The Costs and Benefits of Front-Loading and Predictability of Immunization

Abstract

How can the international community save more children's lives faster and more effectively in the 21 st century? This Working Paper analyzes the extent to which "frontloading" and predictable vaccine funding, as proposed by the International Finance Facility for Immunization (IFFIm), is more effective in impacting vaccine coverage than spending vaccine funds equally throughout the lives of projects. The IFFIm is an initiative of the Global Alliance for Vaccines and Immunization (GAVI), and supported by the governments of the United Kingdom, France, Sweden, Italy, Spain and Norway. An initial IFFIm investment of $4 billion is expected to prevent 5 million child deaths by 2015, and more than 5 million future adult deaths. Using a stylized model, the authors quantify the positive and negative effects of predictable vaccine funds and frontloading, and finds IFFIm's approach can increase the impact of vaccine coverage by 22%. This is because stable and long-term financing allows vaccine manufacturers and countries to plan for long periods of time, knowing that resources will be available. Front-loading helps to reduce the spread of disease and to immunize large groups of people faster.The Center for Global Development is an independent think tank that works to reduce global poverty and inequality through rigorous research and active engagement with the policy community. This Working Paper was made possible in part by funding from the William and Flora Hewlett Foundation.Use and dissemination of this Working Paper is encouraged, however reproduced copies may not be used for commercial purposes. Further usage is permitted under the terms of the Creative Commons License. The views expressed in this paper are those of the author and should not be attributed to the directors or funders of the Center for Global Development.

Multi‐Treatment Inventory Allocation in Humanitarian Health Settings under Funding Constraints

“…In their paper, the authors numerically analyze the impact of front‐loading and reducing funding uncertainty in the context of immunization programs. The front‐loading scenario in Barder and Yeh (2006) is similar to the moderate front‐loading case that we consider in our paper and according to their estimates, front‐loading the funding results in a 10% reduction in the number of DALYs lost. This is somewhat lower than our estimate of the benefits of moderate front‐loading (especially for longer planning horizons) but we believe that there are two key factors that could explain, at least partially, the gap in the estimates.…”

“…This is somewhat lower than our estimate of the benefits of moderate front‐loading (especially for longer planning horizons) but we believe that there are two key factors that could explain, at least partially, the gap in the estimates. First is the cost of front‐loading—Barder and Yeh (2006) assume a 3.5% cost of capital while we do not factor in the cost of front loading in our estimates. Second, in our setting, health state deteriorates in the absence of treatment, elevating the importance of funding timing even more relative to situations where there is no health state deterioration, as is the case with immunization.…”

“…Before ending our discussion in this section, we briefly comment on the magnitude of impact of funding timing by comparing our results with Barder and Yeh (2006). In their paper, the authors numerically analyze the impact of front-loading and reducing funding uncertainty in the context of immunization programs.…”

“…A study commissioned by the Brookings Institution (Lane and Glassman 2008) estimates that for every dollar received in aid funding by humanitarian health organizations, 7-28 cents of the potential aid value is lost due to funding delays. On a related note, Barder and Yeh (2006) report that improving the predictability of funding could lead to a 11% gain in performance in certain immunization programs. Natarajan and Swaminathan (2014) analyze the impact of funding timing and funding uncertainty in humanitarian operations in the context of managing inventory of a nutritional product.…”

Perspectives on advancing preventative medicine through vaccinology at the comparative veterinary, human and conservation medicine interface: Not missing the opportunities

“…Interventions are generally considered extremely costeffective if the cost per year of life is less than $100. By comparison, antiretroviral treatment for HIV/AIDS-an intervention that donors widely support in the developing world costs up to five times as much at $350 to $500 per life-year saved; by way of comparison, in the US and the UK medical interventions are considered cost effective at $50,000 to $100,000 per life-year saved [1,[3][4][5].…”