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GAVI Update

Fifth GAVI Board Meeting, 21-22 June 2001, London, England

June 2001

Complex Emergencies – Update and Policy Recommendations

BACKGROUND:

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.

POLICY RECOMMENDATIONS:

1. Using its 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.
2. In 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.
3. In 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 implementation.
4. The 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.