Transitioning from Gavi Support in Lower-Middle-Income Countries

April 25, 2016

Since 2000, the U.S. government has been a strong partner of Gavi, the Vaccine Alliance, providing more than US$730 million through the end of September 2015 to support the introduction of new and underutilized vaccines in the world’s poorest countries. Lower-income countries receiving Gavi assistance have long been required to cofinance a portion of each vaccine dose procured with Gavi funds, with the expectation that as the countries reach lower-middle-income country status (LMIC), they will eventually transition away from Gavi support. To date, at least 24 of the original 73 Gavi-eligible countries have started to transition, with 16 expected to complete the process by the end of 2018.
 
The long history of U.S. support for global maternal and child health programs, its emphasis on assisting countries in strengthening their immunization programs, and considerable U.S. investments in Gavi over the past 15 years all underscore why the United States has an interest in ensuring LMIC transitions from Gavi support proceed smoothly and sustainably. Yet in many LMICs, the United States is scaling back its bilateral engagement on health. Examining the factors shaping the way countries in Latin America and the Caribbean are experiencing the Gavi transition process provides a helpful lens through which to examine options for U.S. engagement to support the sustainability of immunization programs in LMICs.