The GAVI Alliance

131 Pages·2014·4.59 MB·English

GLOBAL
PROGRAM
REVIEW
The GAVI Alliance
Global Program Review

The World Bank’s Partnership with the GAVI
Alliance
Main Report and Annexes
Contents
ABBREVIATIONS .................................................................................................................................. V
ACKNOWLEDGMENTS ........................................................................................................................ XI
PROGRAM AT A GLANCE: THE GAVI ALLIANCE ............................................................................ XII
KEY BANK STAFF RESPONSIBLE DURING PERIOD UNDER REVIEW ........................................ XIV
GLOSSARY ......................................................................................................................................... XV
OVERVIEW ........................................................................................................................................ XVII
GAVI ALLIANCE MANAGEMENT RESPONSE .............................................................................. XXV
WORLD BANK GROUP MANAGEMENT RESPONSE ................................................................... XXIX
CHAIRPERSON’S SUMMARY ......................................................................................................... XXXI
1. THE WORLD BANK-GAVI PARTNERSHIP AND THE PURPOSE OF THE REVIEW ...................... 1
Evolution of GAVI ...................................................................................................................................................... 1
Funding and Results ................................................................................................................................................. 2
Purpose of the Review .............................................................................................................................................. 5
Data, Methodology, and Timeframe .......................................................................................................................... 7
2. THE WORLD BANK AS A FINANCIAL PARTNER TO GAVI ........................................................... 9
Setting up an International Finance Facility for Immunisation ................................................................................... 9
Origin and Establishment of IFFIm ........................................................................................................................................ 9
Financing IFFIm ................................................................................................................................................................... 11
IFFIm’s Governance and Management ............................................................................................................................... 13
The World Bank’s Role and Responsibilities as Treasury Manager of IFFIm ..................................................................... 13
External Evaluation of IFFIm ............................................................................................................................................... 15
Advanced Market Commitment to Spur Vaccine Development .............................................................................. 16
Origin and Establishment of the AMC ................................................................................................................................. 16
AMC Funding and Operations ............................................................................................................................................. 18
The World Bank’s Role in AMC’s Financial Platform .......................................................................................................... 19
Conclusions and Lessons on the Bank’s Contributions to Innovative Finance on Behalf of GAVI ......................... 20
3. THE WORLD BANK AS DEVELOPMENT PARTNER TO GAVI ..................................................... 21
Opportunities for Stronger Development Effectiveness in Immunization ................................................................ 21
Opportunities to Help Ensure Adequate and Sustainable Funding for Immunization ............................................. 22
Opportunities to Address Inequities in Immunization Access ................................................................................. 24
Opportunities to Coordinate Support to Health and Immunization via Global Health Partnerships ........................ 26
The Bank’s Limited Engagement in Immunization .................................................................................................. 27
Limited Bank-GAVI Country-level Engagements................................................................................................................. 30
Direct Bank-GAVI Trust Fund Collaboration Has Ceased ................................................................................................... 32
Country Visits Also Find Opportunities for Stronger Bank Engagement in Immunization ................................................... 35
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CONTENTS

4. THE BANK AS A GOVERNANCE PARTNER .................................................................................. 37
Pre-governance Reform Period .............................................................................................................................. 37
Post-governance Reform Period ............................................................................................................................. 39
GAVI’s Evolving Strategy and Relationship with the Bank ...................................................................................... 41
Lessons for Future Engagement with GAVI and other Partnership Programs ........................................................ 44
5. CONCLUSIONS AND LESSONS ..................................................................................................... 47
Lessons for the Bank’s relationship with GAVI and other partnership programs. ................................................... 49
REFERENCES ...................................................................................................................................... 95
ENDNOTES ........................................................................................................................................... 99

Boxes
Box 1. The International Health Partnership ..........................................................................................27
Box 2. Major Findings from Survey of World Bank TTLs .......................................................................34
Box 3. The World Bank’s Participation in GAVI Board Committees .......................................................41
Box 4. GAVI’s Phases and Strategies ...................................................................................................42

Tables
Table 1. Contribution Receipts from AMC Donors, as of March 31, 2013 .............................................19
Table 2. Immunization-related Projects by Sector Board .......................................................................28
Table 3. Polio Projects, US$ million .......................................................................................................30
Table 4. References to GAVI in Country Assistance Strategies and Project Appraisal Documents,
Fiscal Years 2001–11. ...........................................................................................................................30
Table 5. References to the Global Fund in Country Assistance Strategies and Project Appraisal
Documents, Fiscal Years 2003–10 ........................................................................................................31
Table 6. DGF Contributions to GAVI, 2001–07 (US$ millions)...............................................................32
Table 7. Cross-Cutting Issues from Country Visits ................................................................................35
Table 8. GAVI Board and GAVI Fund Board Compositions Before the Reform, 2005 ...........................38

Figures
Figure 1. Contributions and Pledges to GAVI (2000 - Present) .............................................................. 2
Figure 2. GAVI’s Commitments to Countries (from inception until August 31, 2013) .............................. 3
Figure 3. . IFFIm Process ......................................................................................................................11
Figure 4. . IFFIm Donor Commitments and Funds Raised, 2006-2030 .................................................12
Figure 5. . Cash Received by GAVI by Source (1999-2009) .................................................................12
Figure 6. . AMC Process ........................................................................................................................17
Figure 7. AMC Funding Structure (Illustrative Example) ........................................................................18
Figure 8. Immunization Operations by Sector Board and as Share of Total Projects, 2003-12 .............29

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CONTENTS

Figure 9. Regional Distribution of Immunization-related Operations ..................................................... 29
Figure 10. World Bank Immunization Operations by GAVI Eligibility ..................................................... 29
Figure 11. Type of Activities Funded by ImGAVI Trust Fund ................................................................ 33
Figure 12. GAVI Alliance Board Composition, 2013 .............................................................................. 39
Figure 13. HNP Department Expenditures for GAVI and Immunization-related Projects, 2002-2013 ... 45

Appendixes
APPENDIX A. GAVI: PURPOSE, CONTRIBUTIONS, AND ACTIVITIES ............................................ 51
APPENDIX B. REPLICABILITY OF INNOVATIVE FINANCIAL MECHANISMS ................................. 63
APPENDIX C. TIMELINE OF GAVI ALLIANCE AND RELATED EVENTS IN THE WORLD BANK
AND ELSEWHERE ............................................................................................................................... 65
APPENDIX D. MEMBERS OF THE GAVI ALLIANCE BOARD ........................................................... 71
APPENDIX E. FINDINGS FROM THE COUNTRY VISITS ................................................................... 73
APPENDIX F. RESULTS OF THE ELECTRONIC SURVEY OF WORLD BANK TASK TEAM
LEADERS ............................................................................................................................................. 79
APPENDIX G. WORLD BANK IMMUNIZATION-RELATED OPERATIONS ....................................... 88
APPENDIX H. LIST OF PERSONS CONSULTED ............................................................................... 91
Evaluation Managers
 Caroline Heider Director-General, Evaluation
 Nick York Director, IEGCC
 Geeta Batra Manager
 Christopher Gerrard Task Manager (for Approach Paper)
 Rasmus Heltberg Task Manager (final Report)

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Abbreviations
AAA Accra Agenda for Action
AEFI Adverse Effects from Immunization
AFR Africa Region
AIDS Acquired Immune Deficiency Syndrome
AMC Advanced Market Commitment
AusAID Australian Agency for International Development
BCG Bacille Calmette-Guérin
CEO Chief Executive Officer
CEPA Cambridge Economic Policy Associates
CSO Civil Society Organization
DAC Development Assistance Committee (of the OECD)
DFID United Kingdom Department for International Development
DGF Development Grant Facility
DTP Diphtheria, Tetanus, and Pertussis
EAP East Asia and Pacific Region
EPI Expanded Program on Immunization
FFA Financial Framework Agreement
FIF Financial Intermediary Fund (World Bank)
G8 Group of Eight Highly-industrialized Nations
GAVI Global Alliance for Vaccines and Immunisation
GDP Gross Domestic Product
GEF Global Environment Facility
GFA GAVI Fund Affiliate
GHAP Global HIV/AIDS Program
GNI Gross National Income
GPEI Global Polio Eradication Initiative
GTZ Deutsche Gesellschaft für Technische Zusammenarbeit
HDN Human Development Network
HepB Hepatitis B
Hib Haemophilus Influenza Type B
HIV Human Immunodeficiency Virus
HLSP Health and Life Sciences Partnership (Consultants)
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ABBREVIATIONS
HNP Health, Nutrition, and Population
HPV Human Papillomavirus
HSCC Health Sector Coordination Committee
HSFP Health Systems Funding Platform
HSS Health Systems Strengthening
IBRD International Bank for Reconstruction and Development
ICC Interagency Coordination Committee (country-level)
IDA International Development Association
IEG Independent Evaluation Group
IFF International Finance Facility
IFFIm International Finance Facility for Immunisation
IHP+ International Health Partnership
ImGAVI Immunization and GAVI (Trust Fund)
INS Injection Safety Support
IPV Inactivated Polio Vaccine
IRC Independent Review Committee (GAVI)
ISS Immunization Services Support
JANS Joint Assessment of National Health Strategies
JFA Joint Financing Agreement
JICA Japan International Cooperation Agency
KFW Kreditanstalt fuer Wiederaufbau, (German Development Bank)
LCR Latin America and Caribbean Region
MAP Multi-Country AIDS Program
M&E Monitoring and Evaluation
MCH Maternal and child health
MDBs Multilateral Development Banks
MDGs Millennium Development Goals
Men A Meningococcal A Vaccine
MNA Middle East and North Africa Region
MNT Maternal and Neonatal Tetanus
MOH Ministry of Health
MOHP Ministry of Health and Population
NDHS National Demographic and Health Survey
NIP National Immunization Program
NVS New and Underused Vaccine Support
OECD Organization for Economic Cooperation and Development
OIC Organization of the Islamic Conference

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ABBREVIATIONS

OPV Oral Polio Vaccine
PBS Promoting Basic Services
POL Polio
PREM Poverty Reduction and Economic Management
SAR South Asia Region
SDC Swiss Agency for Development and Cooperation
SP Social Protection
SWAp Sector-wide Approach
TB Tuberculosis
TMA Treasury Manager Agreement
TTL Task Team Leader
UK United Kingdom
UNAIDS Joint United Nations Programme on HIV/AIDS
UNDP United Nations Development Programme
UNFPA United Nations Population Fund
UNICEF United Nations Children’s Fund
US United States of America
USAID U.S. Agency for International Development
WHO World Health Organization

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Fiscal Year of the GAVI Alliance
January 1 to December 31

GAVI Alliance Phases
GAVI Phase Period Governance Phase
Phase I 2000-2006 Pre-governance reform
(2000-October 2008)
Phase II 2007-2010
Post-governance reform
Phase III 2011-2015 (October 2008-present)

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Acknowledgments
This review has been prepared by a team led by Bernhard Liese under the
supervision of first Chris Gerrard and later Rasmus Heltberg following the outline
and methodology in the Approach Paper that was issued in October 2012. Other
members of the core team were Calvin Siow, Moritz Piatti, and Anahit Aghumian.
Further support was provided by Yasmin Angeles. Nick York, Director, Country,
Corporate, and Global Evaluations provided overall guidance. Bernhard Liese,
Calvin Siow, and Rasmus Heltberg were the principal authors.
The Independent Evaluation Group (IEG) gratefully acknowledges all who made
their time available for interviews and provided useful information and insights for
this review. IEG especially wishes to acknowledge the cooperation of the Bank
Group’s Health, Nutrition, and Population Sector and the GAVI Alliance Secretariat
in providing all requested information and documents. IEG is also grateful to Bank
staff in country offices who facilitated the country visits.
Peer reviewers for this report were Mark Rosenberg, the Task Force for Global
Health; Enis Baris, Sector Manager for Health, Nutrition, and Population in the
Middle East and North Africa Region of the World Bank; and the late Ciro de
Quadras, the Sabin Vaccine Institute.
The Norwegian Agency for Development Cooperation contributed financial support
to this review.

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