Introducing new vaccines in the poorest countries: What did we learn from the GAVI experience with financial sustainability?

Health system cost of delivering routine vaccination in low- and lower-middle income countries: what is needed over the next decade?

“…2 During the period from 2000 to 2010, countries rapidly scaled up the use of pentavalent vaccine and, as a result, the total cost of country immunization programmes doubled or tripled. 5 Recurrent investments in vaccines suddenly comprised the bulk of immunization programme costs: an average of more than 50% of total investments, and in many cases, well over this average. 6 Part of the reason for this rise in the component of the total costs comprised by vaccines was that the incremental health system (i.e.…”

Combination vaccines in the South African setting

“…In light of all these controversies, bulk procurement by Governments, with or without external financial aid by organizations like Global Alliance for Vaccines and Immunization (GAVI) etc, may negate the issues surrounding cost of these vaccines [1]. South Africa is not included amongst the 75 countries receiving support from GAVI [1,26] as the annual per capita gross national income is more than $1 000 [27].…”

Matching Grants for New and Underutilized Vaccines in Resource-poor Settings: Determinants of Generation of New Money

“…In recent times, levels of donor funding for health have increased considerably [2], most notably in immunization programs of low-income countries, but effectiveness of the aid in terms of progression of recipients towards sustainable self-financing among beneficiary countries has not been achieved [3,4]. While many donors would like to see governments take over financial responsibility of immunization programs [5], ongoing introduction of expensive new vaccines has only increased concerns about sustained donor dependency among low-income countries [6,7].…”

“…Initially Gavi, a non-profit organization dedicated to increasing access to immunization in low-income countries, provided general or non-matching grants to national immunization programs [12], but due to lack of progress in sustainable self-financing among the recipient countries [3,13], a co-financing form of matching grant was introduced in 2008 with the aim of stimulating an increase in budgetary allocations from local revenue, and funding from other donors [14]. Under co-financing arrangements, grant recipients contribute to the total cost of new and underutilized vaccines from domestic revenue based on a mutually agreed upon formula [14].…”