DFID –  GAVI – Summary Assessment 2013
Excerpt
Summary assessment: Continues to deliver results with activity across all reform priorities. Impact of increased focus on market shaping being felt. Key changes have begun to support health system strengthening.

Baseline
The GAVI Alliance is a public-private partnership committed to saving children’s lives and protecting people’s health by increasing access to immunisation in developing countries. The MAR highlighted several strengths:
:: GAVI has made a significant contribution to MDG 4 by increasing finance for vaccinations, including from innovative sources, and has improved coverage of new and underused vaccines.
:: It has a strong partnership with governments, civil society and the private sector.
:: It provides highly cost-effective health interventions with vaccines selected on strict criteria for health impact and cost effectiveness with appropriate administration costs.
:: It has effective financial oversight, with a proactive Audit and Finance Committee, an internal auditor and a robust Transparency and Accountability Policy.

The MAR also highlighted several weaknesses:
:: The need for more focus on market shaping to reduce prices and secure sustainable supply.
:: It has relatively poor performance of cash based programmes, particularly Health Systems Strengthening (HSS) support.
:: The need for a more systematic evidence based approach to working in fragile contexts.
:: There is lack of clarity in roles and responsibilities of key partners, such as WHO and UNICEF, and on the inclusion of civil society.

DFID’s reform priorities for the MAR Update were:
:: Better approach to working in fragile settings through the development of a policy and systematic evidence of performance in fragile contexts – assessed under attention to cross-cutting issues (fragile states).
:: Greater focus on outcomes and performance, specifically in relation to the delivery of its cash based programmes (HSS) – assessed under strategic and performance management and financial resource management.
:: Stronger performance on influencing markets and more strategic approach to procurement for sustainable and affordable vaccine supply – assessed under cost and value consciousness.
:: Further alignment and clarity in roles and responsibilities of partners, including civil society – assessed under partnership behaviour.

Summary of Overall Progress
GAVI continues to be a high performing institution providing a very cost-effective health intervention. From the 2011 MAR high baseline, evidence collected for the 2013 MAR Update demonstrates GAVI’s on-going commitment to improvement across the DFID reform priorities and in all at least some evidence of commitment being translated into implementation exists. However work streams are at different stages and for some, e.g. HSS support, it is too early to judge country level impact.

Full DFID Documentation – Multilateral Aid Review: Global Alliance for Vaccines and Immunisation (GAVI) at: https://www.gov.uk/government/publications/multilateral-aid-review-global-alliance-for-vaccines-and-immunisation-gavi