Fifth GAVI Board Meeting, 21-22 June 2001, London, England
Emergencies Update and Policy Recommendations
For the purpose of this analysis, we have used the UN Consolidated
Appeals definition of countries in "complex emergencies" as countries
with armed conflicts affecting large civilian populations through direct
violence, forced displacement and food scarcity, resulting in
malnutrition, high morbidity and mortality.
Emergencies can be considered in three phases: active conflict, chronic
conflict, and rehabilitation (or development). An acute conflict usually
generates sufficient funding for immunization through international
appeals. However, this is not sustained; in a chronic conflict or
rehabilitation phase, appeals are much less successful, leaving large
gaps in the funding needs for immunization.
Of the 28 countries classified as those experiencing complex
emergencies, 22 are eligible for support from the Vaccine Fund (see
Table 1 ). Of these, 12 have been approved/recommended for support or
conditional approval, 3 are preparing proposals, and 2 have been asked
to re-submit. The status of 5 countries is currently unknown. Thus, the
proposal process appears to be working for a majority of countries
classified as experiencing complex emergencies.
advocacy channels, GAVI could encourage international and national
authorities to include longer-term support to immunization services in
their resource mobilization efforts during the acute conflict phase,
to ensure sustained funding.
countries with well-functioning national governments and relatively
high immunization coverage, there may be vulnerable populations within
their borders that are not reached by the health system. GAVI could
encourage partners to ensure that immunization services are reaching
those at risk.
countries where governments are weak or non-functional, GAVI could
consider proposals submitted by an operational partner or partners
(such as WHO and UNICEF), engaging the multiple partners most suited
to reach all parts of the countries (e.g., UNHCR, Medicins sans
Frontières) with those partners taking responsibility for
Independent Review Committee will continue on a case by case basis to
highlight the complexities and program challenges faced by countries
in complex emergencies and take these into account when assessing the
quality and appropriateness of their proposals. Innovative approaches
needed to fulfill program needs will be encouraged.