GAVI second evaluation report

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The GAVI second evaluation report sets out the main findings of an independent assessment of the Alliance's achievements in Phase II (2007-2010)

In 2009, GAVI commissioned Cambridge Economic Policy Associates (CEPA) to conduct an independent evaluation of its performance in its second phase (2007-2010). The evaluation sought to answer two high-level questions:

  1. to what extent has the GAVI Alliance met its four Strategic Goals (SGs)?
  2. to what extent has GAVI added value at the global and country levels over and above what would have been accomplished without the Alliance?

Method

In thinking about what constitutes 'value added', the evaluation considers the following characteristics:

  • More (additional): actions that were being conducted before, but there are now more of them at a markedly increased level of activity;
  • Improved: actions that were being conducted previously but are now appreciably more effective, efficient, or strategic;
  • Unique: actions/ contributions that are exclusive or exceptional to GAVI;
  • Faster: actions that were being conducted previously but now at a more accelerated pace;
  • New or Innovative: actions that are entirely new or original to GAVI and initiated because of GAVI.

Findings

Financial value add: global

  • Despite a fair wind GAVI has attracted funding to immunisation that probably wouldn't have occurred in its absence…
  • . …and a big area of financial added value has been through International Finance Facility for Immunisation, where GAVI's role has been unique in immunisation.
  • International Finance Facility for Immunisation's key innovation is that it has dramatically improved the period of bilateral donor commitments to GAVI, supporting its ability to provide predictable support to country immunisation programmes.
  • GAVI's role in the ongoing implementation of the Advance Market Commitment pneumococcal pilot is also identified as a significant achievement.

Financial value add: national

  • GAVI's basic programmatic approaches and the development of tools to support countries' financial planning was a key source of innovation in Phase I.
  • Co-financing has supported country ownership, but it has contributed relatively little to financial sustainability and changes to the policy have been a cause of confusion at the country level.
  • GAVI's choice of vaccines and its basic funding model - despite its contributions to tools and country approaches - has had a negative impact on country financial sustainability.

Programmatic value add

  • There is strong evidence that GAVI's flagship program, new vaccine support, has accelerated countries' introduction of life saving vaccines and immunisation outcomes - which might not have happened in its absence.
  • However, GAVI has not contributed to a reduction in Yellow Fever and pentavalent vaccine prices - as originally anticipated - with serious implications for country affordability and sustainability
  • GAVI is unique in financing associated vaccine technologies through its injection safety program, which has clearly been successful and sustainable - although waste management remains an issue.
  • GAVI's focus on health system bottlenecks in countries through its Health System Strengthening window is deemed necessary for increasing coverage, but there are several issues in relation to the effectiveness of its delivery model, and the dilution of GAVI's focus and its comparative advantage.
  • GAVI's Immunisation Services Support program has also received 'mixed' feedback. Although generally regarded as being highly innovative, the impacts achieved and scope for sustainability are less conclusive.

Organisational value add

  • GAVI's approach of working through its Partners, particularly at country level, goes to the heart of its Alliance model and 'lean' structure.
  • Evidence suggests that GAVI's program application and monitoring processes and communication at country level need to improve further, although a significant positive characteristic of GAVI's approach is 'country ownership.'
  • GAVI's partnership of public and private immunisation stakeholders is on one hand a key driver of its innovation, but on the other, a contributing factor to the challenges of work planning, budgeting, and performance monitoring.
  • As GAVI has evolved, there have been changes to the structure of the Partnership (and Secretariat) and nature of its innovations - but the evaluators view is that these have not detracted significantly from its added value.
  • GAVI has increased the interest in and commitment to immunisation at global and country level - borne out, as a minimum, by increased levels of funding.

Final documents

After a review process by the Evaluation Advisory Committee, the GAVI second evaluation report was discussed by the GAVI Board at its November 2010 Board meeting in Kigali, Rwanda. The report sets out the main findings of an independent assessment of the Alliance's achievements against its four Strategic Goals (SGs) in Phase II (2006-2010).

The report is accompanied by four separate SG reports, which provide the detailed analysis and evaluation material for each of the SGs. In addition, there are a series of Supporting Papers (SPs), which contain analysis and evidence that is applicable across the four goals - for example, the five country reports.

The evaluation informed GAVI's new Phase III strategy and business plan (2011-15).

6 million

Approximately six million future deaths averted from hepatitis B, Haemophilus influenzae type B, measles, pertussis, pneumococcal disease, polio, rotavirus diarrhoea and yellow fever since GAVI's launch in 2000.

WHO Department of Immunisation, Vaccines and Biologicals’ estimates and projections, as of October 2013

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