Transcript Measles Initiative Financing 2001-2008

Measles Initiative Financing
2001-2008
February 28, 2007
Washington, D.C.
Andrea Gay
UN Foundation for Measles Partners
SUMMARY OF ACHIEVEMENTS 2001-2006
2005 mortality reduction goal achieved
60% reduction worldwide
75% in Africa
>360 million children vaccinated in SIAs
2.3 million additional deaths prevented
HOW ACHIEVED?
Commitment, Proven Strategy and Resources [$]
7th year of partnership meetings
6th year of financial reports
•Initial 2 years MI had 3 grants/year for WHO AFRO (total nightmare)
•3rd year moved to annual budget and to WHO EMRO, SEARO
•Now in 7th year moving to biannual budget with front-loaded funding to all
WHO regions
This is PROGRESS!
Measles Initiative
Funding History 2001-2006
•
2001: total $20 million (CDC, ARC, UNF) in AFRO *
•
2002: total $20 million (CDC, ARC, UNF) plus CIDA $3 million in AFRO
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2003: total $18.25 million (CDC, ARC, UNF, Vodafone Fdn) plus CIDA $11.3 million in AFRO;
$4.0 million in EMRO/SEARO**
[33.55]
•
2004: total $21.75 million (CDC, ARC,UNF, LDS, Vodafone Fdn, Gates Fdn) plus CIDA $12.4
million in AFRO
[34.15]
•
2005: total $41.525 million (CDC, UNF, ARC, GAVI, Vodafone) plus CIDA $6.3 million in AFRO
and EMRO; tsunami funds from ARC totaling $81.2 million for S.E. Asia [47.825 plus 81.2]
•
2006: total $34.22 million (CDC, UNF, ARC, GAVI, LDS) plus CIDA approx $9 million in AFRO &
EMRO [43.22]
•
TOTAL $282.945 million plus country contributions, UNICEF (CDC, JICA,
others)
* IFRC contributed funds for national RC society volunteers since 2001
** LDS contributed volunteers in country for campaigns since 2003
[20]
[23]
Total annual funds in USD
Measles Initiative Funds
180
160
140
120
100
80
60
40
20
0
2001
2003
2005
Year
2007
2009
Year After Year
One Question Remains the Same
Are anticipated resources sufficient to attain goal?
Original 2005 goal attained
New GIVS goal of 90% reduction in measles deaths by 2010 (vs. 2000)
Additional Regional WHO targets:
• complete at least one follow-up campaign for all AFRO countries by end of 2009
(unless conflict country) – 30 country follow-ups will be complete by end 2007; all
countries start follow-ups by end 2008
• complete catch-up (Somalia, Sudan, Pakistan) campaigns in EMRO in 2007
• Measles elimination in EMRO and EURO by 2010
• Measles elimination in WPRO by 2012
• SEARO?
Target population during 2007-2008 at least 274 million --- more resources available to
increase speed and scope of SIA implementation
Measles Initiative
Funding 2007 - 2008
90
80
70
60
50
target
pop (m)
cost ($m)
40
30
20
3-D
Column 3
10
0
AF
EM SEA WP AM EU
Measles Initiative
Funding Outlook 2009-2010
• 2009: $11,333,000 (CDC, UNF)
• 2010: $11,333,000 (CDC, UNF)
2007 – 2010 estimated funding need is $479 million (Measles
Investment Case II) excluding country contributions (notably India)
MI has (if all goes well) $197.886 million through 2010
GAP = $281.114 million minus country
contributions
[India]
Key Issues and Challenges for Initiative with
Funding Implications
•
Lower incidence of measles may lead to declining financial support
•
Increasing costs for SIAs (staff, transport, vaccines, surveillance)??
•
Sustaining and expanding surveillance – increase costs
•
Increasing country budget support – decrease costs
•
Addressing 2nd routine dose (potential GAVI/IFFIm funds) – decrease costs
•
Coordination of integration activities and identification of cost savings:
increase cost sharing for add-ons to SIAs will decrease cost; with polio will
increase costs
•
Defining, piloting integrated M&E methods including routine immunizations,
ITN use – increase or decrease costs (who pays?)
Routine Immunization Strengthening
Support by Measles Initiative
[global increase from 71 to 77% between 1999 and 2005;
in Africa, increase from 50 to 65%]
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•
•
•
•
•
Cold chain equipment (carriers, ice packs)
EPI staff training (national to local)
Injection safety (assessment, AD syringe introduction)
Waste management (incinerators)
Surveillance (staff, data managers)
Laboratory network (equipment, kits)
Swaziland example: funds used to improve injection safety skills of EPI
staff; printing of tools to initiate RED in all districts for monitoring
coverage; supervisor training to prepare for implementation of RED
strategy in 2007
Routine Immunization Strengthening
Measles Initiative Contribution
•
Since 2004, 10% of Measles Initiative funds to WHO AFRO for SIA
operational costs are made available to countries to strengthen routine
immunization systems during year of SIAs
•
To access these funds, countries submit plans to AFRO for review &
approval; funds used primarily for RED (Reaching Every District) activities
•
UNICEF contributes remaining SIA funds for purchase of bundled vaccines,
cold chain, social mobilization – amount varies with country and is affected
by wastage rate, accuracy of target population, etc
•
In 2006, WHO sent $810,000 to 7 countries
Zimbabwe ($40,000), Swaziland ($10,000), Burundi ($25,000), Angola
($75,000), Rwanda ($30,000), DRC ($230,670), Nigeria ($400,000)
•
What about countries who have completed SIAs in previous years? Should
MI funds also support these routine systems each year?
Measles Initiative Funding for CaseBased Surveillance in AFRO
2006
Total 35 countries under CB surveillance
$824,710 total 2006 contribution
$762,710 sent to 26 countries [range
$9,000-150,000]
$62,000 additional sent for lab operational
costs in 25 countries [$2-3,000/country]
Child Health Interventions Beyond
Measles Vaccinations
Opportunities
•
•
•
•
Vitamin A (CIDA)
Routine immunization strengthening (MP, GAVI, others)
OPV (PEI)
ITNs – approximately18 million ITNs distributed with measles
campaigns
• Deworming medication (mebendazole from Johnson & Johnson)
• Others
• Child Health Days as vehicle – cIMCI
Note: Funds for ITNs to distribute during measles campaigns from Global Fund, IFRC,
PMI, WB, ExxonMobil, Izumi Fdn, Vodafone Fdn, Mark Gordon, Rotary, UNF’s
Nothing But Nets
Note: funding is primarily parallel to MP process
Strategy Needed to Close the Funding
Gap
Goals:
•
GIVS goal of 90% mortality reduction by 2010
•
Elimination goals of each WHO region with latest date set at 2012
•
Goals for SEARO and AFRO?
What is reasonable to expect from country support? By when?
Changes:
Implementing at increased speed with increase in funding
Preparation process in countries improved with draft POA largely available at start of 2007
Funding disbursed more rapidly – this week almost $100 million is at UN agency HQs and will be sent
to regions/countries next week
Annual reports received on time this year
Increase in country support for operational costs of follow-up campaigns
Management::
We have always managed with what we have available – can this continue?
What lessons can we use to help with resources (ex: wastage rate)
IDEAS ARE WELCOME