BACKGROUND Introduction of new vaccines in low- and lower middle-income countries has accelerated since Gavi, the Vaccine Alliance was established in 2000. This study sought to (i) estimate the costs of introducing pneumococcal conjugate vaccine, rotavirus vaccine and a second dose of measles vaccine in Zambia; and (ii) assess affordability of the new vaccines in relation to Gavi's co-financing...

BACKGROUND The GAVI Alliance was created in 2000 to increase access to vaccines. More recently, GAVI has supported evidence-based health systems strengthening to overcome barriers to vaccination. Our objectives were: to explore countries' priorities for health systems strengthening; to describe published research summaries for each priority area in relation to their number, quality and relevanc...

Orin S. Levine, Thomas Cherian, Rana Hajjeh, and Maria Deloria Knoll GAVI Alliance’s PneumoADIP, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Hib Initiative, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Atlanta, Georgia; and Immunizations, Vaccines, and Biologics, World Health Organizatio...

Shortages, geographic imbalances and poor performance of health workers pose major challenges for improving health service delivery in developing countries. In response, multilateral agencies have increasingly recognized the need to invest in human resources for health (HRH) to assist countries in achieving their health system goals. In this paper we analyse the HRH-related activities of three ...

1596 www.thelancet.com Vol 374 November 7, 2009 direct engagement with countries, and weak design and assessment mechanisms. GAVI relies on in-country WHO and UNICEF staff , both better versed in immunisation than in health systems, and the Global Fund relies on country coordinating mechanisms whose members have disease-specifi c interests, mostly HIV. Both use panels in Geneva—the Independent ...

BACKGROUND Rotavirus infection is responsible for about 500,000 deaths annually, and the disease burden is disproportionately borne by children in low-income countries. Recently the World Health Organization (WHO) has released a global recommendation that all countries include infant rotavirus vaccination in their national immunization programs. Our objective was to provide information on the e...

Luis Sambo, Margaret Chan, Steve Davis, Anthony Lake, Seth Berkley, Cyrus Poonawalla, and Christopher J. Elias World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo; World Health Organization, Geneva, Switzerland; PATH, Seattle, Washington; United Nations Children’s Fund, New York, New York; Gavi, Geneva, Switzerland; Serum Institute of India Ltd, Pune; and Bill ...

BACKGROUND Adoption of new and underutilized vaccines by national immunization programs is an essential step towards reducing child mortality. Policy decisions to adopt new vaccines in high mortality countries often lag behind decisions in high-income countries. Using the case of Haemophilus influenzae type b (Hib) vaccine, this paper endeavors to explain these delays through the analysis of co...