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GAVI Update


Sixth GAVI Board Meeting, 17 October 2001, Ottawa, Canada

October 2001

1. Into Implementation: Reports from the Field

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  • The Board greatly appreciated the comprehensive overviews of the health and immunization situations in Africa and Central & Eastern Europe/Central Asia.

  • Some of the lessons learned from the initial use of GAVI funds are

    • In Mali and Kenya: use of performance contracts,

    • In Tanzania: use of HIPC funds

    • In Ghana: reinforcement of infrastructure

    • In Zimbabwe: organisation of local immunization days in low performing districts

    • In Rwanda: microplans for low performing districts reviewed by the ICC

  • Some of the regional concerns raised are:

    • GAVI is perceived as another project or organization rather than an alliance

    • Sustainability of national immunization programmes is a concern

    • Unmet needs of countries not eligible for funding from the Vaccine Fund, and how GAVI experience can be used in such countries

    • The need for strategies to define, identify and reach the harder to reach populations

    • Unmet needs in countries eligible for funding from the Vaccine Fund (e.g. support to new vaccine introduction costs in countries which receive system strengthening funds but in which this amount is small)

    • Conflicting messages on measles control

  • The presentations amply illustrated that with resources flowing from the Vaccine Fund, GAVI Partners at all levels – national, regional and global – are in an implementation phase of actively supporting countries to strengthen routine immunization and introduce new vaccines.

  • Both presentations highlighted the need for increased efforts to identify new financing mechanisms to improve sustainability. The example of Tanzania using HIPC relief to increase its immunization budget is extremely important; there is a need to explore how this can be related to other countries’ situations. The Board may wish to may come back to this in later discussions (a HIPC and Health meeting on 3-7 December in Nairobi may be of interest to Board members). Leveraging additional resources, including more long-term bilateral funding, is also a message that needs to be advocated.

  • The other major challenge in country programs is insufficient managerial capacity. We should also keep in mind that the new Global Fund to Fight AIDS, TB and Malaria demands systems that can deliver.

  • We need to be watchful that enthusiasm and momentum gained with GAVI is not lost; we have seen coverage rise in the past in response to infusion of support and attention, and then dwindle. The challenge now is to integrate these initiatives and ensure that GAVI support results in sustainable immunization services, to strengthen advocacy efforts to increase demand for immunization and that the support serves to strengthen health systems in a long-term perspective. One strategy would be to identify precise indicators that demonstrate how the polio initiative contributed to the strengthening of health systems.

  • GAVI needs to consider its role with respect to middle-income countries (GNP above $1,000 per capita).


The Board:

1.1 agreed that the next Board meeting agenda should also include presentations from the field, and that Asia would be the most relevant to examine at this time

1.2 agreed that a future Board meeting should allow for an in-depth discussion of financial sustainability

1.3 welcomed the suggestion that ideas about how to support middle income countries would be on the agenda at the next Board meeting

1.4 agreed that representatives from regions should regularly be invited to future Board meetings as observers.


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