In this note, we summarize the changing context and its relevance for Gavi, exploring the specific issues relevant to transitioning countries, never-eligible MICs, and countries dealing with complex emergencies or large-scale protracted displacement. We then offer four recommendations to increase Gavi’s relevance and effectiveness in a changing world.
Gavi’s Role in Market Shaping and Procurement: Progress, Challenges, and Recommendations for an Evolving Approach
In this note, we diagnose key challenges that will strain Gavi’s model during the 2021–2025 period and beyond. We then offer recommendations for an evolving approach, which closely align with Gavi’s goal to maximize the impact of countries’ current and future domestic investments.
Gavi’s Approach to Health Systems Strengthening: Reforms for Enhanced Effectiveness and Relevance in the 2021–2025 Strategy
In this note, we highlight the results of Gavi HSS evaluations, how Gavi has responded to identified challenges and limitations in the HSS proposal and implementation process, and what options are available to enhance the effectiveness of HSS support for Gavi’s core mandate. We also discuss the importance of 4G (Gavi, the Global Fund, the Global Financing Facility, and the World Bank Group) collaboration.
With a vision of “creating equal access to new and underused vaccines,” Gavi set several coverage-specific targets for 2020 as part of its Phase IV strategy, including the immunization of an additional 300 million children, increased pentavalent 3 and measles-containing vaccine (MCV) 1 coverage, and greater equity in coverage across wealth quintiles. In this note, we explore these coverage challenges in greater detail and offer recommendations for how Gavi can address them in its 5.0 strategy.
This overview note lays out five challenges and summarizes some of our ideas to address them; backing up each is a standalone note that provides greater detail and options for action. An accompanying note looks at the full set of issues through a country lens.
In this note, we explore some of the challenges facing Gavi-eligible countries. We then propose procedural improvements or adaptations to Gavi’s operations to better support the needs of country governments and other partners.
The Declaration of Alma-Ata at 40: Realizing the Promise of Primary Health Care and Avoiding the Pitfalls in Making Vision Reality
In October, world leaders renewed their commitment to Primary Health Care. Now is an opportune time to identify lessons learned and key challenges from the past 40 years, and to acknowledge the work that remains to be done to make vision reality.
Are USAID programs high impact and good value for money? Do they work? Do they generate more results for less cost than if the agency just gave poor people cash? We don’t always know the answers to those questions, but USAID is trying to find out.
The USG International Family Planning Landscape: Defining Approaches to Address Uncertainties in Funding and Programming
The international family planning community has made impressive gains in increasing global access to high-quality, voluntary family planning services. However, significant challenges remain with maintaining current support and meeting the growing need projected for family planning services and commodities across low- and middle-income countries (LMICs).
Despite the considerable interest in Development Impact Bonds, only a few have reached the implementation phase. We use information from stakeholder interviews to describe the design of one DIB in-depth and use lessons from a range of impact bonds to develop recommendations for potential partners to future DIBs. Lessons from the set of impact bonds reveal a need to reset expectations, particularly around the time and effort needed to develop and market a DIB.
Reproductive Choices to Life Chances: New and Existing Evidence on the Impact of Contraception on Women’s Economic Empowerment
Researchers from many academic institutions and think tanks have studied the relationship between contraception and women's economic empowerment. In both the developing and developed world, the evidence suggests that access to contraception is not only correlated with but can even cause women’s economic empowerment and drive economic growth.
What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.
What’s In, What’s Out: Designing Benefits for Universal Health Coverage: Key Messages for Donors and Advocates
Many low- and middle-income countries aspire to universal health coverage (UHC), but for rhetoric to become reality, the health services offered must be consistent with the funds available, which may require tough tradeoffs. An explicit health benefits package—a defined list of services that are and are not subsidized—is essential in creating a sustainable UHC system.
Front and center in discussions around the reform and redesign of the United States Agency for International Development (USAID) are the objectives of increased efficiency and effectiveness. The agency’s new administrator, Mark Green, who has highlighted these goals from day one, has an excellent opportunity to improve the agency’s efficiency and effectiveness through better generation and use of evidence to inform policy and programming decisions.
Nigeria Will Become Polio-Free: Challenges, Successes, and Lessons Learned for the Quest to Eradicate Polio
Despite no reported cases of polio in two years in Nigeria, on August 11, 2016, the WHO announced two new wild polio cases had been discovered in Northern Nigeria. While undoubtedly a setback, Nigeria has mobilized its immunization forces and will look to take heed of four key lessons learned during almost three decades of anti-polio efforts: 1) establishing and sustaining trust is critical to the success of eradication campaigns; 2) frequent, independent monitoring and evaluation are key to tracking the progress of an intervention and making modifications; 3) holding all actors accountable is essential to pushing an intervention forward; and 4) contextualized health initiatives are key in fighting polio and other diseases. These lessons will reinforce a cohesive, multilateral strategy that builds on past successes to secure a polio-free Nigeria.
In July 2012, world leaders gathered in London to support the right of women and girls to make informed and autonomous choices about whether, when, and how many children they want to have. There, low income-country governments and donors committed to a new partnership—Family Planning 2020 (FP2020). Since then, the focus countries involved in the FP2020 partnership have made significant progress. Yet as FP2020 reaches its halfway point, and new, even more ambitious goals are set as part of the Sustainable Development Goals, gains fall short of aspirations.
Attention presidential transition teams: The first hundred days of the new administration should kick start an ambitious agenda in global health alongside long-needed reforms to enhance the efficiency and effectiveness of US action. Building on our earlier work, we suggest seven priority actions within three broad categories.
Since 2015, India has devolved an increasing share of its national tax yield to state governments and undertaken reforms to other kinds of centre-to-state grants. For many, the increased revenue via the tax devolution was considered good news but some health experts worried that states would give little priority to health under these conditions of greater autonomy. We find that at least two states, Bihar and Uttar Pradesh, have much more to spend in general and are budgeting more for health in 2015-2016 as compared to previous fiscal years.