Department of Global Health, University of Washington, Harris Hydraulics Laboratory, Box 357965, Seattle, WA 98195, USA; Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121, USA.
Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Avenue, Suite 600, Seattle, WA 98121, USA.
Vaccine. 2018 Nov 26;36(49):7487-7495. doi: 10.1016/j.vaccine.2018.10.062. Epub 2018 Oct 23.
Efforts driving universal coverage have recently been strengthened through implementation of the Global Vaccine Action Plan (GVAP) where cost estimates for immunization support were developed totaling US$40 billion of donor assistance by 2020. In addition to resource mobilization, there has been an increasing focus on improving both vaccine access and delivery systems. We track donor assistance for immunization by funding objective and channel from 1990 to 2016, and illustrate projections through 2020 to inform progress of the GVAP. Using available data from development agencies supporting immunization, we categorize funding by vaccine and quantify support for systems strengthening. We split time into four periods including the post universal childhood immunization era (1990-1999) and Gavi's three funding phases between 2000 and 2015, during which annualized funding changes are estimated. Lastly, we perform a linear extrapolation through 2020 to predict the success of stipulated resource mobilization targets. Double counting was eliminated and results presented in real 2017 US dollars. Over the last 27 years, funding for immunization increased by 10.5% annually, with non-Gavi funding increasing by 7.1% and Gavi funding by 23.6% in the last 17 years. Gavi disbursements targeting vaccines and health system improvements increased uniformly at 15%, compared to 22.5% for vaccines and 11.7% for system strengthening from non-Gavi channels. Funding fluctuated for non-Gavi channels with disbursements declining before 2000 and during Gavi funding phase II, while Gavi disbursements continued to grow relative the previous phase. New and underused vaccines were prioritized by Gavi whereas non-Gavi channels focused on elimination efforts. Projected funding targets were estimated to be on track for Gavi contrary to non-Gavi support which was estimated to remain 40% below the stipulated target. Renewed assessments for funding requirements need to be undertaken, while strengthening existing resource efficiencies in order to achieve current global universal coverage targets.
为推动全民覆盖，全球疫苗行动计划（GVAP）得以实施，该计划预计 2020 年之前，免疫支持的成本将达到 400 亿美元，其中包括来自捐助方的 400 亿美元援助。除了资源调动，还越来越重视改善疫苗获取和提供系统。我们按供资目标和渠道追踪免疫方面的捐助方援助，时间跨度为 1990 年至 2016 年，并通过 2020 年的预测来展示进展情况。我们使用支持免疫的发展机构的现有数据，对疫苗进行资金分类，并量化支持系统强化的资金。我们将时间分为四个时期，包括普及儿童免疫接种时代（1990-1999 年）和 2000 年至 2015 年加维的三个供资阶段，在此期间估计了年化供资变化。最后，我们通过线性外推法预测 2020 年的规定资源调动目标是否能实现。我们消除了重复计算，结果以实际 2017 年美元呈现。在过去的 27 年里，免疫供资每年增长 10.5%，其中非加维供资增长 7.1%，过去 17 年加维供资增长 23.6%。加维在疫苗和卫生系统改善方面的支出增加了 15%，而同期非加维渠道的疫苗支出增加了 22.5%，系统强化支出增加了 11.7%。非加维渠道的供资波动较大，2000 年前和加维供资第二阶段供资下降，而加维供资继续增长。加维优先考虑新疫苗和使用不足的疫苗，而非加维渠道则侧重于消除努力。据估计，加维的项目供资目标有望实现，而非加维的供资则估计仍比规定目标低 40%。需要对供资需求进行重新评估，同时加强现有资源效率，以实现当前全球全民覆盖目标。
