The World Bank
1818 H Street, NW
Washington, D.C. 20433
U.S.A.

James Christopher Lovelace
Director
Health, Nutrition and Population

Dear Ms. Hayes,

Thank you for your letter of March 15, 2001 to Mr. Wolfensohn, in which you shared your concerns about some aspects of the Global Alliance for Vaccines and Immunization (GAVI). As the World Bank's representative on the GAVI Board, I have been asked to respond on his behalf.

We appreciate the interest that Health Action International has in GAVI and its continuing evolution. A number of GAVI partners are working to address the concerns you raise in your letter. While no one agency or organization can speak for GAVI as a whole, we in the Bank would like to invite you to continue to dialogue on immunization services and other GAVI-related areas either with us or directly with the lead partners such as UNICEF or the World Health Organization.

On the issue of financial sustainability that was raised, and perhaps to clarify a bit, funding from the Global Fund for Children's Vaccines was never intended by GAVI to replace existing or potential other sources of funding for immunization: rather, it was meant to be catalytic. Insofar as a number of other donor governments are now contributing to this effort, and renewed enthusiasm for meeting immunization goals is apparent, GAVI has helped to catalyze action on immunization activities.

Several GAVI partners have nevertheless been concerned, as you are, about key questions related to financial sustainability of vaccines and immunization services. As one avenue for addressing such issues, a sub-committee of the GAVI Task Force on Financing (FTF), which the Bank co-chairs, is completing a document which specifically addresses issues related to financial sustainability. The FTF is establishing a link on the GAVI website (www.VaccineAlliance.org) in which these financing papers will be made broadly available for wider dissemination and discussion, and we invite your comment.

As you know, the World Bank Group works with partners to support national and regional communicable disease control and health sector reform efforts, and it supports activities which address diseases of the poor. Through GAVI mechanisms, we have begun to see improved coordination among partners at country and global level. With Ministries of Health and other GAVI partners, we share the goal of striving to ensure that immunization needs are met on a sustainable basis--now, and for the future.

We would appreciate receiving a copy of the public/private interactions seminar report you mentioned. If you would like to discuss your ideas and concerns further, please contact my colleague, Ms. Amie Batson, who is a member of the GAVI Working Group. Currently, she is out of town and away from the office, but she will return April 6, 2001 should you wish to follow up with her.

GAVI welcomes new partners and new inspirations. Thank you for your interest in GAVI and the World Bank's role in it.

Sincerely yours,

Chris Lovelace
Director
Health, Nutrition and Population
Human Development Network