Strengthening the global ecosystem
to better deliver vaccines

The value of investing in lifesaving vaccines and immunization programs is well understood, but progress on extending coverage of routine immunization to reach all children has stagnated.

That’s why Gavi, the Vaccine Alliance has supported many low-resourced countries in strengthening their national immunization programs. But as the economies of these countries grow, they are required to transition away from Gavi support to full domestic financing of their programs — and they need support in navigating the challenges that come with this transition.

In 2017, R4D launched the Learning Network for Countries in Transition (LNCT) — with support from Bill & Melinda Gates Foundation and Gavi — and began serving as its network coordinator. Using a variety of collaborative learning modalities, R4D engaged policymakers and practitioners and supported them to unpack common challenges and generate new knowledge and practical solutions to make informed resource allocation and programmatic decisions.

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One of the main collaborative learning modalities LNCT facilitates is the in-person or online workshop, which enables in-depth learning and cross-country experience-sharing on a specific priority topic within the learning agenda. Photo © Adrian Wiradjaja for the Learning Network for Countries in Transition

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Another collaborative learning modality LNCT employs is country pairings, which enables ongoing peer support between two countries to address a common challenge. For example, through LNCT, R4D facilitated an exchange between Congo and Cote d’Ivoire on a rotavirus vaccine switch. Following the success of that conversation, the two countries wished to continue the exchange to discuss strengthening their National Immunization Technical Advisory Groups. Photo © Adrian Wiradjaja for the Learning Network for Countries in Transition

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Since 2018, LNCT has hosted 20 webinars — aimed at helping countries share their common challenges and experiences. For example, in May 2021, LNCT — in partnership with the Curatio International Foundation — held a regional webinar to discuss strategies and challenges related to the rollout of the COVID-19 vaccine in LNCT’s European countries — Armenia, Azerbaijan, Georgia, Moldova, and Uzbekistan.

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In partnership with Common Thread, LNCT developed two video case studies on vaccine demand in Vietnam. The stories detail the immunization journeys of young mothers in the H’mong community of Yên Bái Province, Cha and Do, through short films to be used for health worker capacity building. Their stories, captured in their own words, show how community engagement strategies can be used effectively to create empathy and build demand for vaccines among vulnerable groups.

Through LNCT, R4D supported 20 member countries undergoing Gavi transition across Europe, Africa and the Asia-Pacific region. We implemented a country-driven learning agenda, and produced 50 global public goods focused on improving the sustainability of immunization programs. These resources have been accessed by more than 20,000 users in more than 120 countries. In addition, LNCT rapidly pivoted to support an all-virtual learning agenda during the COVID-19 pandemic, integrated COVID-relevant topics into LNCT activities, and developed new learning modalities to be responsive to pandemic realities and member needs.

Based on the success of LNCT, Gavi re-engaged R4D in September 2021 to support former-Gavi middle-income countries in sustaining their immunization program performance. The program will also support countries that have never received Gavi assistance to introduce essential new vaccines. The goal of this new 5-year project is to ensure these countries do not backslide on their hard-won progress against vaccine-preventable diseases, and to improve global equity in accessing lifesaving vaccines.

What change agents are saying about LNCT

In 2021, R4D surveyed 247 government and non-government officials from 17 member countries to find out whether they felt LNCT had made positive contributions to their immunization efforts. The vast majority of respondents felt LNCT had contributed to their successes:

89% of respondents felt their country had progressed toward a more sustainable immunization program.
92% of respondents felt that LNCT had contributed at least “some” to their country’s successful transition, and 57% felt it had contributed “a lot.”

We went on a journey that allowed us to change with other countries in transition and those who have succeeded. We had similar experiences to other countries. It reassured us that we are in the right transition process.”
—Anonymous respondent

Banner photo © USAID/Fernando Fidélis, MCSP

Collaborative learning platform on immunization financing

In 2017, R4D began serving as the network coordinator of the Learning Network for Countries in Transition (LNCT) which used collaborative learning to support immunization program practitioners and policymakers in countries transitioning from Gavi support. Now, R4D leads the Linked Immunization Action Network (Linked) which supports middle-income countries transitioning from Gavi support or that have never received Gavi support.

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Global & Regional Initiatives to Catalyze Stronger Systems

R4D designs and leads global and regional initiatives that connect local leaders and their partners to promote local agendas and achieve locally led results.