Although the GAVI Alliance has made significant investments since 2000 to improve immunisation service delivery, progress in many countries has been impeded by broader health system constraints such as demotivated workers, inadequate management skills and unpredictable financing and more needs to be done at the periphery to increase and sustain immunisation coverage.
In December 2005, new funding for health system strengthening (HSS), made available in parallel with immunisation services support (ISS), was agreed upon by the GAVI Board.
Currently US $ 800 million is available from GAVI for HSS to help countries overcome institutional bottlenecks and barriers that constrain productivity and progress in providing child and maternal health services.
Between November 2006 and December 2007, 40 of the 72 countries eligible for GAVI HSS funding had applied for it. Twenty-nine of these applications have been approved and this corresponds to a multi-year, predictable investment of US $403 million to strengthen health systems in these countries.