This page provides background information on the various groups that have been supporting the development of the immunization financing website and database.
Financing Task Force
With the launch of the first phase of the Global Alliance for Vaccines and Immunization (GAVI) in 2000, a time-limited task force on immunization financing was created.
"The GAVI Task Force on Financing (FTF) is responsible for increasing the understanding of the reasons behind inadequate funding for vaccines and immunization in the poorest countries and to assessing strategies which will improve the capacity of governments, donors and development banks to finance the improvement and expansion of national immunization programs."
To help fulfil its role, the FTF recognized the importance of developing a comprehensive database on immunization financing. Such a database would yield new insights about donor and government financing patterns for immunization, and strategies for long-term financial sustainability. By providing baseline data on immunization expenditures and financial flows, it would contribute to the understanding of the influence of the GAVI Fund on immunization financial sustainability at national, regional and global levels. Moreover, the immunization financing database would support any GAVI Alliance policy making and address concerns such as assessing the relationship between funding patterns and programme performance and efficiency, the additionality of GAVI Fund support in countries, and assist in the provision of guidance to countries on how to most effectively use additional funds for immunization.
With the ending of the first phase of GAVI in late 2005, the FTF was discontinued. It is expected that during the second phase of GAVI Alliance support and starting in 2006, a new group will be formed to continue working on immunization financing and sustainability challenges. WHO's Immunization Vaccines and Biologicals department (IVB) will continue to be a key partner in this area.
In November 2001 and under the auspices of the GAVI Financing Task Force, a team of technical experts with representations from the World Bank, USAID’s Partnership for Health Reform (PHR+) and Immunization Basics, the Center for Global Development, WHO, the Bill & Melinda Gates Foundation, the Children’s Vaccine Programme at PATH (CVP), UNICEF and the PAHO was brought together to develop methodologies for the immunization financing database, review progress and provides ongoing technical oversight.
Summary of database team's work
While the initial work of the database development team consisted of collecting and analysing existing data from a wide variety of sources (ex: project reports, published articles, on immunization costing and financing), the key challenge of the work has been to address its quality and comparability of the information given the wide variety of data sources available.
- Costing and financing studies
- Immunization financing: a review of the literature [pdf 108kb]
- Economics of immunization: a guide to the literature [pdf 1.6Mb]
After thorough examination of the set of available data on immunization financing, the database team identified that there was a:
- Lack of consistency in the way the original data sources defined specific spending categories;
- Lack of consistency in the way the original data sources defined the boundaries of the immunization programme itself; some data sources included shared health systems costs, while others were more restrictive;
- Lack of consistency in the methodologies for estimating expenditures, when those methodologies are described;
- Lack of information about how expenditures were estimated;
- Inconsistent and incomplete information about the sources of funding for the immunization programme; and
- Missing data (countries, years, and expenditure categories)
After careful review of the retrospective data available, the database development team determined that there was no reasonable way to address the comparability issues for robust analyses of the data, nor to use modelling or other statistical methods to adjust for lack of comparability in the original sources.
In light of the clear data comparability and quality issues that the database development group identified and systematically analysed, the efforts were directed towards ensuring that all future data collection efforts related to financing and expenditures under GAVI auspices use a standard methodology and reporting systems. Beginning in 2002 the Financing Task Force placed its emphasis on ensuring that the database development team would help strengthen both national and regional capacities to report this information through the Financial Sustainability Planning process. Between 2002 and 2005, the FSP methodologies and tools developed, have been applied by GAVI Fund recipient countries that are required to develop Financial Sustainability Plans (FSP). The data generated through this process is entered into the database.
In late 2005, WHO and UNICEF, together with GAVI Alliance partners, developed Guidelines for Developing a Comprehensive Multi-Year Plan (cMYP) for immunization to support countries in improving their planning for immunization. The development of cMYP's aligned with national health sector planning cycles and process is among the new principles of the second phase of GAVI Alliance support beginning in 2006. The cMYP process marks current efforts to streamline immunization planning process at national level into a single comprehensive and costed plan. It is within this context that these new guidelines build on existing multi-year planning experience, while adding the critical elements of costing and financing by drawing heavily upon the methods developed for the immunization Financial Sustainability Plans (FSP). Since this new process builds on the FSP guidelines, costing tools and methodologies, the data generated through this cMYP process will form the basis of the future data for the immunization financing database.