Since 2011, a five-year strategy has guided Gavi’s mission to save children’s lives and protect people’s health by increasing access to immunisation.
In this edition of our Annual Progress Report, we look back at the final year of the 2011-2015 period and report on Gavi’s progress towards achieving our targets: the successes and the challenges.
This report describes a pilot project that PATH conducted in the Afar Region of Ethiopia that aimed to increase vaccination coverage through social mobilization committees and communication activities. It examines the challenges to achieving vaccination coverage in the region, provides success stories demonstrating behavior change, and best practices and lessons learned.
FULFILLING A PROMISE: ENSURING IMMUNIZATION FOR ALL IN AFRICA
See the official conference report for a look at the current state of immunization on the African continent.
A new report issued today by the World Health Organization (WHO) Regional Office for Africa and the Eastern Mediterranean Region shows that despite considerable progress in expanding access to vaccines in Africa, one in five children on the continent still do not receive life-saving immunizations. Africa’s routine immunization coverage of 80% is the lowest of any region in the world.
The two most common household surveys conducted in developing countries to obtain nationally representative estimates of immunization coverage are the USAID-financed Demographic and Health Survey (DHS) and UNICEF-financed Multiple Indicator Cluster Survey (MICS). These surveys use similar methods and their results in terms of quality and precision are generally comparable.
The GAVI Alliance strategy and business plan for 2013-2014 includes a range of activities related to the assessment and improvement of immunization coverage data quality. These activities include assessment of numerators from country administrative data systems, assessment of denominator data, conduct of household surveys, refinement of WHO/UNICEF estimates of national immunization coverage and support to countries in development and implementation of data quality improvement plans. Additionally, the GAVI Alliance invests in vaccine preventable disease surveillance systems, targeted studies and evaluations—these activities provide a basis to triangulate data across multiple approaches. In addition to the business plan items listed below, the guidelines for GAVI’s health systems strengthening (HSS) grants to countries recommend that countries invest approximately 5-10% of the grant amount in M&E strengthening activities. At present, no investment framework is provided to give guidance on how these investments may be structured. In practice, the majority of countries spend substantially less than this amount on M&E strengthening activities.
The following report displays data and figures on the introduction status of Hib vaccine, pneumococcal conjugate vaccine (PCV) and rotavirus vaccine both globally and in 73 GAVI eligible countries. It uses information stored in the Vaccine Information Management System (VIMS) online database maintained by IVAC at the Johns Hopkins Bloomberg School of Public Health and supported by the GAVI Alliance. The images and text below describe: how many countries have introduced each vaccine or plan to in the future; global and GAVI rates of coverage and access; projected introduction dates for GAVI eligible countries; historical trends of the rate of introduction globally; and the introduction status of every country individually. The report concludes with a more detailed description of VIMS and its potential uses.
This paper estimates and compares the costs and financing of a sample of 54 national immunization programs as reflected in comprehensive multi-year plans (cMYPs) submitted to the GAVI Alliance, for the period 2004 to 2015.
Immunization is a critical intervention for achieving the Millennium Development Goal of reducing deaths among children less than five years of age (MDG4) by two-thirds. More than 100 million children are vaccinated each year, protecting them against life-threatening diseases (WHO and UNICEF, 2010). Immunization is considered to be one of the ‘best buys’ in public health (WHO and UNICEF, 2010; World Bank 2010). Traditional vaccines cost pennies per dose and provide health benefits not only for the immunized child, but also for the community in which a child lives through herd immunity. In addition, studies have shown that immunization extends life expectancy and the time spent on productive activity later in life, thereby contributing to economic growth. Given the public goods aspect of immunization and its potential returns for growth and poverty reduction, this is an intervention definitely worth investment by governments. While newer vaccines are more expensive on a per dose basis, they have been shown to be highly cost-effective investments. The purpose of this analysis is to summarize historical trends in immunization costs and financing, both for routine services and campaigns, as countries have introduced new vaccines. The main audience for this document is national, regional, and global technical staff working on national immunization programs.
Immunization is one of the “best buys” in global health. However, for the poorest countries, even modest expenditures may be out of reach. The GAVI Alliance is a public-private partnership created to help the poorest countries introduce new vaccines. Since 2008 GAVI has required that countries cover a share of the cost of vaccines introduced with GAVI support. To determine how much countries can contribute to the cost of vaccines—without displacing spending on other essential programs—we analyzed their fiscal capacity to contribute to the purchase of vaccines over the coming decade. For low-income countries, external financing will be required to purchase vaccines supported by GAVI, so co-financing needs to be modest. Relatively better-off “intermediate” countries could support initially modest but gradually increasing co-financing levels. The countries soon to graduate from GAVI can generally afford to follow a rapid path to self-sufficiency. Co-financing for these countries needs to ramp up so that national budgets fully cover the costs of the new generation of vaccines once GAVI support ends.