We are mid-way through the Decade of Vaccines, marking a period of significant activity to prevent

millions of deaths through more equitable access to vaccines. Today, about 80% of children around

the world receive a complete routine of life-saving vaccines during their first year of life. The Decade

of Vaccines was established to bring attention to the importance of reaching the final 20% of children without access to life-saving vaccines. This decade is bearing witness to many exciting efforts to strengthen routine immunization, accelerate control of vaccine-preventable diseases, and introduce new and improved vaccines. To a large extent, the evaluation of this decade’s success will be based on the degree to which vaccines reach the children who need them. A strong end-to-end immunization supply chain (iSC) should be able to adapt to the resource constraints of communities to ensure that delivery, from the point of production to the point of immunization, is complete. This policy series considers the different components of the supply chain, addresses the challenges faced at the last mile for distribution, and presents examples of innovative approaches to address those challenges. The sixth paper in the series considers how the financial structure and flow can influence the performance of the supply chain.