By forming close partnerships to remove redundancy and increase efficiency and impact, and by leveraging the strengths of its individual members, Gavi shows that the whole really can be greater than the sum of its parts.
Continuing to leverage the comparative advantages of Gavi’s public-private partnership will be critical to addressing the challenges that have emerged in the current reporting period.
“Gavi is building deeper and wider collaboration with partners, including other global health and civil society organisations and the private sector.”
Mid-Term Review report, page 18
Effective partnerships and collaboration have long been part of Gavi’s DNA. This involves forging alliances with a wide range of partners across a multitude of sectors.
Since its foundation in 2000, the Alliance has brought together the key stakeholders in global immunisation. Each partner brings its own unique area of expertise: the leadership of developing countries; the technical skills of research agencies, UNICEF, WHO and the World Bank; the production capabilities of the vaccine manufacturers; the know-how and support of the private sector, donor governments and the Bill & Melinda Gates Foundation; and the immunisation delivery and advocacy skills of civil society organisations.
By working together to create synergies and economies of scale as well as to coordinate existing systems and avoid duplication, the Alliance has helped countries to scale up their immunisation programmes. Efforts to strengthen collaboration beyond Gavi’s traditional partners are intensifying in this period. The Alliance and our partners continue to demonstrate how a partnership built around a common mission can achieve more than any agency alone.
Gavi continuously works to strengthen its existing partnerships. However, it also recognises the need to develop new ways of working together to reach the underimmunised. At the same time, the organisation is always looking to build new partnerships, particularly to leverage expertise and investment from the private sector.
Increasingly, the Alliance is sharing its investments in health systems through collaboration with other global health players such as the Global Fund and the Global Financing Facility. Gavi also continues to expand its partnerships to tackle long-standing immunisation challenges, such as polio eradication and disease outbreak prevention and control.
Partners’ engagement framework
Gavi has put in place a range of new tools and approaches which allow it to better collaborate with partners in addressing bottlenecks to improved immunisation coverage and equity. Introduced in 2016, the partners’ engagement framework (PEF) brings a country-centric, bottom-up approach to technical assistance provided by Alliance partners, helping to better leverage their comparative strengths and to increase accountability.
This new approach has led to a progressive increase in country-level funding, which now constitutes 59% of funding to all partners. Today, Gavi supports nearly 240 national and sub-national WHO and UNICEF staff through PEF. Since 2016, country-level funding has increased by 46% for WHO and by 58% for UNICEF. This represents a significant evolution in the way in which Alliance partners work together and provide countries with technical support matched to their specific needs.
Collaborating to prevent outbreaks
The Alliance collaborates with a range of partners to prevent and control disease outbreaks. Whether through the Global Task Force for Cholera Control, WHO’s Eliminate Yellow Fever Epidemics (EYE) strategy, the Measles & Rubella Initiative or the Global Polio Eradication Initiative, these partnerships help to foster a more integrated approach to global health security.
TIMELINE: COLLABORATION IN ACTION
Private sector partnerships
The Alliance leverages the expertise of the private sector to tackle bottlenecks to strong health systems. Improving supply chain performance – including storage capacity, human resources and information systems – in developing countries is a vital component in these efforts.
Supply chain leadership
Gavi collaborates with a wide range of partners, including United Parcel Service and the International Federation of Pharmaceutical Wholesalers, to provide a training course on health supply chain leadership. The Strategic Training Executive Programme (STEP) was launched in Rwanda’s East African Community Regional Centre of Excellence for Vaccines, Immunisation and Health Supply Chain Management.
In 2017, STEP courses expanded to the Democratic Republic of Congo and Pakistan. To date, 76 supply chain executives have graduated from STEP training courses, creating a new generation of supply chain managers spread across 15 countries.
Gavi is harnessing several private sector innovations to improve the quality and quantity of immunisation data. The Alliance’s collaboration with the private sector helps countries identify and reach children who are still missing out on critical vaccines. In India, for example, Gavi is building on Unilever’s efforts to improve hand-washing. This partnership combines messages around sanitation and immunisation to boost demand for immunisation in hard-to-reach communities.
Improving immunisation data: private sector solutions
- Kenya: linking electronic vaccine registries to birth registries;
- Indonesia: phone-based monitoring of vaccination campaigns; and
- Cote d’Ivoire: using SMS reminders through Orange to reduce drop-out rates.
COLLABORATION FOR SUSTAINABILITY
Building sustainable immunisation programmes which maintain high and equitable coverage after Gavi support stops, depends on a range of factors from robust systems and efficient decision-making processes to strong political commitment and adequate human and financial resources. Ensuring that countries can address gaps in all these areas and take financial ownership of their immunisation programmes requires collaboration not only with national governments but also with other global health and development organisations.
In 2017, the Alliance took steps to formalise its engagement with countries that have transitioned and intensified its collaboration with key partners. In a significant evolution of its approach to sustainability, Gavi is increasingly partnering with the World Bank, the Global Fund and the Global Financing Facility on health financing and transition.
Strong political commitment to immunisation across government agencies is critical to long-term sustainability. In addition to working with other global health entities, the Alliance has strengthened both high-level and technical/programmatic collaboration with ministries of finance in Gavi-supported countries. This helps to ensure that dedicated budget plans and domestic funding are available for immunisation and transition.
COLLABORATING TO SHAPE MARKETS
Collaboration has long been a cornerstone of Gavi’s market shaping approach, whether with UNICEF’s Supply Division or vaccine manufacturers.
Ensuring that manufacturers produce appropriate vaccines in the right quantities at affordable prices to meet country needs requires constant dialogue and interaction with the pharmaceutical industry. This is true both for manufacturers already working with the Alliance, as well as potential new entrants into the market.
Gavi’s ground-breaking partnership with UNICEF has proven pivotal to its market shaping strategy. By procuring all vaccines for Gavi-supported programmes through UNICEF, the Alliance cannot only secure volume discounts, but also foster efficiencies and transparencies in the procurement and distribution of vaccines. The partnership between Alliance members and manufacturers also helps to bolster vaccine supply security by ensuring quality and affordable vaccines are readily available for countries. In addition to vaccines and equipment, UNICEF’s Supply Division also provides technical assistance and management support to guide the Alliance’s procurement and distribution efforts.
Advance Market Commitment for pneumococcal vaccine
Another Gavi-supported market shaping initiative which showcases the importance of collaboration with the pharmaceutical industry is the Advance Market Commitment (AMC). This innovative financing mechanism has attracted new suppliers to the pneumococcal vaccine market and ensured that this critical vaccine can protects millions of children against the world’s biggest killer of under-fives (see market shaping).
COOPERATING ON SUSTAINABLE DEVELOPMENT GOAL 3
Two of the new Sustainable Development Goals (SDGs), launched in 2015, underlined the importance of health (SDG3) and partnership (SDG17) to achieving its 2030 targets.
Gavi will be one of the core implementers of The Global Action Plan for Healthy Lives and Wellbeing for All. Coordinated by WHO, this initiative unites 11 organisations around a joint commitment to exploring new ways of collaborating to accelerate progress towards achieving the SDGs. Gavi has already worked closely with four of these organisations, WHO, UNICEF, World Bank and the Global Fund, since its inception in 2000.
With basic childhood vaccines reaching more than 60 million children annually in Gavi-supported countries, immunisation has a critical role to play in achieving universal health coverage (UHC) by 2030 – part of SDG3. In its most basic form, routine immunisation reaches more than 90% of the world’s children and brings the vast majority of families into contact with the primary health system up to five times during the first year of life. This equates to at least 300 million contacts – more than any other health intervention and means the Alliance, with other partners, is helping to lay the foundations for primary healthcare.
The Global Fund and the Global Financing Facility
Gavi has a longstanding history of working with the Global Fund as well as coordinating country-level engagements and investments with the Global Financing Facility. Since June 2018, Gavi shares its headquarter offices in Geneva, Switzerland with the Global Fund.
The Gavi CEO and the Global Fund Executive Director have jointly discussed their collaboration at recent Board meetings. The two organisations continue to deepen their collaboration where it brings added value and to make it more systematic across teams.
Globally, these collaboration efforts include better alignment of health system strengthening support. This is achieved by coordinating discussions around upcoming health system funding as well as aligning categories used to monitor the organisations’ respective investments. Country-level collaboration includes alignment of grants, joint planning of investments and use of common fiduciary mechanisms.