What is Global Alliance for Vaccines and Immunization (GAVI)?
The Global Alliance for Vaccines and Immunization, launched in 2000, is a public-private partnership committed to improving child health and alleviating disparities in vaccine access in poor countries. The alliance has agreed on the following objectives:
- Improve access to sustainable immunization services;
- Expand the use of all existing safe and cost-effective vaccines, and promote delivery of other appropriate interventions at immunization contacts;
- Support the national and international accelerated disease control targets for vaccine-preventable diseases;
- Accelerate the development and introduction of new vaccines and technologies;
- Accelerate R&D efforts for vaccines needed primarily in developing countries; and
- Make immunization coverage a centerpiece in international development efforts.
GAVI provides support for vaccines (hepatitis B, Haemophilus Influenzae-B and yellow fever) as well as safe injection materials (auto-disable syringes) and resources to strengthen immunization services. These resources may be in the form of in-kind support (vaccines, supplies) or cash support for system strengthening. GAVI partners also work with governments to help them establish independent, long-term funding for their immunization programs.
Within GAVI, a Board oversees a working group and regional and issue-specific task forces that make up the Alliance. The Board sets the policies of the alliance. This Board is supported by the Secretariat, based in Geneva, which coordinates the activities among Alliance partners. Daily management issues are handled by the GAVI Executive Committee. Committee members include four renewable members (WHO, UNICEF, the World Bank, and the Gates Foundation), one rotating member each from developing and industrialized country governments and one rotating member each from developing and industrialized countries vaccine industry. GAVI also maintains an Independent Review Committee (IRC) comprised of immunization experts, two thirds of whom are from developing countries. The IRC is responsible for reviewing all applications for funding and makes recommendations to the Board for their approval.
GAVI draws on its strength as an alliance to focus on areas in which no one partner can work effectively alone and to add value to what partners are already doing. These areas include coordination, consensus building, funding support to countries, innovation, advocacy and communications.
How does GAVI work?
Typically, countries with less than US$1,000 per capita annual GDP are eligible for support from GAVI. 75 such countries are currently eligible, with 71 currently receiving support from GAVI. Countries with DPT3 coverage between 50% to 80% can receive vaccines and financial support to expand immunization services. Countries with weak immunization services, where less than 50% of children are currently immunized with DPT3, can only receive funds to strengthen services. Such countries must achieve at least 50% DPT3 coverage before qualifying for new vaccines.
To apply for funding, countries submit applications to GAVI’s Independent Review Committee. For these applications to be approved by the IRC, countries must establish an Inter-agency Coordination Committee (ICC). The ICC, which must be led by government and include representatives of local agencies involved with immunization, helps guide the application process and helps the country’s government with program management. An additional requirement for IRC approval is the completion of a recent review (within 3 years) of immunization services and the development of a multi-year plan outlining improvement and expansion of immunization services and mechanisms for sustainable financing by countries.
GAVI support to countries is for a limited period of time and quantity of resources. Countries can receive vaccine support for five years, supplies for three years, and support for systems strengthening for three years—with subsequent amounts a function of the number of additional children immunized annually. These resources are intended to be enough to meet program plans for improvement in the three categories of support for five years, though this support can be spread over the longer period. GAVI intends that its support be “catalytic”. That is, the limited-term GAVI funding is intended to stimulate program improvements (e.g. higher coverage, improved safety, and use of new vaccines) and the mobilization of resources to sustain the improvements. As a part of this approach, GAVI requires the countries it supports to also prepare a Financial Sustainability Plan document (FSP) after receiving two years of initial assistance. The primary objective of this requirement is to increase the likelihood of the countries sustaining the gains in program performance that GAVI has supported, by being able to support the additional resource requirements through their own and external partner resources. Countries are provided with requests for revisions and invitation for resubmission if submitted financial sustainability plans warrant improvement.
What donors and other global partners contribute to, or play a major role in GAVI?
GAVI has several major partners, including the Bill & Melinda Gates Foundation, WHO, UNICEF, The World Bank, country governments, NGOs, research institutions, the vaccine industry, and academic institutions. In 2005, the Gates Foundation contributed $750 million to GAVI, whilst the Government of Norway committed $290 million.
What countries does GAVI support?
Typically, countries with less than US$1,000 per capita annual GDP are eligible for support from GAVI. 75 such countries are currently eligible, with 71 currently receiving support from GAVI.
What are good sources of information about GAVI?
Update on plans and process to support countries in developing their Financial Sustainability Plans
GAVI 2004-2005 Work Plan
Questions & Answers about GAVI and the Vaccine Fund
Godal, Torre. GAVI, the first steps: lessons for the Global Fund. The Lancet, Vol 360. July 13, 2002.
Martin, Jacques-Francois and John Marshall. New tendencies and strategies in international immunisation: GAVI and The Vaccine Fund. Vaccine 21 (2003) 587-592.
Nossal, Gustav. Gates, GAVI, the glorious global funds and more: All you ever wanted to know. Immunology and Cell Biology (2003) 81, 20-22.
Wittet, Scott. Introducing GAVI and the Global Fund for Children's Vaccines. Vaccine 19 (2001) 385-386.