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11th GAVI BOARD MEETING
Washington, DC, 15-16 July 2003
SUMMARY REPORT

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Documents
Executive Summary and letter to the GAVI Board
(Word - 125K)

5. Financial Sustainability

  • World Bank President, James D. Wolfensohn, emphasized that GAVI was pioneering new approaches for strengthening financial sustainability of important public health programs, and that this is a potential model for other global initiatives. He mentioned that immunization financing and financial sustainability needs to be worked out within the framework of general health programs and priorities. He committed the World Bank to work with partners to continue developing innovative financing mechanisms, and to work with partners to support national governments in their efforts to improve the prospects for financial sustainability. The Bank is ready, willing, and able to play its role alongside other partners. He is also committed to encouraging World Bank staff to support the work of GAVI, given the importance of immunization for achieving the MDGs.


  • The financial gaps identified by the first round of national Financial Sustainability Plans pose a great challenge to the GAVI partners as they seek ways to support governments in mobilizing additional and reallocating existing national resources, and identifying and mobilizing external resources to reduce the funding gap.


  • GAVI needs to also recognize the role of other health system constraints affecting both institutional and financial sustainability. Limited human resource capacity in focus countries will be an issue that cannot be addressed through national immunization programs alone.


  • Just as governments are being asked to think seriously about reallocating national health and other resources toward financing immunization programs, GAVI partners must be held accountable for addressing the financing challenges that have been revealed through the process of financial sustainability planning. Existing bilateral donations need to be more reliable and longer-term; new donors must be found; and core partners must identify their different forms of contributions.

DECISIONS

The Board:

    5.1 Requested that at upcoming Board meetings, representatives from selected countries be asked to report on progress in implementing their financial sustainability plans, and how they are working to address financing gaps, including reports on how much of their government budget goes to health, and how much of the health budget goes toward immunization. Selected countries should be from the range of experience, including those countries facing the greatest financing challenges.

    5.2 Requested the Secretariat follow-up with Board members to ensure that they report to future Board meetings on how they as individual partners will help to address the financial gaps that countries are facing. The World Bank may be the appropriate partner to make the first report.

    5.3 Requested the Financing Task Force to provide more clarification on its recommendation that countries should report back on how they are addressing their financing gaps, as this is also included in the annual progress reporting system.

    5.4 Requested the Secretariat to explore the proposal to work with other global mechanisms such as the Global Fund to Fight AIDS, TB and Malaria, Roll Back Malaria, Stop TB and others to address financing gaps in a more comprehensive way. This effort will need to be linked with MDG-related initiatives, such as a “Framework for Action”, an MDG project that looks at costs of achieving the goals.

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