund
support
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Eligibility
Countries
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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
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Large countries
Special
arrangements for China, India and
Indonesia
What will the Vaccine Fund finance ?
DTP3
coverage
<50%
Support for
immunization
services
Basic Conditions
GNP/capita < US$ 1000
ICC or equivalent
Immunization assessment
in last 3 years
Multi-year plan for
immunization
DTP3
coverage
50% - 80%
DTP3
coverage
>80%
Support for
immunization
services and new
and under-used
vaccines
Support for new
and under-used
vaccines
New and under-used vaccines :
Principles
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Hepatitis B globally
Hib vaccine for Africa, Latin America, Middle
East & where evidence exists
Yellow fever where recommended in Africa &
South America
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when DTP3<50%
Safe injection equipment:
auto-disable
syringes and safety boxes
‘bundled’ with vaccines shipped to countries
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Combination vaccines
priority
to weakest programmes
Immunization services sub-account:
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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)
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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
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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
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How are applications assessed ?
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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
Status of 74 eligible countries
June 2001
For resubmission
Not
approved
2
12
Approved
36
Not
applied
17
Conditional
approval
4
June approvals
Approved: Uzbekistan
Approved with clarification: Turkmenistan, Albania, Tajikistan
Conditional Approval: Bosnia & Herz
* (GNP per capita < US$ 1,000)
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 2001
Mid 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