Immunization Financing

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• Immunization Financing
• Database
• (IFD)
• GAVI Board Meeting
• Stockholm, Sweden
• March 11, 2002

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Government Financing of Vaccines and
Vaccine Fund Recipient Countries in
Africa
For Illustration only. Do not quote
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Financial Sustainability

• Although self-sufficiency is the ultimate goal,
  in the nearer term, sustainable financing is the
  ability of a country to mobilize and efficiently
  use domestic and supplementary external resources
  on a reliable basis to achieve target levels of
  immunization performance.

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Objectives of the IFD

• Objectives
• 1. Monitor trends in expenditure and financial
  flows at the country, region and global levels
• How much are countries spending on immunization
  services?
• -By whom? National, donor agencies, other
  lending
• agencies
• -For what? Programme specific expenditures

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Objectives of the IFD

• 2. Measure the influence of GAVI and the Vaccine
  Fund on immunization programmes and their
  sustainability
• What are the trends in Vaccine Fund financing for
  immunization?
• -Tracking the trends in financial sustainability
  
• -Is GAVI leveraging more funds for immunization?

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Objectives of the IFD

• 3. To serve as a tool to help strengthen
  strategic planning for immunization services and
  to mobilize resources for improvement and
  expansion
• 4 To serve as a reference tool to answer policy
  relevant questions
• How far is current spending falling short of a
  defined ideal in countries?
• Is there a relationship between financing
  patterns and immunization programme performance
  and efficiency?
• ???

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Existing Data

• Primary data
• Availability
• in-depth costing
• financing case studies
• country-specific financing assessments
• Data quality
• High and comprehensive
• Frequently not comparable due to variation in
  study objectives and methodologies

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Existing Data

• Secondary data
• Availability
• Partner databases (USAID, World Bank, WHO,
  UNICEF, OECD)
• Data quality
• Inconsistent and difficult to assess
• Many estimates known to
• best guesses
• estimated using institution-specific
  methodologies
• frequent double counting

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Existing Data

• Country data
• Availability
• provided directly by countries
• joint WHO-UNICEF reporting form,
• PAHO reporting form
• GAVI vaccine fund application
• Quality
• inconsistent and difficult to assess
• comprehensiveness varies greatly

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Main Issues Challenges

• Challenge will be to assure that an accurate,
  consistent, and comparable series of data is
• Collected in the future
• Derived from the existing data

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Future Data

• Main source of future data will be
• WHO-UNICEF joint reporting form
• PAHO reporting form
• GAVI financial sustainability plans

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Development Team

• Wide range of in-depth knowledge and experiences
  is invaluable
• Need representatives from a broad range of
  backgrounds and institutions that will use and
  feed the IFD
• Participation from regions and countries is
  crucial
• Current membership
• -Abt Associates CVP USAID
• -PAHO
• -UNICEF
• -WHO
• -World Bank

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Final Products

• A publicly available database on immunization
  expenditures and financing estimates
• Publicly available documentation describing the
  data sources, data quality and database
  methodologies
• Publicly available reports on key findings
• All IFD documents are available on
  www.gaviftf.org
• The estimates prepared by the database
  development team
• will become GAVI partner standards

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Priority Activities (Short-Term)

• (1) Methodological guidelines and tools as an
  Annex to the Financial Sustainability Plans and
  PAHO reporting form (April).
• (2) Baseline estimates on immunization
  expenditures and financing for limited number of
  countries (June).
• (3) Analyses of comparability of primary data,
  including methods and potential for generalizing
  results (September).
• (4) Progress report on any on-going special
  studies

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Sample Analyses

• Meeting the objectives of the IFD can yield
  useful information
• Will present sample analysis
• -Monitoring Expenditure and financial flows
• -Monitoring Indicators and Financial
  Sustainability
• Caveats!
• For illustrative purposes ONLY
• NOT representative based on available data
• NOT for quotation

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For Illustration only. Do not quote
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For Illustration only. Do not quote
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Average Vaccine Expenditure Estimated Fund
Allocation of Vaccines
For Illustration only. Do not quote
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For Illustration only. Do not quote
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Objectives of the Development Team

• Objective 1
• Provide technical guidance for the collection of
  prospective data
• Objective 2
• Establish methods, standard definitions, and
  standard protocols, to ensure comparability of
  the results of the analyses of existing
  retrospective data
• Objective 3
• Review and finalize expenditure and financing
  information
• Review and endorse existing methods, relevant
  tools and guidelines
• Identify data needs and commission studies