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Fifth
GAVI Board Meeting, 21-22 June 2001, London, England
June 2001
Complex Emergencies Update and Policy Recommendations
BACKGROUND:
For the purpose of this analysis, we have used
the UN Consolidated Appeals definition of countries in "complex
emergencies" as countries with armed conflicts affecting large
civilian populations through direct violence, forced displacement
and food scarcity, resulting in malnutrition, high morbidity and
mortality.
Emergencies can be considered in three phases:
active conflict, chronic conflict, and rehabilitation (or development).
An acute conflict usually generates sufficient funding for immunization
through international appeals. However, this is not sustained; in
a chronic conflict or rehabilitation phase, appeals are much less
successful, leaving large gaps in the funding needs for immunization.
Of the 28 countries classified as those experiencing
complex emergencies, 22 are eligible for support from the Vaccine Fund (see Table
1). Of these, 12 have been approved/recommended for support
or conditional approval, 3 are preparing proposals, and 2 have been
asked to re-submit. The status of 5 countries is currently unknown.
Thus, the proposal process appears to be working for a majority
of countries classified as experiencing complex emergencies.
POLICY RECOMMENDATIONS:
- Using its advocacy channels, GAVI could encourage
international and national authorities to include longer-term
support to immunization services in their resource mobilization
efforts during the acute conflict phase, to ensure sustained funding.
- In countries with well-functioning national governments
and relatively high immunization coverage, there may be vulnerable
populations within their borders that are not reached by the health
system. GAVI could encourage partners to ensure that immunization
services are reaching those at risk.
- In countries where governments are weak or non-functional,
GAVI could consider proposals submitted by an operational partner
or partners (such as WHO and UNICEF), engaging the multiple partners
most suited to reach all parts of the countries (e.g., UNHCR,
Medicins sans Frontières) with those partners taking responsibility
for implementation.
- The Independent Review Committee will continue
on a case by case basis to highlight the complexities and program
challenges faced by countries in complex emergencies and take
these into account when assessing the quality and appropriateness
of their proposals. Innovative approaches needed to fulfill program
needs will be encouraged.
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