In order to achieve its mission to increase access to immunization in poor countries, Gavi provides financial and non-financial support to countries to run their vaccination and health systems strengthening programs. In 2015, Gavi was determining how best to help countries that were graduating from its support to smoothly transition to self-financing their own immunization programs. If Gavi financing is suddenly withdrawn, countries run the risk of not being able to procure the tens of millions of vaccines needed to immunize children and prevent life-threatening diseases like polio from returning. Approximately 25 low-income countries currently receiving Gavi financing will graduate to self-financing vaccines by 2020.

Dalberg worked with the Gavi Secretariat and the Gavi Board Committees to determine how best to support access to appropriate vaccine pricing for these Gavi graduated countries, in order to ensure that countries can sustain immunization programs that started with Gavi support, and also continue to introduce new life-saving vaccines.

OUR APPROACH

In collaboration with the Gavi Secretariat, Dalberg led:

An analytic approach to:
• Identify which vaccines were most at risk of increased pricing
• Understand the greatest barriers related to payment for and procurement of vaccines
• Develop and prioritize recommendations that would best address the identified gaps
• Deliver a single solution to support Gavi graduated countries with access to appropriate pricing

Stakeholder engagement with core Gavi partners – including WHO, UNICEF, private sector vaccine manufacturers, other funders such as the Bill and Melinda Gates Foundation, and graduating country government representatives – to ensure all partners were aligned and could provide their own technical input on the final recommended solution.

RESULTS

We recommended that Gavi provide graduated countries access to a mechanism that would include countries in ongoing Gavi/UNICEF tenders for a limited period of time following graduation, and a payment mechanism, UNICEF’s Vaccine Independence Initiative, to provide pre-financing to countries to procure vaccines on a need basis. The Gavi board approved our recommendation in June 2015, which will ensure vaccination of over 10 million children annually.