Global Alliance for Vaccines and Immunization

1. Global Alliance for Vaccines and Immunization

2. What is GAVI ? • An Alliance • Traditional and new partners • Public and private sector • Partners have in common: • Situation Analysis • Vision • Set of strategic objectives

3. Three Gaps in Vaccines and Immunization • 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

4. 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”

5. 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

6. WHO is GAVI? • 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

7. How Does GAVI Work ? 15 members High-Level : Institutional Commitment GAVI Board Monthly Tele/Video Conferences 3 meetings per year Weekly Tele/Video Conferences 5-6 Meetings per year 10 members Joint policy development, Agency workplans Working Group Small team, Funded by partner fees Coordination Support coordination of partners input Secretariat

8. How Does GAVI Work ? Task Forces : • Advocacy (UNICEF) • Country Coordination (WHO) • Financing (World Bank and USAID) • R&D (Academia, Industry, WHO) Regional Working Groups • Africa, East Asia -Pacific, South Asia, Middle East and ….

9. The Global Fund For Children’s Vaccines GAVI Board Establishes Principles recommendations on fund allocation • The Fund • 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, ... Immunization services Vaccines & Safe injection materials R & D (not yet active) $$$ Financial Tools: Shares, matching grants Vaccine procurement Strengthened Immunization Services and New Vaccines Delivered in Countries

10. Requirements for GFCV Support • Eligibility • Countries with < US$ 1,000 GNP / capita • Special arrangements foreseen for China, India and Indonesia • Assessment Criteria • Functioning collaborative mechanism (e.g., ICC) • Immunization assessment within last three years • Multi-year plan for immunization

11. Support for immunization services DTP3 coverage <50% Basic Conditions GNP/capita < US$1000 ICC or equivalent Immunization assessment in last 3 years Multi-year plan for immunization Support for immunization services and new and under-used vaccines DTP3 coverage 50% - 80% Support for new and under-used vaccines DTP3 coverage >80% What will the FUND Finance ?

12. New and Under-used Vaccines • 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 vaccine shipped to countries • Combination vaccines • priority to weakest programmes

13. Immunization Services • Add to pool of existing funding • Investin 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.

14. How are Applications Assessed ? • Independent review committee (10 members) • Tunisia, Ghana, Tanzania, Cameroon, USA, Thailand, Slovenia, Bahamas, Moldova • 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

15. Pledges to GAVI Objectives • Gates Foundation : US $ 750 million (5 yrs) • USA : US $ 50 Million (1 yr ) • Norway NKr 1 billion (5 yrs) • UK : GB £ 3 million (1 yr) • Netherlands : NGL 250 million (5 yrs) • Denmark : Dkr 20 million (1yr) • Sweden US $ 2 million (1yr) • Total Pledges to date : 0ver US $ 1 029 million

16. Status of 74 Eligible* Countries Commitments through 2002: US $ 16,5 Million for immunization services strengthening US $ 74 Million in new vaccines * (GNP per capita < US$ 1,000)

17. Next Milestones Progress report : 1 October 2001 Mid term review : 1 October 2002 Next reviews of applications: • 1 May : Review starting 24 May • November 2001 ...until Spring 2002 • All applications approved before Spring 2002 will result in 5 years support

18. 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

19. 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