1. Innovative Financing Mechanisms: Best Practice to Bridge Funding Gaps for Health Dr. Rupa Rai Maitra November 2014

2. © 2014 Development Finance International, Inc. TM All rights reserved. Financial stretch to meet health MDGs in 2015 Every year nearly 22.6 million infants don’t receive basic vaccines. Most of them in Africa 2 New sources of funding − traditional & innovative − are needed to guard hard-won gains and support the introduction of breakthrough vaccines With rapidly changing burden of disease, vaccines compete for limited resources with other priorities © 2014 Development Finance International, Inc. All rights reserved.

3. © 2014 Development Finance International, Inc. TM All rights reserved. 3 Innovative Financing Mechanism (IFM) is defined as non-traditional applications of ODA, joint public-private mechanisms, and flows that either support fundraising by tapping new resources or deliver financial solutions to development problems. WHO Taskforce Working Group 2, 2009.

4. © 2014 Development Finance International, Inc. TM All rights reserved. 8 1 Additional Procurement Mechanisms 2 Debt for Development Fundraising through PPPs T YPES OF I NNOVATIVE F INANCE M ECHANISMS 3 International Taxation Schemes 4 Frontloading Instruments 6 Risk Mitigation Instruments to Fund Outbreaks 7 Domestic Fundraising 4 5 Pull Mechanisms for R&D

5. © 2014 Development Finance International, Inc. TM All rights reserved. Approach: Earmark funds from National Lottery in support of National Immunization Program Objectives: Raise additional funding to improve immunization coverage across the country Success Factors: National Commission for Immunization has independence to partner and raise funds 5 Funds from national lottery D OMESTIC F INANCING : C OSTA R ICAN L OTTERY National Immunization Fund National Commission for Immunization and Epidemiology (NCIE) Funds from national insurance Funds from health budget Does not substitute traditional funding Offers little flexibility to use funds for other needs Mechanism demonstrates country’s ability to implement an IFM to raise additional funding as donors scale down Funds are earmarked – new vaccine MOH San Jose Social Protection Board Costa Rican Social Security

6. © 2014 Development Finance International, Inc. TM All rights reserved. Approach: Long-term donor resources are provided up front through the issuance of bonds Objectives: Provide stable donor commitment Success Factors: Vast high- level political commitment, GAVI leadership 6 GAVI F RONTLOADING I NSTRUMENTS – IFFI M Meets immediate funding needs. Stable funding for immunization Inspiration for other IFMs beyond vaccines Initial start-up costs, expertise Front-loading could reduce donor capacity to finance in the future Assumes that there will be less reliance on donor funding in the future Source: GAVI

7. © 2014 Development Finance International, Inc. TM All rights reserved. Holiday Bring value and additional resources Serve to complement ODA and government funding – not to substitute them More successful with multi-stakeholder alliances with shared vision, roles and responsibilities Must be built with transparent dialogue and actions Political will is a must! 7 W HAT D ID W E L EARN ?

8. © 2014 Development Finance International, Inc. TM All rights reserved. Move from dialogue to actions Build on new international platforms set to mobilize public and private funding Capitalize on resource generating domestically, but yet look beyond tax revenues Health Bonds Remittances Use “UHC momentum” to apply innovative approaches under national Health Insurance Schemes 8 W HERE D O W E G O N EXT ?

9. Global Headquarters 4630 Montgomery Ave. Suite 300 Bethesda, MD 20814 United States 1 301 986 1226 Asia Regional Office 11/F Net One Center Bonifacio Global City Taguig, Metro Manila 1634 Philippines 632 818 1156 India Office 9th Floor Spaze i-Tech Park Tower-A1, Sector-49 Sohna Road, Gurgaon-122018 India 91 124 676 8688 www.dfintl.com Africa Regional Office 6th Floor, Wing A Westend Towers Waiyaki Way, Nairobi Kenya 254 20 421 4206