GAVI's policies can be broken into two phases reflecting its strategy and responding to changes in the immunisation landscape.
Support was concentrated in two primary areas:
The new and underused vaccine strategy primarily focused on Hib, hepatitis B and yellow fever. Support was provided in the form of five-year grants with the expectation that countries would increase their national contribution, leading to eventual financial sustainability.
Delivery systems were improved through funding Injection Safety Support (INS) initiatives. As most infections result from the re-use of equipment, GAVI enabled the supply of disposable auto-disable (AD) syringes for all vaccines to all countries. In addition to minimising infection risk, this has driven down the price of AD syringes and increased vaccine demand.
Incentives to immunise more children were given through performance-based funding Immunisation Services Support (ISS) with countries receiving extra money per additional child immunised.
In its second phase of operation (2005-2010), a combination of factors is causing GAVI to review how best to deploy its growing resources.
This has led GAVI to review how best to use its resources. The new and underused vaccine strategy has two new vaccines added to its portfolio - pnuemococcal and rotavirus, and an evaluation of the many new vaccines becoming available has been carried out. There has also been a fundamental shift in the GAVI co-financing policy.
GAVI’s support for new vaccines is increasingly conditional on complementary investment in delivery systems. In addition to expanding ISS support, it now offers a new form of support funding – Health System Strengthening (HSS).