GAVI Executive Committee Teleconference

20 February 2004

FINAL Summary Report

1. GAVI / The Vaccine Fund Convergence Study
2. GAVI investment case framework
3. Update on the International Financing Facility (IFF)
4. Recommendations of the Independent Review Committee (IRC)

1. GAVI / The Vaccine Fund Convergence Study

• The report, “Architecture for Convergence: Aligning The Vaccine Fund and the Global Alliance for Vaccines and Immunization” will be a valuable foundation for more in-depth discussions of GAVI’s added value and comparative strengths as we look forward to 2015.



• There are three related yet distinct areas that need to be considered as we think long-term:



1. the strategic vision of GAVI/The Vaccine Fund;
2. roles and responsibilities of partners; and
3. convergence of the Vaccine Fund management and the GAVI Secretariat.

Any decisions about changes in the above areas should not be made in isolation but with the full context in mind. Furthermore, a wide and inclusive consultative process should be conducted prior to decisions.

• Regarding strategic planning and resource mobilization, it will be important to discuss both the explicit and defined roles of The Vaccine Fund, and the broader question of support to all immunization activities. This discussion would be to ensure that GAVI/Vaccine Fund activities and investments do not compete with other activities and that the affordability and sustainability of immunization improvements are kept in mind.



• It will be important to increase efforts to keep all of the GAVI partners informed of important activities that can impact them, such as the IFF.

DECISIONS

The GAVI Executive Committee:

1.1 Accepted the report as submitted and agreed to the recommendations on procedural convergence.

1.2 Decided not to make any of the recommended structural changes at this time, opting to further develop the long-term strategic direction for GAVI and The Vaccine Fund prior to making any changes to the current structures.

1.3 Requested that in order to progress toward procedural convergence, The Vaccine Fund and GAVI Secretariat should submit to the EC a short-term work plan, including timeline, towards strengthening collaboration and further harmonizing their work.

1.4 Agreed to the proposal from the Gates Foundation, WHO, and UNICEF, to work together in organizing a retreat in late May/early June to develop and reach consensus on GAVI and The Vaccine Fund’s long-term strategy. It will be important to involve all EC members as well as representatives from the vaccine industry, developing countries, and the Vaccine Fund Executive Committee.

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2. GAVI investment case framework

• The GAVI Board is responsible for two levels of decision-making regarding use of Vaccine Fund resources. The first level is general decisions about areas in which to invest, e.g., introduction of hepatitis B vaccine in all Vaccine Fund eligible countries with DTP3 coverage above 50 percent. The second level of decisions concerns funding requests by individual countries, e.g., provision of hepatitis B vaccine to a specific country.



• The draft GAVI investment case framework promises to be very useful in helping the GAVI Board make its first-level decisions about the best use of Vaccine Fund resources in the future. The current draft investment case framework is not designed to be used to make second-level, or country-specific, decisions about Vaccine Fund resources.



• As the framework is further developed it will be important to streamline the guidelines to ensure a smoother and more simple decision-making process. A balance needs to be struck between providing the Board enough information for an informed, evidence-based decision without overwhelming members with too much information.



• When making decisions about future Vaccine Fund investments it will be important to have information on cost-effectiveness and morbidity and mortality reduction. There may also be different options in a specific area. For instance, there may be a number of different avenues for supporting measles mortality reduction and the Board should not be confined to consider only one strategy.



• In order to ensure full participation of all concerned entities within GAVI and ensure sustainability of the project, it is important that the investment case framework be developed in collaboration with the Financing Task Force.

DECISIONS

The GAVI Executive Committee:

2.1 Endorsed the general approach taken by the draft investment case framework and committed its resources to support further development of the framework.

2.2 Agreed to the proposed timeline, including the proposal that the measles investment case be submitted to the Executive Committee by mid-April.

2.3 Welcomed the proposal from USAID to develop an options paper regarding measles. The paper will be designed to provide the GAVI Board with a background context for considering the measles investment case, using the WHO/UNICEF strategy for measles mortality reduction 2001-05 as a critical piece of strategic thinking.

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3. Update on the International Financing Facility (IFF)

• There is general support for continued discussion with the UK Treasury department and DFID to explore the possibilities of using an IFF-type financing mechanism to support GAVI objectives. However, it remains to be seen whether an IFF will offer funding that is truly additional, and whether immunization programs would benefit from the ‘frontloading’ approach.



• The analysis of ‘pros and cons’ for GAVI and The Vaccine Fund in working with an IFF-type mechanism will be completed by The Vaccine Fund by the end of March.

DECISIONS

The GAVI Executive Committee:

3.1 Agreed to support The Vaccine Fund with technical support of members’ respective agencies necessary to complete the analysis. The Vaccine Fund requested EC members to identify IFF focal points within their agencies; Amie Batson will be focal point for World Bank, Peter Mason will be focal point for UNICEF, and Joy Phumaphi will be focal point for WHO.

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4. Recommendations of the Independent Review Committee (IRC)

• The work of the new IRC financial sustainability plan review team and the IRC monitoring team is comprehensive and valuable to the GAVI alliance.



• The policy recommendations from both the monitoring and financial sustainability plan review teams of the IRC will be further reviewed by the GAVI Working Group which will make its recommendations to the GAVI EC in due course.



• It would be valuable to identify ‘best practices’ in immunization financing so that countries can learn from each other.

DECISIONS

The GAVI Executive Committee:

4.1 Approved the financial implications of the IRC Monitoring team’s recommendations as follows:

Immunization Services Support (ISS): $3.1 million
Injection Safety Support (INS): $4.9 million
Vaccines Support (NVS): $19.3 million
Total: $27.4 million

4.2 Agreed that it would be warranted to conduct a population-based survey in Pakistan to supplement the data quality audit (DQA), considering the country’s large population and substantial immunization services funding.

4.3 Requested that the Executive Secretary, in his future visits with country officials, raise the need to identify sources of funding to continue the support for injection safety, which The Vaccine Fund provides for a period of three years.

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Related information

Executive Committee membership

Executive Committee reports

Executive Committee functions

GAVI Governance