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The GAVI Alliance: immunization as a key component of primary health care Marc Hofstetter

The GAVI Alliance: immunization as a key component of primary health care Marc Hofstetter. Action for Global Health Conference Berlin, 11 February 2009. Why GAVI?. 9.2 million annual child deaths  25% vaccine-preventable  MDG 4 Vaccines: life-saving, simple and highly cost-effective:

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The GAVI Alliance: immunization as a key component of primary health care Marc Hofstetter

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  1. The GAVI Alliance: immunization as a key component of primary health careMarc Hofstetter Action for Global Health ConferenceBerlin, 11 February 2009

  2. Why GAVI? • 9.2 million annual child deaths  25% vaccine-preventable  MDG 4 • Vaccines: life-saving, simple and highly cost-effective: • Harvard economists: “the economic impact and benefits of immunization have been greatly underestimated; GAVI programmes could earn a rate of return of 18%” • North-South inequity in access to vaccines

  3. The response: private-public alliance

  4. GAVI programmes: New and under-used vaccines Leading causes of vaccine-preventable death in children under 5 years old: GAVI supported vaccines: • Hepatitis B • Hib • Yellow fever • Pneumococcal disease • Rotavirus diarrhoea • Meningitis • 4 new vaccines prioritized: HPV, Japanese Encephalitis, Typhoid, Rubella

  5. Using pentavalent vaccine to reach MDG 4 (2000)

  6. Using pentavalent vaccine to reach MDG 4 (2008)

  7. Elimination of Hib meningitis in Uganda 2002-2007 H. Influenzae meningitis cases, Mulago Hospital, Kampala, Uganda Source/credits: Lewis R, et al Action for child survival: Elimination of meningitis due to Haemophilus influenzae type b following introduction of Hib vaccine in Uganda. WHO Bulletin. April 2008

  8. Overall results Measuring impact: future deaths averted through GAVI vaccine support (hepatitis B, Hib and pertussis vaccines) Source: WHO

  9. World Health report 2008 – Revitalizing primary health care • Key role for immunisation • Too many children still miss out on vaccinations • Goal: universal coverage, equitable access • Strengthening health service delivery platforms

  10. GAVI Programmes:Health Systems Strengthening Support Why? • GAVI’s outcome-based immunisation programmes revealed system weaknesses, bottlenecks for further progress • Infrastructure, human resources, service delivery, constraints at peripheral level, organization and management, etc. How? • Use principles outlined in DAC Paris declaration: alignment, country ownership, accountability, managing by results • Active involvement of CSOs in implementation How much? • $800 million -2015 • Evaluation in 2009 to guide direction

  11. HSS example: Ethiopia

  12. Aid effectiveness: Paris and Accra • GAVI business model based on Paris principles, active role in aid effectiveness debates, pioneering new models • Predictability: long-term commitments to countries • Ownership: countries apply for the support they need and contribute financially, countries define indicators for HSS monitoring • Alignment: GAVI support must be in line with countries’ existing national health plans and not replace existing funding • Performance-based funding to reward results • H8 - Health Leaders of 8 organisations collaborating for better and measurable outcomes • IHP: strengthen GAVI business model to start IHP implementation in Ethiopia and Mozambique

  13. Moving forward - the funding gap • Expenditures reflect known and estimated country demand for vaccines that can shift the needle on MDG4 • Key donors: USA: $70 m/year – Norway: $75 m/year – Netherlands: €25 m/year - UK: $2 b through IFFim - France: $1.5 b through IFFim – Italy: $1.2 b through IFFIm and AMC – BMGF: $1.5 b over 15 years. • Germany: €4 million in 2009 Estimates as at January 2009

  14. Danke WHO/Christopher Black

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