A conversation with the Gates Foundation (Immunization) on August 20, 2012


Funding gap in routine immunization

Ms. Mitchell believes that there are funding opportunities to extend and improve routing immunization. While some national governments receive technical assistance from WHO and UNICEF and support for strengthening health and immunization systems from GAVI, they are otherwise responsible for funding and delivering vaccines.

In the past, WHO and UNICEF had many more staff focused on immunization. UNICEF used to play a much larger role in implementation of routine immunization systems in many countries. As there has been more of a focus since the late 1980s and 1990s on country ownership and global focus has shifted to other priorities such as polio eradication, UNICEF has scaled back its work on routine vaccination. There are now only a handful of staff at UNICEF focused on routine vaccination (there are others focused on specific vaccination efforts, such as polio eradication). There is now a general feeling in the global health community that there has been too little emphasis on routine vaccine in recent years.

Funders and implementers have begun to coordinate more in some countries, such as Chad and DRC, to develop a common immunization plan that includes groups such as the Measles and Rubella Initiative and the Global Polio Eradication Initiative, which had previously operated independently of one another.​

Gates Foundation approach to measles/rubella control

Good Ventures and GiveWell asked for Ms. Mitchell's opinion on three vaccination campaign initiatives: Measles and Rubella Initiative, Maternal and Neonatal Tetanus Elimination Initiative, and meningitis A vaccination campaigns.

Ms. Mitchell said that she believed them all to be good uses of funding. One of the challenges with funding for campaigns is that while countries set aside funding for regular GAVI co-payments, they are rarely able to plan sufficiently to support campaigns, which are less predictable.