Post00270 GAVI GUIDELINES 1 August 2000 CONTENTS 1. GAVI: GUIDELINES AND FORMS ARE AVAILABLE 2. BILL & MELINDA GATES FOUNDATION'S GLOBAL HEALTH PROGRAM The Technet Forum File Library has been updated! See what is available! Download files or get them by email! Go to the website ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/ or Send an email to: [[email protected]][email protected][/email] To get the file list - send the message: dir technet To get the file - send the message: get technet "filename" * Previous postings are available for download. ____________________________________*______________________________________ 1. GAVI: GUIDELINES AND FORMS ARE AVAILABLE Steve Landry, USAID, Michel Zaffran, WHO, and Lisa Jacobs, UNICEF - GAVI Secretariat, have kindly made the GAVI and CVF documents "Guidelines on Country Proposals for Support to Immunization Services and New and Under- used Vaccines" and the forms for CVF submission available for Technet download. APPLICATION- COVER LETTER.DOC 20992 [English Only] APPLICATION- FORMS.DOC 191488 APPLICATION- GUIDELINES.DOC 137728 The files are available in three languages, French, English, and Russian, and are in MS Word format. They have been virus scanned using the latest Norton AntiVirus 2000 update, and are contained in zip files. GAVI-GuidelinesFormsFrenchJuly2000.zip GAVI-GuidelinesFormsRussianJuly2000.zip GAVI-GuidelinesFormsEnglishJuly2000.zip * The text of the executive summary is posted below. Go to the website ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/GAVI or Send an email to: [[email protected]][email protected][/email] With the message: get technet GAVI-GuidelinesFormsEnglishJuly2000.zip or get technet GAVI-GuidelinesFormsFrenchJuly2000.zip or get technet GAVI-GuidelinesFormsRussianJuly2000.zip ___________________________________________________________________________ Extract: Executive Summary ___________________________________________________________________________ Global Alliance for Vaccines and Immunization (GAVI) and the Global Fund for Children's Vaccines (The Fund) EXECUTIVE SUMMARY * In January 2000, a new multi-million dollar Global Fund for Children's Vaccines (the Fund) was launched by the partners of the Global Alliance for Vaccines and Immunization (GAVI). The Fund is a new experiment in the field of international public health designed to capitalize on past immunization successes and recent developments in vaccine technology. With the Fund, GAVI seeks to catalyze greater commitment to improve immunization coverage and distribute new and under-used vaccines in low income countries. * National governments of countries with GNP/capita equal to or below US$1, 000 are eligible for support from the Fund, according to the noncompetitive terms outlined in this document. Special arrangements are foreseen for China, India and Indonesia. * Current Fund resources have been budgeted to reach the objective of providing all eligible countries with five years of funding support. The partners of the Alliance recognize the need for sustained support and will work with countries to find additional resources to improve immunization programs that contribute to better overall health systems. In addition, GAVI partners are taking steps to extend the Fund beyond five years. * It is anticipated that country proposals to the Fund will be submitted to GAVI during the next two years, and be reviewed twice a year. Proposals received by 1 July 2000 will be reviewed for the first round of disbursements starting in August. Proposals received by 15 October will be considered during the second review this year for disbursements starting in November. Proposals submitted thereafter will be considered during the two rounds of review in 2001. * The three basic conditions for support are: a functioning Inter-agency Coordination Committee (ICC) or equivalent collaboration mechanism; a recent assessment of immunization services; and the existence of a multi- year plan for immunization. It is anticipated that the role of national ICCs will grow to provide support to governments in their immunization planning and monitoring efforts. * The Fund includes three sub-accounts: for immunization services; new and under-used vaccines; and research and development. In this first round, support from the first two sub-accounts will be available to governments. * Countries with DTP3* coverage below 80% will be considered for funding from the sub-account for immunization services. Support for increasing access to and strengthening of safe immunization services will be provided in a flexible way with an emphasis on performance. A strict and transparent system of performance monitoring with output indicators at district level will be applied. * Countries with DTP3 coverage above 50% will be considered for support from the sub-account for new and under-used vaccines. In this initial phase, vaccines for hepatitis B (hepB), Haemophilus influenzae type b (Hib), and yellow fever will be available from the Fund, together with related safe injection equipment. * Countries with current DTP3 coverage below 50% that wish to introduce the new vaccines are encouraged to initially focus on improving their systems for delivering vaccines by seeking support from their country partners, and from the sub-account for immunization services, in order to meet eligibility requirements. * Country proposals should be developed in close consultation with technical and financial partners committed to health and immunization programs, following the guidelines in this document and be forwarded to the GAVI Secretariat on the enclosed form, with relevant documentation attached. BACKGROUND Immunization is one of the most successful public health efforts in history, but we are at a critical juncture: Enormous strides in science, technology and delivery systems can improve upon past successes, but declining global commitment to routine immunization are impeding efforts to build upon these advances. As a result, three widening gaps have been identified: 1. the nearly 30 million children born every year in developing countries who are not fully immunized; 2. the growing number of new vaccines given to children in industrialized countries that are under-used or not available in developing countries; 3. the lack of investment in vaccine research and development for diseases that are prevalent in developing countries, especially HIV/AIDS, malaria and tuberculosis. To address these gaps, the Global Alliance for Vaccines and Immunization (GAVI), a unique coalition of public and private institutions, brings together national governments, UN agencies, the World Bank Group, the pharmaceutical industry, and nongovernmental organizations toward a common goal of ensuring that every child is protected against vaccine-preventable diseases. All of the main partners and constituencies are represented on the GAVI Board; Dr. Gro Harlem Brundtland, Director-General of WHO, currently serves as chair. The main responsibilities and functions of the Alliance are being carried out by its partners, under the coordination of a Working Group, which also includes representatives of the primary implementing partners, and reports to the Board. A small Secretariat has been established at the UNICEF regional office in Geneva to facilitate collaboration and promote the common goals. The GAVI Board has adopted the following global milestones to provide a measure for progress: * By 2005, 80% of developing countries will have routine immunization coverage of at least 80% in all districts. * By 2002, 80% of countries with adequate delivery system will have introduced Hepatitis B vaccine and all countries by 2007. * By 2005, 50% of poorest countries with high burden of disease and adequate delivery systems will have introduced Hib vaccine. * By 2005, the vaccine efficacy and burden-of-disease will be known for all regions for rotavirus and pneumococcal vaccines, and mechanisms identified to make the vaccines available to the poorest countries. The Global Fund for Children's Vaccines In January 2000, a new multi-million dollar Global Fund for Children's Vaccines (the Fund) was launched by the GAVI partners. The Fund is a new experiment in the field of international public health - a recognition that in the face of unique opportunities and new challenges to improve immunization services, 'business as usual' will not suffice. The Fund has been designed not to replace current funding or pre-empt new sources of funding. On the contrary, the Fund has been envisioned as a catalyst to raise awareness and commitment to immunization as a key ingredient to a well-functioning health system. The GAVI partners aim to identify new strategies for building sustained improvements to immunization services, with the ultimate goal of achieving improvements in overall health systems. The Fund has received an initial commitment of US$ 750 million (US$ 150 per year over five years) from the Bill and Melinda Gates Foundation, and several governments have also indicated interest to support the Fund. Current resources have been budgeted to reach the objective of providing all eligible countries with five years of funding support. GAVI partners recognize the need for sustained support and will work with countries to find additional resources to improve immunization programs that contribute to better overall health systems. In addition, the Alliance is taking steps to extend the Fund beyond five years. It is anticipated that the Fund will ultimately provide three sub-accounts of support for: * development of immunization services as part of the health system; * introduction of new and under-used vaccines and associated safe injection equipment; * research and development of vaccines for diseases that are prevalent in developing countries, such as HIV/AIDS, tuberculosis and malaria. The Fund will rely on the technical recommendations provided by the GAVI Board and its partners in making its expenditures. The first review of country proposals, to be conducted in July of this year, will consider support from the first two sub-accounts - for immunization services and for new and under-used vaccines. The sub-account for immunization services will provide support to governments in countries with low current coverage (as indicated by national DTP3 coverage of less than 80%) to strengthen their health systems to improve immunization services in all districts. The sub-account for new and under-used vaccines will initially be used to purchase vaccines against hepatitis B (hepB), Haemophilus influenzae type b (Hib) and yellow fever, and associated safe injection materials for countries with adequate current coverage (as indicated by national DTP3 coverage of more than 50%). A comprehensive country proposal including needs for expansion of immunization services as well as needs for support to the new and under- used vaccines is hereby invited. The eligibility criteria, forms of support and procedure for the first round of country proposals to GAVI and the Fund are outlined below. Development of country proposals should be undertaken by governments in consultation with an Inter-agency Coordinating Committee (ICC) or equivalent collaboration mechanism. National ICC's are expected to assume new and larger roles in supporting governments in their effort to improve and expand national immunization programs. Proposals must include current commitments by government and partners, i.e., multilateral, bilateral agencies and NGOs, and unmet needs. As well as being the basis for GAVI for considering support from the Fund, the process should also provide an opportunity for partners at the country level to commit themselves for additional support. The Alliance will also seek increases in global commitments to address unmet needs. One of the overriding concerns of the GAVI partners is to help countries formulate strategies to sustain improved performance over time. Recognizing that the lowest income countries will require continued external support for their immunization programs, support from the Fund has not been envisioned to continue indefinitely but to form a foundation for governments to expand support from other sources. Governments are urged to submit proposals that reflect an effort to secure additional funding for vaccines and immunization services in coming years. Proposals will be reviewed by an independent panel of experts, with recommendations forwarded to the Alliance for decision. Countries submitting proposals by 1 July, 2000 will be notified about the outcome of the review by the end of July. Countries that require more time to complete preparations may consider submitting their proposals during a later cycle; incomplete proposals will be returned to countries for resubmission at a later date. It is anticipated that country proposals to the Fund will be submitted to GAVI during the next two years, and be reviewed twice a year. Proposals received by 15 October will be considered during the second review this year for disbursements starting in November. Applications submitted thereafter will be considered during the two rounds of review in 2001. ____________________________________*______________________________________ 2. BILL & MELINDA GATES FOUNDATION'S GLOBAL HEALTH PROGRAM Selected news items reprinted under the fair use doctrine of international copyright law: http://www4.law.cornell.edu/uscode/17/107.html Contributions, comments and additions please: [[email protected]][email protected][/email] or use your reply button ___________________________________________________________________________ "A Conversation With the Leaders of the Gates Foundation's Global Health Program: Gordon Perkin and William Foege" Lancet (http://www.thelancet.com) (07/08/00) Vol. 356, No. 9224, P. 153; McCarthy, Michael Gordon Perkin, the executive director of the Bill & Melinda Gates Foundation's Global Health Program, and William Foege, the senior advisor to the program, were interviewed by The Lancet. The foundation has committed over $1.7 billion in the past three years to fighting the diseases that affect people in the world's most impoverished nations. The primary objective of the foundation's health program has been childhood vaccination. Perkin explains, " Bill and Melinda realized that there were vaccines that their children were receiving, vaccines that we take for granted, that weren't reaching children in many of the poorer countries of the world." Perkins points out that their multi-million dollar contributions for the Gates Children's Vaccine Program and the Global Fund for Children's Vaccines have generated renewed interest in the vaccine movement. The foundation focuses on diseases that impose the greatest burdens on the poor, including HIV, malaria, and tuberculosis (TB). As a result, the foundation made a $25 million grant to the Sequella Global Tuberculosis Foundation to develop a TB vaccine, a $50 million grant to establish a Malaria Vaccine Initiative, and a $25 million award to the International AIDS Vaccine Initiative. Foege adds that the organization is also working to reduce maternal and infant mortality and to address conditions associated with poverty in developing nations. --- Gates Give Harvard $45M For Research SEATTLE (AP) via NewsEdge Corporation - Bill and Melinda Gates are giving Harvard Medical School nearly $45 million to fight drug-resistant strains of tuberculosis. It's the largest private donation ever to combat the disease. Harvard says it will use the five-year grant to join other groups, including the World Health Organization and U.S. Centers for Disease Control and Prevention, in fighting TB in Peru. Peru has a pilot program that can cure patients with drug-resistant TB at a fraction of what it costs to treat them in the United States, Harvard said. The Gates Foundation wanted to expand that program so other countries could use it as a model, the school said. TB is a highly infectious bacterial disease spread by coughing. It attacks the lungs and kills more than 2 million people every year. = --- "Gates Couple Giving Harvard $45 Million to Fight TB Strains" Deseret News (http://www.desnews.com) (07/30/00) P. A8 The Bill & Melinda Gates Foundation has donated approximately $45 million to Harvard Medical School for the fight against drug-resistant strains of tuberculosis (TB). Harvard reports that it will use the five-year grant to work with groups including the Centers for Disease Control and Prevention and the World Health Organization in fighting the disease in Peru. A pilot treatment program in Peru has cured patients with drug-resistant TB for just a small portion of what such treatment would cost in the United States. --- "London Centre Gets Pounds 26m for Malaria Research" Financial Times (http://www.ft.com) (07/31/00) P. 4; Pilling, David The Bill & Melinda Gates Foundation is slated to announce today a $40 million (26.3 million pounds) donation to the London School of Hygiene and Tropical Medicine for malaria research. The Gates Foundation has made malaria a priority, having also donated $50 million to the Malaria Vaccine Initiative and $25 million to the Medicines for Malaria Venture. The new funding will be used for research to design new products, including vaccines and insecticides. A professor of infectious disease immunology at the London school, Eleanor Riley, noted that drug resistance has developed from "indiscriminate" administration of anti-malarial drugs. Riley said, "More research on the mechanisms by which resistance develops and spreads will allow us to extend the useful lifespan of the existent drugs, but there is an urgent need also to develop and test new drugs, insecticides, and vaccines."