FINANCIAL SUSTAINABILITY PLANNING AND IMPLEMENTATION Progress and Challenges

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FINANCIAL SUSTAINABILITY PLANNING AND
IMPLEMENTATION Progress and Challenges
Lidija Kamara, Immunization, Vaccines and
Biologicals, WHO, Geneva
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Presentation Outline

• Progress since 2002
• Support to Countries
• FS Implementation Progress and Challenges
• Discussion Points
• Recommendations

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AFRO FSP Development

• 2002 - 8 / 12 Countries
• 2003 - 12 / 22 Countries
• 2004 - 14 / 30 Countries
• ( Angola,Nigeria, Ethiopia,DR Congo ...)
• 2005 - 3 / 4 Countries

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AFRO - FSP Development Support to Countries 2003

• Geneva (Consultants training)
• Kampala ( 6 Countries)
• Douala (5 Countries)
• SRWG Coordination and support
• Technical Assistance

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Country FSP Implementation Update

• Request for extending current GAVI / VF support
  over a 10 year period
• ( Rwanda, Ghana )
• Increasing national resource contributions (
  Kenya 10 of pentavalent costs with annual
  increases)
• Zambia increased contributions for routine
  vaccine procurement through VII
• Vaccine Management
• Phasing in Vaccine Procurement

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National FSP Implementation Challenges

• Human Resources
• Existing capacities in MoH/ MoF, EPI Programme
• Resource Mobilization
• Limited financial resources from national sources
• Allocations often short of expectations
• Poor macroeconomic outlook
• Financial Management - timely / adequate
  disbursements
• Advocacy -ministerial/partner levels

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National FSP Implementation Challenges Cont...

• Programme Management
• Prioritizing Objectives / Strategies
• Vaccine presentations Vs available supply
• Implementing Strategies
• Improving Programme Efficiency
• Training on Programmatic Aspects
• Advocacy
• Vaccine Procurement / Financing

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National FSP Implementation Challenges Cont...

• Partner support
• ICCs, RWGs, Partners
• Lack of multi-year commitments
• Differing financial years ( effect on
  disbursements)
• Changing partner priorities
• Integration into broader health system

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FS Discussion Points

• Strengthening SRWG Coordination and Support
• Working with national ICCs to ensure overlap /
• linkages with other coordinating mechanisms
  and broader health system
• Opportunities to further strengthen FSP with back
  up of regional institutions ( ARIVA, ADB, etc )
• Integrating FSP into programme planning
  (Routine, New Vaccines, Measles, SIAs, etc)
• Relevance of FS to RED Approach
• Implementation support / Country experiences

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TFI Recommendations on Financial Sustainability
Planning

• 1.All countries to create budget line items for
  vaccines
• 2.Financial sustainability training workshops to
  be held in the first quarter of 2004
• 3.Special financial sustainability workshop to be
  organized in 2004 for big 4s
• 4.GAVI / Vaccine Fund to consider extending both
  the period of support and funding support
  currently being provided to countries