TENTH GAVI BOARD MEETING
New York City, 6 March 2003
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2 Report of the McKinsey Study
- Board members thanked McKinsey and Company for their perceptive in-depth analysis which will be a valuable tool for the future work of the Alliance.
- Many Board members noted that the differentiation and segmentation of countries highlight priority areas and form a useful basis for additional interventions particularly in a broader health sector context. Several cautioned that a differentiated approach did not mean that GAVI would narrow its focus to 10-15 countries alone. The Alliance has a responsibility to continue its broader efforts for all countries.
- It was noted that GAVI should seek to maintain the transparency and accountability of its current standardized support reinforcing and modifying when required to allow for a differentiated approach between countries.
- Many board members noted that advances in immunization coverage in large countries with low coverage are only likely to be achieved if larger systemic problems are addressed both within and outside of the health sector.
- Such countries also fall short of delivering many other essential services to their populations. This provides opportunities for a consolidated approached and synergies in working towards the Millennium Development Goals.
- Several Board members stressed the importance of ensuring sustainability when considering any efforts to extend immunization coverage or add new vaccines. They noted that while each country would make its own decision about expanding coverage or adding new vaccines, GAVI would help provide decision makers with data to ensure well-considered, balanced decisions.
- The urgency of strengthening ICCs in countries and of all partners being involved was emphasized.
- There was some concern that the McKinsey analysis may lead to a focus on remediation at the expense of reward and results-oriented interventions supported by GAVI/VF to date.
- Many Board members expressed their reluctance to embark on a new initiative such as the Facilitated Recovery Plans, preferring to use existing government-partner mechanisms and efforts to strengthen national immunization plans and prepare Financial Sustainability Plans.
- The McKinsey report sparked a broader discussion of how GAVI and GAVI partners should relate to countries, recognizing that countries are currently overwhelmed with global initiatives, and it is often the same few people in countries expected to work on these initiatives and attend ICC type of meetings.
- Board members agreed that there is a need to better link GAVI and immunization goals to the Millennium Development Goals noting that forthcoming opportunities include the spring World Bank meetings and the G20 in Canada later in 2003.
- It was noted that the financial sustainability plans will be reviewed at the July Board meeting. This will allow for a discussion of the gaps in immunization financing and how they can be met.
- The Gates Foundation representative noted that the Gates Foundation remains committed to immunization and GAVI, and that this commitment will extend beyond the current five-year time horizon.
- The representative from the Government of India requested that coverage data from India be updated in the final McKinsey report.
- Although NGOs are playing a major role in immunization, often in areas outside of MOH control, NGOs have not traditionally been included in ICCs, nor received targeted funding for their immunization work.
- 2.1 Adopted a revised milestone to replace the current '80/80' milestone in order to link it to the Millennium Development Goals and the United Nations Special Session on Children goals. The revised milestone thus reads:
"By 2010 or sooner all countries will have routine immunization coverage at 90 per cent nationally with at least 80 per cent coverage in every district."
- 2.2 Decided to integrate relevant parts of the McKinsey analysis into the development of the strategic framework and explore the possibilities to use a differentiated approach for possible additional country support.
- 2.3 Requested McKinsey & Company in their final report to further develop and clarify the following three areas for discussion next Board meeting:
- 2.3.1 vaccine management and economics initiative to reduce the costs of vaccination across countries development
- 2.3.2 consolidation of training to increase efficiency of programs
- 2.3.3 knowledge-sharing network to facilitate exchange of learning between countries.
- 2.4 Requested the Secretariat to further review with the Working Group and the ITF the criteria and list of priority countries proposed by McKinsey and revise as appropriate.
- 2.5 Requested the Secretariat to facilitate the mapping out of major partners and initiatives in priority countries and the emerging thinking on how to accelerate efforts to meet the MDGs, to see how these could address and that could be used for strengthening of immunization services. This analysis will form the basis for the Board to consider how to address the situation of these countries at the next Board meeting.
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