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Financing Immunization

Identifying long-term financing options

The challenge: sustainable sources of funds

In most developing countries, immunization programmes are financed and delivered largely through the public sector. While some countries are able to finance most of their essential national health needs, and can accord immunization a high priority, many rely heavily on external donors. This dependence on donors can result in inconsistent levels of funding from one year to the next, depending on donor priorities and programming.

In addition to the problem of ensuring funding for immunization with traditional vaccines such as polio, measles, and diphtheria, tetanus and pertussis (DTP), many countries are concerned how they will be able to routinely mobilize sufficient funds to expand their programs both to reach more children and to include new and improved vaccines.


Grandmother and granddaughter: the challenge for governments is to ensure a stable health system that can immunize generation after generation

The Task Force’s contribution

The GAVI Financing Task Force is committed to identifying options and assessing strategies, which will improve the capacity of governments, donors, development banks and others to mobilize funds required to finance the improvement and expansion of national immunization programmes.

Immunization, as one of the most cost-effective interventions known, is a critical component of a well-functioning health system. Sustainable financing for immunization must be considered within the context of overall health sector and national budgets.

The Vaccine Fund is a new source of support for countries with a GNP/capita of less than or equal to $1000. The Vaccine Fund’s current budget allows for five years of support (although countries may elect to spread this support over a longer term). It is fully anticipated that successful use of the Vaccine Fund’s resources will pave the way for a replenishment of the Vaccine Fund, permitting countries to introduce the next generation of life-saving vaccines to their programmes.

In order to encourage a gradual assumption of the financial responsibility for programme improvements, countries that receive funds for new vaccines or to improve their vaccine delivery systems through the Vaccine Fund are expected to provide mid-term plans for financial sustainability to the GAVI Board. These plans, which are to be signed off by the Ministry of Finance, will detail the long-term financial sustainability strategies for the country’s immunization programme when initial support from the Vaccine Fund ceases. Countries with approved plans will be eligible to receive their next installment of Vaccine Fund support. The FTF is responsible for the development of guidelines, indicators, and targets for countries to consider when drafting their financial sustainability plans.


Draft paper
Financial sustainability of childhood immunization: issues and options. Ruth Levine, Magdalene Rosenmöller and Peyvand Khaleghian The World Bank, Washington DC. April 2001:


This paper is intended to:

(I) clarify the critical issues affecting the sustainability of immunization financing in developing countries;

(II) provide the framework for subsequent deliberations by the GAVI Board regarding preferred mechanisms for investment by all the GAVI partners to encourage sustainable financing; and

(III) explore a range of possible financial sustainability indicators and targets for countries eligible to receive support from the Vaccine Fund.

Issues in immunization finance: background papers and case studies:

  • Costs and financing of immunization programmes: findings of four case studies

    PDF document (approx. 329kb)
    Word document (approx. 622kb)

  • Case study on the costs and financing of immunization services in Bangladesh

    Word document (approx. 968kb)

  • Case study on the costs and financing of immunization services in Cote d’Ivoire

    PDF document (approx. 475kb)

  • Case study on the costs and financing of immunization services in Morocco

    PDF document (approx. 488kb)

Download Adobe Acrobat (Required to read PDF documents)

Introduction Financing Task Force Identifying long-term financing options
Promoting the development of new vaccines for low-income and middle-income countries Forecasting vaccine demand Capacity Building in Financial Management


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