GAVI Alliance Mid-Term Review – October 2013

The GAVI Alliance released it Mid-Term Review report, described as “a comprehensive and transparent assessment…aimed at examining the progress GAVI has made midway through its current strategic period from 2011 to 2015, and the challenges it faces in meeting its commitments to developing countries and to donors.” GAVI noted that the report is being published two weeks before GAVI partners – including the World Health Organization, UNICEF, the World Bank, the Bill & Melinda Gates Foundation, implementing and donor countries, civil society organisations and vaccine manufacturers – meet in Stockholm for the Alliance’s Mid-Term Review. GAVI said the report highlights that:

:: Since 2011, GAVI has funded a total of 67 new vaccine introductions and campaigns. By 2014 all 73 GAVI-supported countries will have introduced 5-in-1 pentavalent vaccines, including introductions in Haiti, Myanmar, Somalia and South Sudan.

:: Following a slow start, GAVI’s recently revamped health system strengthening programme now ensures that investments are translated more clearly into improved immunisation outcomes. As a result, GAVI is seeing investments and improvements in health system rapidly picking up speed.

:: GAVI is close to achieving its target of timely receipt of 100% of co-financing payments (contributions made by developing countries towards the cost of the vaccines). As of August, 64 of the 67 co-financing countries had fulfilled their commitments for 2012. And from 2011 to 2013 these payments totalled US$ 125 million, representing 8% of GAVI’s total support to these countries. All this is also helping to drive increases in country investment in their own health systems.

:: GAVI has also helped to produce more predictability and competition in the vaccine market, which has helped to bring down the cost of fully vaccinating a child with three priority vaccines – pentavalent, pneumococcal and rotavirus – from US$ 35 in 2010 to US$ 23 in 2012.

GAVI said the report “also highlights the challenges that the Alliance is attempting to address” including “improving the reliability of supply chains and finding ways to improve in-country data collection; adopting tailored approaches to meet the unique and challenging needs of fragile states; and ensuring the sustainability of immunisation programmes in countries whose wealth has increased to the point that they are no longer eligible for GAVI support.”


GAVI’s Mid-Term Review report
October 2013
[Editor’s formatting and extracted detail]

:: Introduction – Foreword by Dagfinn Høybråten, Chair of the GAVI Alliance Board

:: Bigger picture – Overview of the health & immunisation landscape & GAVI’s impact since 2000

:: Results- Delivering on the GAVI mission & strategic goals 2011-2015

:: Challenges – New approaches and measures in response to the changing global context

:: Looking ahead – GAVI’s role until 2015 and beyond

:: Key performance indicators
    Updates on the mission & goal-level indicators that monitor GAVI’s progress

GAVI uses 14 key performance indicators to monitor its five-year strategy. Click on each indicator below for a mid-term assessment of the Alliance’s progress against its 2015 targets. 

Mission: To save children’s lives and protect people’s health by increasing access to immunisation in poor countriesGAVI is currently on track to meet 2015 targets for its mission indicators. Key issues affecting progress include the strength of country systems and GAVI’s ability to mobilise timely, effective support in response to country demand. Other key issues to watch include uncertainties in global estimates of disease burden and immunisation coverage, and changes in estimates over time.

Under-five mortality rate

Number of future deaths averted Number of additional children fully immunised
Accelerate vaccines: Accelerate the uptake & use of underused & new vaccines by strengthening country decision-making & introduction
Progress against GAVI’s vaccine goal targets has been mixed. GAVI is likely to meet some but not all of the targets. Key issues affecting progress against the 2015 targets include supply constraints and countries’ preparedness to introduce new vaccines.
Country introductions of vaccines
Coverage of new and underused vaccines
Strengthen capacity: Contribute to strengthening the capacity of integrated health systems to deliver immunisation
The Alliance is not likely to achieve the 2015 targets for its health systems goal. All partners are working together to accelerate progress on the four indicators. Examples of intensified efforts include a new performance-based health system support model, initiatives to strengthen routine immunisation systems, country-tailored approaches, strengthened technical support and greater focus on data quality.
Drop-out rate
Coverage of three doses of diphtheria-tetanus-pertussis vaccine (DTP3)
Equity in immunisation
First dose of measles vaccine (MCV1) coverage
Increase predictability and sustainability: Increase the predictability of global financing and improve the sustainability of national financing for immunisation
GAVI is on track to meet some but not all of its targets for this strategic goal. Key issues that affect progress include the push to encourage donors to sign multi-year agreements with GAVI and country mobilisation of domestic resources for vaccines.
Total resources mobilised to meet demand
Country investment in vaccines per child
Fulfilment of co-financing commitments
Shape the market: Shape vaccine markets to ensure adequate supply of appropriate, quality vaccines at low and sustainable prices for developing countries
The GAVI Alliance has made good progress in reducing the price of key vaccines, and securing sufficient supply. Key factors that will affect progress include having manufacturers fulfil their commitments for supplying vaccines, GAVI meeting its projected demand and new manufacturers entering the market.
Total cost to fully immunise a child with pentavalent, pneumococcal & rotavirus vaccines
Security of supply (number of products offered as % of 5-year target)

:: Timeline of vaccine introductions and campaigns, 2011–2013

:: View all the data graphics in this report

:: The role GAVI’s founding partners play in the Alliance

:: Donors to the GAVI Alliance

[See Lancet editorial in Journal Watch below]