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GAVI Board Teleconference
6 May 2004
Summary Report (PDF - 24K)
1. Measles Investment Case
2. Long-term strategy development
1. Measles Investment Case
- The measles investment case was prepared by the Africa Measles Partnership. It is a pilot case for the draft investment case framework that is being developed by a World Bank team.
- Even though the topic is a complex issue to be considered over the telephone, the GAVI Board agreed at its December Board meeting that, considering the urgency of measles mortality, it would consider this very important proposal exceptionally during a teleconference.
- The decision about whether to use Vaccine Fund resources in the manner outlined in the proposal could have financial implications for certain members of the GAVI Board. In the past, when GAVI Board members have had a potential conflict of interest regarding decisions about the use of Vaccine Fund resources, those members have recused themselves from the decision.
- Considering the potential for conflict of interest, the Chair requested all Board members to make a brief statement declaring their interests in the proposal. The only Board member to state a potential for conflict was the representative of developing country vaccine manufacturers. However, since he represents the constituency and not his individual company, he was invited to participate in the decision.
- One Board member suggested that the issue of conflict of interest in GAVI Board decisions in general should be addressed in more depth, with perhaps some guidelines proposed to the Board.
- There was wide consensus that the arguments presented in the measles investment case provide a strong and compelling case for the use of Vaccine Fund resources to reduce measles mortality in Africa. It was suggested that the Partnership receive a clear message regarding the one-time nature of this funding.
- A number of Board members voiced the concern that countries need to own the measles effort and include the relevant strategies within their comprehensive national health and immunization plans, and that this effort should dove-tail with attempts in countries to strengthen routine immunization plans. The impact on human resource capacity should be considered, ie, are there opportunity costs for staff in carrying out measles campaigns? However, opportunity costs need to be balanced against the costs of treatment and mortality of measles cases which could have been prevented through vaccination, as well as understanding that measles campaigns will need only to be held periodically (every 3-5 years, not every year like polio campaigns).
- It was noted that in approving $50 million support for measles the GAVI Board was making a historic decision. As such, it is important to not appear ad hoc in this, but rather to explicitly explain the relationship of the approved measles support to GAVI's objectives, goals and added-value. The principles followed in the decision on the measles investment case should be in line with GAVI policies relating to future funding decisions. Future decisions that have financial implications should also be accompanied by a clear picture of their financial implications for GAVI as well as any other GAVI management or governance implications.
- With regard to funding channels, the World Bank suggested the following strategy for consideration:
- For countries engaging in their initial catch-up campaign (Central African Republic, DR Congo, Djibouti, Mozambique, Nigeria, Niger, Sudan, Somalia and Rep Congo), funds would be channelled through the UN Foundation and the measles partnership as outlined in the measles investment case.
- For countries now engaging in follow-up campaigns for which they will be responsible for many years to come, funds/support would be provided to the governments based on national applications to GAVI (the existing GAVI funding route).
DECISIONS
The GAVI Board:
1.1 Approved in principle the use of $50 million in Vaccine Fund resources for measles mortality reduction efforts.
1.2 Requested the Director of the WHO Department of Immunization Vaccines and Biologicals (IVB) and the GAVI Executive Secretary to prepare a short addendum to the measles investment case for circulation to Board members addressing the following concerns:
1.2.1 Clarification on how the GAVI/Vaccine Fund investment in measles mortality reduction is aligned with Vaccine Fund strategic approach, ie:
1.2.1.1 Funds should be time limited to reflect that the activity funded makes sense as one time funding - activities like new antigen introduction, one time system strengthening, measles catch up, etc
1.2.1.2 Funds should provide a step change in immunization that can then be sustained in the routine immunization system by non-Vaccine Fund resources at this new level of performance
1.2.1.3 Funds should be for country-owned processes that are subject to the review and accountability that characterizes GAVI.
1.2.2 The need for the Partnership to demonstrate how it could use current GAVI/Vaccine Fund funding mechanisms, to the greatest extent possible.
1.2.3 Country ownership and needs must be ensured.
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2. Long-term strategy development
- Three graphics were provided as background information to help Board members understand the timeline of various decisions needed to develop the long-term strategy for GAVI and their relationship to countries’ integrated multiyear immunization plans.
- Some Board members felt that the timeline was too optimistic.
- Based on further input, the Secretariat will revise and update these graphics on a regular basis.
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