Robert Oelrichs, Senior Health Specialist May 4 th 2011

1. Robert Oelrichs, Senior Health Specialist May 4th 2011 An Immunization Financing Toolkit World Bank and the GAVI Alliance

2. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers • GAVI Alliance and World Bank • HNP team • GAVI Trust Fund • Sustained predictable financing • International, regional, domestic tools • Private and public finance • Toolkit for government • Accessible, updated, web-based • Range of options presented Source: www.worldbank.org

3. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers Strategy and Planning – Briefs 1 &2 • The Importance of Immunization Financing • Higher costs of vaccines • Higher marginal costs at higher coverage levels • Changes in international donor financing for health • Immunization Resource Needs, Planning, and Budgeting • Comprehensive multi-year plan with • Cost and financing plan within • Multi-year health budget within • Available Fiscal space

4. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers Country Level Mechanisms– Briefs 3 to 7 • Tax-Based Financing • Largest source of program financing in most countries • Appropriate for highly cost effective public good • Underfunded relative to needs in many LMIC • Decentralization may threaten service delivery • Risk pooling • User Fees • Associated with lower utilization of services • Can add to financial burden of poor households • Waiver programs can be inefficient • May have the potential to improve service access & quality • May formalize existing informal fee systems

5. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers Country Level Mechanisms– Briefs 3 to 7 • National Trust Funds • Predictable and potentially highly sustainable • Long term protection of resources – potentially tax free • Useful when sudden availability of new resources • Other Country level Innovative Financing Mechanisms • Oil revenues (Mexico) • Lotteries (Costa Rica) • Luxury and Sin taxes (Tajikistan, Vietnam, Haiti)

6. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers International Assistance– Briefs 8 to 11 • Development Project Assistance • Developmental Loans for Immunization • Budget Support • Debt Relief

7. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers Vaccine Market Mechanisms– Briefs 12 to 15 • Pooled procurement • UNICEF Vaccine Independence Initiative • Tiered Market Pricing • Vaccine Production and the Market

8. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers Innovative Financing Mechanisms– Briefs 16 to 19 • The International Facility for Immunization • Advance Market Commitments • Airline Ticket Tax • Results-based Financing

9. IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers and Program Managers Comparison of Immunization Financing Options