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1 Revisiting the GAVI Milestones


  • The GAVI milestones were developed before the alliance was underway, therefore it is timely to revisit them with an intention of achieving greater clarity and more consistency. For example, different milestones refer to, respectively, 'all countries', 'all developing countries', or 'the poorest countries'.

  • The GAVI partners have achieved great progress toward their goal of increasing use of hepatitis B vaccine; the first GAVI milestone, that 'by 2002, 80% of all countries with adequate delivery systems will have introduced hepatitis B vaccine' will be achieved. In fact, the milestone that 'by 2007 all countries will have introdued the vaccine'7i>may not be ambitious enough. However, this may depend upon on whether the combination vaccines including hepatitis B will become more widely available.

  • The challenges we face in reaching the GAVI milestone that 'by 2005, 80% of developing countries will have routine immunization coverage of at least 80% in all districts', or the '80/80 goal', are great. It will be important that the work done to analyze and recommend strategies for increasing access will help to establish whether this goal is feasible or should be modified, and how it, or a new goal, could reached.

  • Progress toward reaching the Haemophilus influenzae type b milestone, that 'by 2005, 50% of poorest countries with high disease burdens and adequate delivery systems will have introduced Hib vaccine' is difficult to measure because of uncertainty concerning disease burden in Asia and Central Europe.

  • Any consideration of the polio milestone, that'by 2005, the world will be certified polio-free' should follow the recommendation of the Global Certification Committee which will meet in March 2003.

  • The milestones concerning rotavirus and pneumococcal vaccines, that 'by 2005, the vaccine efficacy and burden of disease will be known for all regions for rotavirus and pneumococcal vaccine, and mechanisms identified to make the vaccines available to the poorest countries' should be considered by the ADIP teams with a goal of identifying more measurable indicators.


The Board:

  • 1.1 Requested more analysis of the milestones, including proposals to make the indicators and denominators more unambiguous and consistent, for presentation to the GAVI Board at its next meeting. They should be looked at both globally and in terms of the 75 Vaccine Fund eligible countries.

  • 1.2 Requested the team to develop and propose GAVI milestones concerning yellow fever vaccine and AD syringes, since these are both GAVI priorities.


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