UPDATE FROM THE SECRETARIAT, INCLUDING 206-2020 STRATEGY, INDICATORS AND KPIs GAVI BOARD MEETING Seth Berkley 4 June 207, Geneva www.gavi.org
Second update on the 206 2020 strategy Systematic, data-driven report on progress Based on new, ambitious framework Starting to bear fruit and strengthen our understanding Learning what works well and where we should revisit Lessons on indicators discussed throughout 2
The Alliance accountability framework Strategy indicators and targets Alliance KPIs Focus of update PEF Performance Management PEF Functions Targeted country assistance Secretariat Performance Management Corporate Performance Management (CPM) Team Performance Management (TPM) Country Performance Management Grant Performance Framework (PF) Joint Appraisal Strategic focus areas Individual Performance (PMP) High-Level Review Panel (HLRP)
206 2020 INDICATORS MISSION PROGRESS Children immunised Estimate as of mid-207: 00 million TARGETS > 65 million 00 million 2 Future deaths averted >.2 million 5-6 million Under-five mortality rate < 64 per,000 58 per,000 0% reduction in rate from 205 baseline by 2020 4 5 Future disability-adjusted life years (DALYs) averted > 56 million Vaccines sustained after Gavi support ends 00% 250 million 00% Projected on track, based on assumed continued improvement over last report (latest available data shown) On track, based on data available year to date 205 206 207 208 209 2020
206 2020 INDICATORS DISEASE DASHBOARD Hepatitis B Percent of Gavi countries with low prevalence of under-5 hepatitis Availability of data 8% (5 of 6 countries) Rotavirus Proportion of acute gastroenteritis hospitalisations testing positive for rotavirus in children under 24% (25 countries) Measles 50% (5 of 70 countries) Percent of Gavi countries reporting fewer than 5 measles cases per million annually 00% 205 206 207 208 209 2020
206 2020 INDICATORS STRATEGY PROGRESS 6 8 ON TRACK MODERATE DELAYS / CHALLENGES SIGNIFICANT DELAYS / CHALLENGES TO BE REPORTED Q 207 Accelerate vaccines 2 Strengthen capacity Improve sustainability 4 Shape the market ROUTINE IMMUNISATION COVERAGE 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET CURRENT: PENTA: +PP 8% PENTA 86% MCV: 78% MCV: 8% SUPPLY CHAIN PERFORMANCE 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET 6% 4% CO-FINANCING COMMITMENTS 00% PREV: 85% TARGET: 00% (2020) SUPPLY SECURITY 9/ PREV: 7/ TARGET: / (2020) 2 BREADTH OF PROTECTION 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET CURRENT: % +PP 6% 2 DATA QUALITY 49% PREV: 45% TARGET: 5% (2020) 2 COUNTRY INVESTMENT IN VACCINES 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET N/A 00% 2 VACCINE PRICE REDUCTION $9 PREV: $20 TARGET: N/A EQUITY: GEOGRAPHIC DISTRIBUTION 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET CURRENT: 6% +PP 26% PENTA COVERAGE & DROP-OUT RATE 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET PENTA: 87% DROP-OUT: 6 PP PENTA: 9% DROP-OUT: PP COUNTRIES ON TRACK TO TRANSITION 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET 6% 75% VACCINE INNOVATION PREV: 0 TARGET: 0 (2020) 4 EQUITY: WEALTH DISTRIBUTION 5% PREV: 9% 2020 TARGET TARGET: 49% (2020) 4 INTEGRATED HEALTH SERVICE DELIVERY 206 DATA AVAILABLE Q 207 205 VALUE 2020 TARGET 26% 6% 4 INSTITUTIONAL CAPACITY 0% TARGET: ** 4 HEALTHY MARKET DYNAMICS 2/ PREV: / TARGET: 6/ (2020) 5 EQUITY: EDUCATION 0% PREV: 4% TARGET: 44% (2020) 5 CIVIL SOCIETY ENGAGEMENT 40% TARGET: ** MCV PP Penta Penta Measles-containing vaccine st dose Percentage point Pentavalent st dose Pentavalent rd dose ** Currently insufficient data to define target; targets to be defined after provision of one full year of PCA version.0 reports Not published due to commercial sensitivity
SG Equity indicators MODERATE CHALLENGES % of Gavi countries with: Data source Geographic equity Wealth equity Gender equity >80% third dose pentavalent coverage in all districts 0% point difference in coverage between richest and poorest quintile 0% point difference in coverage between children of mothers with no education vs secondary/higher education Administrative data Surveys Surveys Challenges Limited number and timing of surveys available Quality of data Thresholds can mask important developments
SG Alliance work on equity Equity mainstreamed in grant processes - key points: Where are the under-immunised children? What are the barriers to immunisation? How can Gavi support? ANGOLA Coverage with the third dose of pentavalent vaccine, 206 Municipal level 0 49% 50 79% >= 80% Improving sub-national data: Sub-national administrative coverage for PEF priority countries reported this year First reporting of sub-national data through joint reporting form Support to triangulation of sources at sub-national level to strengthen decision-making
SG Vaccine introductions across strategy periods Routine introductions Vaccination campaigns 25 ~270 27 67 Gavi.0 (200-5) Gavi 2.0 (2006-0) Gavi.0 (20-5) Gavi 4.0 (206-20)
SG Target of 50 introductions in 207 59 0 49 9 68 7 72 27 5 () 45 24 4 Target: 50 ~80 MODERATE CHALLENGES ~40 At risk Gap to projection Forthcoming/ projected Completed ~5 204 205 206 207 208 209 2020 Introductions as of 2 June 207
4 introductions in 207 majority are campaigns Since January 207: 5 routine introductions 9 campaigns/demos Mali Meningitis A Meningitis A Burkina Faso Meningitis A Côte d Ivoire Rotavirus CAR Meningitis A Ethiopia Measles Uganda Meningitis A Burundi Measles-rubella India Measlesrubella Pneumococcal Cambodia HPV Measles-rubella Bolivia HPV Lesotho Measles-rubella
SG2 Grant performance frameworks: long-term vision Completed/ongoing In progress Planned Compliance Use Quality Learning All countries have grant performance frameworks (GPFs) Joint appraisals High-level review panels Focus on improving quality Analyses & visualisation 80% of countries meet reporting requirement Target: all 207 joint appraisals use GPF analyses Programmatic & financial performance analysis Refine guidance, particularly for HSS metrics Results & learning to inform 202-2025 strategy
SG2 Using grant data to inform our strategy: Niger Examining data Bringing together and reallocating grants Monitoring Incorporating new data Underimmunised children concentrated in urban and a few rural areas Reinforcing outreach and mobile services in rural areas Some HSS funds reallocated towards underimmunised children in urban areas PEF technical support to ensure robust 207 coverage survey % surviving infants receiving rd dose pentavalent vaccine through each of fixed, outreach and mobile immunisation services Use survey data to map unimmunised children by geographic areas Joint appraisal to focus on challenges with urban strategy
2020 deliverables Current status SG2 Supply chain strategy: progress Leadership 5 countries have dedicated and competent supply chain leaders Continuous improvement plans All Gavi countries implement comprehensive supply chain management plans Data for management 0-40 countries use data to oversee supply chain and measure performance Cold chain equipment 40-50 countries have improved cold chain equipment System design At least 0 countries have done system design SC leaders in 0 countries meet competency requirements 2/47 countries show improvement in EVMs; 6 countries with EVMs >80% 2 countries started implementation Applications from 42/5 eligible countries 0 countries started analyses; 7 countries implementing On track
SG Transitioning countries 4 more countries transitioned end 206 8 5 9 8 7 7 8 6 9 9 2 55 50 48 47 47 4 40 2 2 ON TRACK Fully self-financing Accelerated transition Fully Gavi-eligible 205 Bhutan Honduras Mongolia Sri Lanka Ukraine 206 Guyana Indonesia Kiribati Moldova 207 Angola Armenia Azerbaijan Bolivia Congo Rep. Cuba Georgia Timor-Leste 208 209 2020 - Vietnam Nicaragua PNG Uzbekistan Ghana Zambia 202 India Lao PDR Nigeria Solomon Isl. Ghana 5 Based on current projections
SG Co-financing $9m Self-financed programmes $m $2m $60m $20m $9m ON TRACK Includes US$ 4m from Kenya and Pakistan, only due in June $6m $64m $2m Pending Payments 20 202 20 204 205 206 % of countries not in arrears 94% 87% 79% 75% 85% 92% As of May 207. Countries with co-financing requirements aligned to fiscal years, with waivers and pending reconciliation of self-procurement amounts. 6
SG Institutional capacity New indicator, measured through programme capacity assessments SIGNIFICANT CHALLENGES Country EPI NITAG ICC capacity Burundi Cambodia Ghana Guinea Malawi Myanmar Nepal Niger N/a Nigeria N/a Togo 47% of sub-indicators pass the threshold 0 countries with data so far ~2 more expected in 207 NITAG National immunisation technical advisory group 7 ICC Interagency coordination committee
SG4 Market shaping ON TRACK -5% 7 9 $20 $9 0 0 2 205 206 205 206 205 206 205 206 Markets with sufficient & uninterrupted supply Average price to fully vaccinate a child* Vaccines/products with improved characteristics Markets with moderate/high market dynamics * with pentavalent, rotavirus and pneumococcal vaccines 8
206 2020 INDICATORS ALLIANCE PROGRESS UPDATED: 25 April 207 5 0 6 ON TRACK MODERATE DELAYS / CHALLENGES SIGNIFICANT DELAYS / CHALLENGES TRACKING TREND ONLY (NO TARGETS OR PERFORMANCE RANKING) 2 4 5 6 206 drivers of delays: Secretariat & partners IPV, HPV, 2rotavirus Secretariat VACCINE INTRODUCTIONS 6% percentage SPEED OF CASH GRANT DISBURSEMENTS 6 Small decrease since Going down but Nov 206 reporting last measurement still above target Partners 8 months 4 Governance PARTNER after GROUP start 0/8 completed; TCA another ACTIVITIES ON TRACK Nov PEF 206 BOARD ATTENDANCE.6m6 close to completion 5% 8% reporting.6 MONTHS TARGET: 90% (206) PREV:.7M TARGET: 9 MONTHS (206) NEW VACCINE COVERAGE out of 4 countries 2 AUDITS ON TRACK 89% 56% with surveys met target TARGET: 90% (206) PREV: 0% TARGET: 80% (206) MEASLES CAMPAIGN COVERAGE HSS PROPOSAL QUALITY HSS FUND UTILISATION PREV: 56% HSS GRANT TARGETS PREV: % 45% 75% TARGET: 90% (206) 90% TARGET: N/A TARGET: N/A TARGET: 80% (2020) point from target Above target but limited 6% number reporting RISK MANAGEMENT PLAN PROGRESS PROGRAMME FINANCE FORECAST PREV: -% -0% -8% 9% TARGET: +/- 0% (206) TARGET: +/- 0% (206) 2 6 7 PREV: 0% SFA/PEF ACHIEVEMENTS CSO ENGAGEMENT 20%* TARGET: 80% (206) PREV: 90% TARGET: 80% (206) TARGET: N/A 4 OPERATING EFFICIENCY 4 PLEDGE CONVERSION Still reflects DONORS 205 $29K 80% baseline from JAs PREV: $2K TARGET: N/A TARGET: 80% (206) 5 OPERATIONAL DEMAND Caused FORECASTby IPV and 5 DONOR cash ENGAGEMENT IN COUNTRY programme delays 70% EVALUATION ALIGNMENT 6 EVALUATIONS COUNTRY REPORTING PREV: 54% 7% TARGET: 80% (206) CSO TARGET: 00% (206) DONORS TARGET: N/A COUNTRIES 80% PEF TARGET: 75% (206) 2 * SECRETARIAT SUPPORT TO GOVERNANCE TO BE REPORTED AT JUNE BOARD TARGET: N/A overall, 46% for the Board HSS TCA No target; tracking trend over time 205 baseline; value to be updated in Q following improvements to data sources to be implemented over 207 JA season SFA PEF CSO PREV: 85% GENDER BALANCE % PREV: 7% Health system strengthening Targeted country assistance Strategic focus area Partners' engagement framework Civil society organisation TARGET: 90% (206) TARGET: 40-60% (206) Gender balance now 6%
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