An Immunization Financing Toolkit World Bank and the GAVI Alliance Robert Oelrichs, Senior Health Specialist May 4 th 2011

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers 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:

IMMUNIZATION FINANCING TOOLKIT A Resource for Policy­Makers 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 Policy­Makers 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 Policy­Makers 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 Policy­Makers 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 Policy­Makers 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 Policy­Makers 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 Policy­Makers and Program Managers Comparison of Immunization Financing Options