Health aid in transition: a review of Gavi, the Vaccine Alliance

Summary

1. Gavi, the Vaccine Alliance (Gavi) has a clear Eligibility and Transition Policy. Eligibility is determined
   using the World Bank’s estimate of gross national income per capita (GNI p.c.).
2. Gavi’s Co-financing Policy is used to determine how much countries will contribute to the cost of
   Gavi-supported vaccines. Gavi’s aim is to support countries based on their ability to pay. A country’s
   co-financing responsibility gradually increases as its GNI p.c. increases.
3. Gavi has four phases of transition: initial self-financing, preparatory transition, accelerated transition, and fully self-financing. A country is considered transitioning when it begins the accelerated
   transition phase, and is considered transitioned when it reaches the fully self-financing stage. The
   goal of these four phases is to help promote financial sustainability through a gradual reduction of
   Gavi financial support paired with a gradual increase of domestic resources.
4. By 2021, eighteen countries are projected to transition out of Gavi support. As of 2019, six countries
   are in the accelerated Gavi transition phase. Another six countries are projected to enter the accelerated transition phase between 2021-2025.
5. Gavi provides both financial and technical support during and after a country’s transition via transition grants, targeted country assistance, and post-transition technical support.