GAVI Board Teleconference
11 September 2000
Summary of Discussion
Dr Gro Harlem Brundtland welcomed the participants
[see attached participant list] and stated that the substance of
the days discussion would be the first disbursement of Vaccine
Fund awards to the 13 countries that had been approved for support
from the Vaccine Fund. In addition, the Board would be updated on
the progress of decisions on administrative procedures of the Vaccine Fund.
First Fund Disbursements to
Tore Godal outlined the figures that have been calculated
for the first Fund disbursement, based on the approved country proposals
and subsequent clarification information. In summary, the total
value of support for the first round of countries would be an estimated
US$27,184,984 for vaccines and supplies (depending on cost of vaccines),
and US$3,379,730 for immunization services, for a total disbursement
of an estimated US$30,564,714.
The Board approved the recommendations
for the Vaccine Funds first disbursements to countries, as
outlined in the documents prepared by the Secretariat. The decision
was made to forward the recommendations to the Vaccine Fund Board,
with the proviso that the precise award amounts to countries may
be adjusted very slightly.
The Vaccine Fund Board approved this request later the same
The issue was raised that in this first disbursement,
funding being provided for vaccines is far greater than funding
provided for immunization services. This may be a reflection of
the fact that some countries have delayed their requests for immunization
services support, and that more countries in this first round are
not eligible for this type of support, as compared to countries
planning to submit proposals in later rounds. While it is too early
to determine whether the appropriate emphasis is being given to
each sub-account, it will be important to monitor whether the Vaccine Fund
is providing appropriate resources to support infrastructure and
health delivery systems.
The GAVI Board welcomed and endorsed the recommendations
of the 8 September meeting in Geneva of UNICEF reps, WRs and ICC
chairs to discuss mechanisms to channel the funds from the immunization
services sub-account. The recommendations were:
- the preferred mechanism is directly to the government,
to an account for health services that has appropriate checks
- in cases where such mechanisms are not in place
to meet the needs for speed and flexibility, partners may be requested
to assist as a stop gap measure; and this should be done in a
manner that does not compromise government's control of the use
of funds nor the partner's role in monitoring the outputs.
The Working Group is currently exploring additional
areas of support from the Vaccine Fund, including: incentives for countries
with greater than 80% immunization coverage; support from a third
sub-account, such as research initiatives; and support to China,
India and Indonesia. Negotiations are currently being held with
Indonesia and India to ascertain appropriate systems for providing
support to these countries from the Vaccine Fund; Mark Kane will provide
a report of the discussions at the GAVI Board meeting in November.
Projections on Fund expenditures for the next
two years will be provided to the Board at the November Board meeting.
Update on the Vaccine Fund
Jacques-François Martin reported that
the Vaccine Fund has released the necessary funds to UNICEF for its administrative
costs in supporting Fund-related activities.
The Agreement between the Vaccine Fund and UNICEF is close
to being finalized. It will reflect a balance between the need for
the Vaccine Fund to be represented as an independent decision-making institution,
in accordance with U.S. laws on nonprofit corporations, and the
need for the Vaccine Fund to be seen as guided by the technical expertise
of the GAVI Board. The overall principles of this working relationship
are consistent with the original intention. An updated draft Agreement
will be circulated shortly to the Board and potential donors for
The Vaccine Fund is currently reviewing options for the Board
constitution. It has been decided that a number of prominent individuals
would be asked to join the Vaccine Fund Board, in order to provide the necessary
advocacy and fundraising support. They would be asked to be available
to meet once a year. In addition, the Vaccine Fund Board would have a smaller
executive committee that would meet four times a year to attend
to the managerial and administrative functions. The GAVI Board is
invited to provide suggestions for Fund Board candidates.
The donations of vaccines announced by pharmaceutical
companies in March of this year will be accepted by the Vaccine Fund. It
is understood that the donations are not based upon stock at hand
but upon longer-term commitments. The donated vaccines will be provided
to those countries that are approved for support for new and under-used
vaccines, and where the donated vaccine presentations are epidemiologically
and logistically appropriate.
After the November Board meeting in the Netherlands,
the next Board meeting will likely be in June 2001. The suggested
exact dates are 20-21 June 2001.
Recommendation to the Vaccine Fund for first round of country
Subsequent to the decision taken by the GAVI Board
on 18 July 2000 the thirteen countries for which support was approved
have now presented the clarifications necessary to calculate their
awards. On the basis of the information received, the support to
be granted to these countries for the year 2001 is shown in the
|Table 1. Calculated support
to first round countries for the year 2001
(amounts in US$, rounded to the nearest thousand)
| GNP per capita
services sub-account (calculated)
|| New and under-used
vaccines sub-account (estimated)
The decision on support from the immunization services
sub-account will result in immediate disbursement. The decision
on support from the new and under-used vaccines sub-account will
result in a tendering procedure by the UNICEF Supply division. UNICEF
Supply Division is currently reviewing offers of vaccines and contributions.
Supply Division is clarifying offers with all 11 companies that
have made them. UNICEF Supply Division will have a product "catalogue"
within 15 days which will then be shared and discussed with
the eligible countries so that allocation decisions can then be
made in mid- to end-November.
- The support under the immunization services sub-account
has been calculated using the 1999 DTP3 baseline, with 50% of
the investment support to be disbursed this year and the remaining
50% end 2001, conditional upon the receipt of a satisfactory progress
- The exact financial implications of the decision
regarding the new and under-used vaccines sub-account can only
be calculated after the tendering procedure in October of this
year. This estimate is based on current vaccine prices.
- The provision of new and under-used vaccines for
the year 2001 has been calculated on the basis of need for the
full year (unless a specific request for support for only part
of the year has been made). However, it can be anticipated that
these vaccines will not be available in time to be used in the
early part of the year. Adjustments of the deliveries and the
consequences for subsequent deliveries will be made when further
information about delivery times for these vaccines is available.
- Issues arising from the clarifications process
- Wastage rates
Current GAVI policy stipulates that wastage rates for combination
vaccines must be less than 25% at the outset, and 15% within
three years. It is proposed that exceptions to this policy
be considered depending on the situation, e.g., when a country
currently has considerably higher wastage rates (example Cambodia).
However, countries with high wastage rates will have to accept
lower priority for the combination vaccines if the supply
of these vaccines is insufficient.
- Non replacement principle
Countries that already pay for new and under-used vaccines
cannot receive support for these vaccines from the Vaccine Fund (example
Guyana Yellow Fever).
- Updated multi-year immunization plan for Malawi
Malawi’s current five year immunization plan will come to
an end in the year 2000. The country is now in the process
of updating its plan to cover the next five year period and
GAVI has requested this updated plan be available before the
delivery of the new vaccines.
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