1. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 1 Thinking Big: Going into Action for Child Survival Sustainable Financing for Health: Where does the risk lie? Julian Lob-Levyt Executive Secretary – GAVI Alliance

2. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 2 Sustainable Financing for Health A big push for health systems Predictable, secure financing through the International Finance Facility for Immunization (IFFIm) Innovation to advance new technology Global Health Partnerships post-2005: added value, harmonisation and alignment Where does the risk lie?

3. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 3 GAVI / Immunization Improved Health Outcomes Improved Economic Growth Improved Educational Outcomes (MDG 4 – Child Mortality)(MDG 1 – Poverty) (MDG 2 – Primary Schooling) Health, Economic Growth & The Millennium Development Goals Bloom, Canning & Weston; World Economics 2005 Commission for Macroeconomics & Health, 2001 Copenhagen Consensus, 2004 The Evidence Base

4. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 4 The Challenge: Current Health Spending US$ per person, per year Source: CGD Making Markets for Vaccines Presentation April 2005

5. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 5 Results: GAVI Support Received by Countries

6. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 6 Results: Increased Financing Immunization spending has more than doubled in GAVI countries Source: WHO/UNICEF, GIVS costing

7. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 7 Results: Reaching More Children Yellow fever Cumulative Number of Children Reached in GAVI- Supported Countries *projected Source: WHO/UNICEF ~14 m ~90 m ~14 m

8. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 8 Democratic Republic of Congo Results: DR Congo will receive over US$ 6 million in ISS reward for reaching additional children Despite a history of conflict, coverage is increasing Percent Coverage of Third Dose of DTP (2001 – 2004) Source: Joint Reporting Form

9. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 9 Gates Foundation Annual income $0 $50 $100 $150 $200 $250 $300 $350 200020012002200320042005 Government donors $4 $93 $112 $105 $169 $303 projected Millions US$ Traditional income through GAVI

10. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 10 The International Finance Facility for Immunization (IFFIm) How to leverage additional funding for health: Donors make long term binding commitments (20 years) IFFIm uses pledges to raise funds through bonds Anticipated to be funded at $4 billion over 10 years, increases near term resources Commitments by UK, France, Italy, Spain, Sweden and Norway

11. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 11 Allocation of IFFIm funds : Focus on the poorest (less than $1000 GDP per capita) 72 countries where disease burden is greatest Two windows of support: 1) Providing new and underused vaccines Providing support to combination vaccines (DTP + Hep B), (DTP+Hep B + Hib) Accelerating introduction of new vaccines – rotavirus and pneumococcus, and HPV 2) Building capacity in developing country health systems for the delivery of immunization services and maternal and child health

12. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 12 Funding Immunization: Predictable Financing Impact of Predictability of Price: Assumed Price Trajectory for Pentavalent Vaccine Source: CGD Working Paper “The costs and benefits of front-loading and predictability of immunization”

13. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 13 Linking Vaccine Initiatives

14. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 14 Global Health Partnerships: Demonstrating added value? High Level Forum outcomes GHPs only make sense: – Within broader strategy of scaling up health systems – With long term, predictable funding for countries – If focus is in line with country-driven priorities and budgetary processes – If priorities are based on clear evidence – If we are prepared to take risks

15. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 15 Global Health Partnerships: Harmonisation and Alignment Integrating at the country and district levels Demonstrating results and learning Challenge and Innovation Broadening partnerships: civil society Country-driven approaches

16. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 16 Where does the risk lie? A big push for health involves risk The risk of not thinking big Risk for donors Risk of not prioritising social sectors Hiding behind harmonisation?

17. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 17 In conclusion Unite around clear focus and simple priorities – 10.5 million deaths, most preventable and treatable – its not rocket science, but needs bucket loads of dollars. The MDG can be met. But do donors get it? You – we, cannot solve all the worlds problems Locate that focus within broader upstream agendas Integrate that focus at the country level Take risks, be opportunistic, be innovative Quick wins and digestible measurable results will mobilise resources. Aid works.

18. Countdown to 2015: Tracking Progress in Child Survival. London, 13-14 December 2005 18 Thinking Big: Going into Action for Maternal & Child Survival