The Global Alliance for Vaccines and Immunization (GAVI), which provides more than a billion dollars a year to the poorest developing countries to strengthen and improve their immunization systems, faced a difficult challenge in determining which countries should be eligible for support in the coming years.

Should access to aid be based on a country’s average per capita income or the number of children currently not being reached with vaccinations? Or some other criteria? How often should thresholds be updated, and how should graduation from GAVI eligibility be handled?

To answer these questions, GAVI engaged the Results for Development Institute (R4D) to carry out a major study on GAVI’s policies on “country eligibility." Over the course of eight months, the R4D team, assessed the strengths and weaknesses of the current eligibility criteria and their consistency with GAVI’s strategic goals; identified new eligibility policy options; evaluated the potential impact of these options on GAVI’s future expenditures and vaccine markets and prices; and proposed improved processes for applying and updating the eligibility policy. The results of the study were presented to the GAVI Board at the annual meeting in November, 2009.

Major deliverables of the project included an inception report, six country case studies, a technical brief on the pharmaceutical manufacturers' likely response to changes in GAVI eligibility policies, a model projecting the future financial requirements of the organization, and draft and final reports to GAVI. These products will be made available in the coming months.