Ground-breaking co-financing policy lays foundations for the long-term sustainability of national financing for vaccines
In the nineties, as child immunisation was overtaken by other donor priorities, immunisation rates in poor countries stagnated.
Gavi has pioneered a co-financing model which requires that recipient countries contribute towards the cost of the vaccines they receive to ensure immunisation programmes are sustained after Gavi's financial support ends.
Co-financing levels are determined by each country's expected ability to pay, with countries divided into low-income, intermediate and graduating groups. As countries approach graduation, co-payments will gradually increase to cover the full cost of vaccines.
Revision of co-financing policy
A 2010 review of Gavi's successful co-financing efforts, in close consultation with ministries of health and finance in implementing countries, led to to a revision of its policy.
Gavi's new strategy requires economically stronger countries to co-finance a higher share of vaccine costs, easing their transition to graduation from Gavi support and preparing them for taking on the full cost of vaccines.
Financial sustainability plans
Gavi introduced the concept of co-financing in 2006, asking countries to develop financial sustainability plans as part of their applications for Gavi funding support to describe how responsibility of vaccine financing would transition to government and other donor financing sources.
All applications have to be signed by both Ministries of Health and Finance. By requiring the inclusion of the latter ministry in decisions to adopt new vaccines, Gavi guarantees a domestic counterpart to the Ministry of Health, empowered to demand evidence of the value of proposals to broaden immunisation programmes.
Gavi also demands that countries applying for funding support develop comprehensive multi-year plans (cMYPs), which integrate vaccine financing into the wider national budget and national health plan. This ensures Gavi-supported programmes are reflected in the national budget - an accepted principle of the Paris Declaration on Aid Effectiveness.