An Immunization Financing Toolkit

World Bank and the GAVI Alliance

Robert Oelrichs, Senior Health SpecialistMay 4th 2011

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

• GAVI Alliance and World Bank– HNP team– GAVI Trust Fund

• Sustained predictable financing– International, regional, domestic tools– Private and public finance

• Toolkit for government– Accessible, updated, web-based– Range of options presented

Source: www.worldbank.org

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

Strategy and Planning – Briefs 1 &2• The Importance of Immunization Financing

– Higher costs of vaccines– Higher marginal costs at higher coverage levels– Changes in international donor financing for health

• Immunization Resource Needs, Planning, and Budgeting – Comprehensive multi-year plan with– Cost and financing plan within– Multi-year health budget within– Available Fiscal space

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

Country Level Mechanisms– Briefs 3 to 7• Tax-Based Financing

– Largest source of program financing in most countries– Appropriate for highly cost effective public good– Underfunded relative to needs in many LMIC– Decentralization may threaten service delivery

• Risk pooling• User Fees

– Associated with lower utilization of services– Can add to financial burden of poor households– Waiver programs can be inefficient– May have the potential to improve service access & quality– May formalize existing informal fee systems

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

Country Level Mechanisms– Briefs 3 to 7• National Trust Funds

– Predictable and potentially highly sustainable– Long term protection of resources – potentially tax free– Useful when sudden availability of new resources

• Other Country level Innovative Financing Mechanisms– Oil revenues (Mexico)– Lotteries (Costa Rica)– Luxury and Sin taxes (Tajikistan, Vietnam, Haiti)

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

International Assistance– Briefs 8 to 11• Development Project Assistance• Developmental Loans for Immunization• Budget Support• Debt Relief

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

Vaccine Market Mechanisms– Briefs 12 to 15• Pooled procurement• UNICEF Vaccine Independence Initiative• Tiered Market Pricing• Vaccine Production and the Market

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

Innovative Financing Mechanisms– Briefs 16 to 19• The International Facility for Immunization• Advance Market Commitments• Airline Ticket Tax• Results-based Financing

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy Makers and Program Managers

Comparison of Immunization Financing Options