180 likes | 289 Views
Thinking Big: Going into Action for Child Survival Sustainable Financing for Health: Where does the risk lie?. Julian Lob-Levyt Executive Secretary – GAVI Alliance. Sustainable Financing for Health. A big push for health systems
E N D
Thinking Big: Going into Action for Child SurvivalSustainable Financing for Health: Where does the risk lie? Julian Lob-Levyt Executive Secretary – GAVI Alliance 1
Sustainable Financing for Health • A big push for health systems • Predictable, secure financing through the International Finance Facility for Immunization (IFFIm) • Innovation to advance new technology • Global Health Partnerships post-2005: added value, harmonisation and alignment • Where does the risk lie? 2
Health, Economic Growth & The Millennium Development Goals The Evidence Base Copenhagen Consensus, 2004 (MDG 4 – Child Mortality) (MDG 1 – Poverty) GAVI / Immunization ImprovedHealth Outcomes ImprovedEconomic Growth Commission for Macroeconomics & Health, 2001 Bloom, Canning & Weston; World Economics 2005 ImprovedEducational Outcomes (MDG 2 – Primary Schooling) 3
The Challenge: Current Health Spending US$ per person, per year Source: CGD Making Markets for Vaccines Presentation April 2005 4
Results: Increased Financing Immunization spending has more than doubled in GAVI countries 6 Source: WHO/UNICEF, GIVS costing
Results: Reaching More Children Cumulative Number of Children Reached in GAVI-Supported Countries ~90 m ~14 m Yellow fever ~14 m *projected Source: WHO/UNICEF 7
Democratic Republic of CongoResults: Percent Coverage of Third Dose of DTP (2001 – 2004) • DR Congo will receive over US$ 6 million in ISS reward for reaching additional children • Despite a history of conflict, coverage is increasing Source: Joint Reporting Form 8
Traditional income through GAVI Annual income Millions US$ $350 $303 projected $300 Government donors $250 $200 $169 Gates Foundation $150 $112 $105 $93 $100 $50 $4 $0 2000 2001 2002 2003 2004 2005 9
The International Finance Facility for Immunization (IFFIm) How to leverage additional funding for health: • Donors make long term binding commitments (20 years) • IFFIm uses pledges to raise funds through bonds • Anticipated to be funded at $4 billion over 10 years, increases near term resources • Commitments by UK, France, Italy, Spain, Sweden and Norway 10
Allocation of IFFIm funds : • Focus on the poorest (less than $1000 GDP per capita) 72 countries where disease burden is greatest • Two windows of support: 1) Providing new and underused vaccines • Providing support to combination vaccines (DTP + Hep B), (DTP+Hep B + Hib) • Accelerating introduction of new vaccines – rotavirus and pneumococcus, and HPV 2) Building capacity in developing country health systems for the delivery of immunization services and maternal and child health 11
Funding Immunization: Predictable Financing Impact of Predictability of Price: Assumed Price Trajectory for Pentavalent Vaccine Source: CGD Working Paper “The costs and benefits of front-loading and predictability of immunization” 12
Global Health Partnerships: Demonstrating added value? • High Level Forum outcomes • GHPs only make sense: • Within broader strategy of scaling up health systems • With long term, predictable funding for countries • If focus is in line with country-driven priorities and budgetary processes • If priorities are based on clear evidence • If we are prepared to take risks 14
Global Health Partnerships: Harmonisation and Alignment • Integrating at the country and district levels • Demonstrating results and learning • Challenge and Innovation • Broadening partnerships: civil society • Country-driven approaches 15
Where does the risk lie? • A big push for health involves risk • The risk of not thinking big • Risk for donors • Risk of not prioritising social sectors • Hiding behind harmonisation? 16
In conclusion • Unite around clear focus and simple priorities • 10.5 million deaths, most preventable and treatable – its not rocket science, but needs bucket loads of dollars. The MDG can be met. But do donors get it? • You – we, cannot solve all the worlds problems • Locate that focus within broader upstream agendas • Integrate that focus at the country level • Take risks, be opportunistic, be innovative • Quick wins and digestible measurable results will mobilise resources. Aid works. 17
Thinking Big: Going into Action for Maternal & Child Survival 18