GLOBAL PROGRAM REVIEW The GAVI Alliance Global Program Review The World Bank’s Partnership with the GAVI Alliance Main Report and Annexes Contents ABBREVIATIONS .................................................................................................................................. V ACKNOWLEDGMENTS ........................................................................................................................ XI PROGRAM AT A GLANCE: THE GAVI ALLIANCE ............................................................................ XII KEY BANK STAFF RESPONSIBLE DURING PERIOD UNDER REVIEW ........................................ XIV GLOSSARY ......................................................................................................................................... XV OVERVIEW ........................................................................................................................................ XVII GAVI ALLIANCE MANAGEMENT RESPONSE .............................................................................. XXV WORLD BANK GROUP MANAGEMENT RESPONSE ................................................................... XXIX CHAIRPERSON’S SUMMARY ......................................................................................................... XXXI 1. THE WORLD BANK-GAVI PARTNERSHIP AND THE PURPOSE OF THE REVIEW ...................... 1 Evolution of GAVI ...................................................................................................................................................... 1 Funding and Results ................................................................................................................................................. 2 Purpose of the Review .............................................................................................................................................. 5 Data, Methodology, and Timeframe .......................................................................................................................... 7 2. THE WORLD BANK AS A FINANCIAL PARTNER TO GAVI ........................................................... 9 Setting up an International Finance Facility for Immunisation ................................................................................... 9 Origin and Establishment of IFFIm ........................................................................................................................................ 9 Financing IFFIm ................................................................................................................................................................... 11 IFFIm’s Governance and Management ............................................................................................................................... 13 The World Bank’s Role and Responsibilities as Treasury Manager of IFFIm ..................................................................... 13 External Evaluation of IFFIm ............................................................................................................................................... 15 Advanced Market Commitment to Spur Vaccine Development .............................................................................. 16 Origin and Establishment of the AMC ................................................................................................................................. 16 AMC Funding and Operations ............................................................................................................................................. 18 The World Bank’s Role in AMC’s Financial Platform .......................................................................................................... 19 Conclusions and Lessons on the Bank’s Contributions to Innovative Finance on Behalf of GAVI ......................... 20 3. THE WORLD BANK AS DEVELOPMENT PARTNER TO GAVI ..................................................... 21 Opportunities for Stronger Development Effectiveness in Immunization ................................................................ 21 Opportunities to Help Ensure Adequate and Sustainable Funding for Immunization ............................................. 22 Opportunities to Address Inequities in Immunization Access ................................................................................. 24 Opportunities to Coordinate Support to Health and Immunization via Global Health Partnerships ........................ 26 The Bank’s Limited Engagement in Immunization .................................................................................................. 27 Limited Bank-GAVI Country-level Engagements................................................................................................................. 30 Direct Bank-GAVI Trust Fund Collaboration Has Ceased ................................................................................................... 32 Country Visits Also Find Opportunities for Stronger Bank Engagement in Immunization ................................................... 35 i CONTENTS 4. THE BANK AS A GOVERNANCE PARTNER .................................................................................. 37 Pre-governance Reform Period .............................................................................................................................. 37 Post-governance Reform Period ............................................................................................................................. 39 GAVI’s Evolving Strategy and Relationship with the Bank ...................................................................................... 41 Lessons for Future Engagement with GAVI and other Partnership Programs ........................................................ 44 5. CONCLUSIONS AND LESSONS ..................................................................................................... 47 Lessons for the Bank’s relationship with GAVI and other partnership programs. ................................................... 49 REFERENCES ...................................................................................................................................... 95 ENDNOTES ........................................................................................................................................... 99 Boxes Box 1. The International Health Partnership ..........................................................................................27 Box 2. Major Findings from Survey of World Bank TTLs .......................................................................34 Box 3. The World Bank’s Participation in GAVI Board Committees .......................................................41 Box 4. GAVI’s Phases and Strategies ...................................................................................................42 Tables Table 1. Contribution Receipts from AMC Donors, as of March 31, 2013 .............................................19 Table 2. Immunization-related Projects by Sector Board .......................................................................28 Table 3. Polio Projects, US$ million .......................................................................................................30 Table 4. References to GAVI in Country Assistance Strategies and Project Appraisal Documents, Fiscal Years 2001–11. ...........................................................................................................................30 Table 5. References to the Global Fund in Country Assistance Strategies and Project Appraisal Documents, Fiscal Years 2003–10 ........................................................................................................31 Table 6. DGF Contributions to GAVI, 2001–07 (US$ millions)...............................................................32 Table 7. Cross-Cutting Issues from Country Visits ................................................................................35 Table 8. GAVI Board and GAVI Fund Board Compositions Before the Reform, 2005 ...........................38 Figures Figure 1. Contributions and Pledges to GAVI (2000 - Present) .............................................................. 2 Figure 2. GAVI’s Commitments to Countries (from inception until August 31, 2013) .............................. 3 Figure 3. IFFIm Process ......................................................................................................................11 Figure 4. IFFIm Donor Commitments and Funds Raised, 2006-2030 .................................................12 Figure 5. Cash Received by GAVI by Source (1999-2009) .................................................................12 Figure 6. AMC Process ........................................................................................................................17 Figure 7. AMC Funding Structure (Illustrative Example) ........................................................................18 Figure 8. Immunization Operations by Sector Board and as Share of Total Projects, 2003-12 .............29 ii CONTENTS Figure 9. Regional Distribution of Immunization-related Operations ..................................................... 29 Figure 10. World Bank Immunization Operations by GAVI Eligibility ..................................................... 29 Figure 11. Type of Activities Funded by ImGAVI Trust Fund ...............................................................