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2001 contents page
Hard work ahead
WITH two out of three eligible countries
still to be approved for awards from the Vaccine Fund, the GAVI
partners have a lot of work to do to meet the goal of supporting
all 74 eligible countries by 2002. This is the conclusion of Alliance
partners who are responsible for ensuring that countries have strong
immunization plans in place so that they can attract new money from
the Vaccine Fund.
Last month, the Alliance's independent
review committee assessed applications from the third round of countries
to apply to GAVI and the Vaccine Fund
for support, following the first two rounds last year. Three new
proposals for support to improve immunization services, from Cameroon,
Pakistan and Tajikistan, were approved in principle pending some
clarifications. But 10 countries did not receive approval for any
request, either for new vaccines or for immunization services.
the 74 eligible countries with incomes below US$ 1000 GNP per capita,
25 have now been approved for awards, and 6 more have received conditional
approval (see Graph). Another 14 countries have been asked to re-submit
their proposals, while 2 countries have been turned down(1).
While relatively well-resourced
countries submitted their applications in the first two rounds,
most of the current wave of applications come from countries that
tend to have weaker capacity in their health ministries or other
demands on their overstretched resources. For example, several of
the countries asked to re-submit are in West Africa where a major
polio campaign has been under way in the past few months.
Dr Tore Godal, executive secretary of
GAVI, said that the review had served to highlight needs that might
otherwise have been missed. "We can use the application process
as a way to diagnose problems at country level and then start to
provide longer-term assistance and capacity building for the countries
that are weakest," he said. "Together with the GAVI Task Force on
Country Coordination, we have identified as our first target 13
countries in Africa that need particular attention." The Task Force
is starting to cost its plans for capacity building. Members say
the needs are substantial.
Dr Bjorn Melgaard, head of the
WHO's department of Vaccines and Biologicals, said that agencies
such as WHO could provide consultants to offer technical support
in the completion of each country's application. But, he stressed,
external support would not be enough in the long term. "You are
not building the capacity or the ownership that is needed," he said.
He said many countries should be employing a full-time member of
staff to develop the government's immunization plans and its application
for funds. Dr Melgaard believes that most African countries already
have qualified personnel available, but that they need to be recruited.
He warns that capacity to plan and implement immunization cannot
be built overnight.
(1) For details of
applications and disbursements to date, see http://www.vaccinealliance.org/reference/awards.html
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