In 2009, the GAVI Alliance Board approved a revision of its eligibility policy, under which countries with GNI per capita above US$ 1500 will graduate from GAVI support. Any country exceeding the eligibility threshold will be reclassified as a graduating country, and lose the option of requesting extensions or introducing new vaccines with GAVI support. One year later, the Board approved a change in the co-financing policy: starting in 2010, countries reclassified as graduating will have a grace period of one year, after which time their share of the total financial burden (their so called co-financing requirement) will increase linearly over four years until 100 percent of the cost is covered from domestic sources. These changes have tremendous ramifications for developing countries currently receiving financial and technical support from the Alliance. Current graduating countries include: Angola, Armenia, Azerbaijan, Bhutan, Bolivia, Congo, Cuba, Georgia, Guyana, Honduras, Indonesia, Kiribati, Moldova, Mongolia, Sri Lanka and Ukraine.
In 2012, the GAVI Alliance, in cooperation with the World Health Organization, plan to assess the situation on the ground in priority graduating countries, and to outline prospects and a potential transition plan to sustain their immunization program following graduation from GAVI support.
The GAVI Alliance and WHO have approached R4D to provide expert technical assistance to the graduation process. R4D’s contribution will include:
- Providing input to a WHO framework for analyzing and assessing country readiness to assume full vaccine financial responsibility
- Participating in visits to four priority countries, to assess the situation on the ground and work with national and international stakeholders to design an optimal program of support
- Helping WHO to foster peer-to-peer exchanges among graduating countries, including organizing a workshop in late 2012 to bring counties together.