Resource Mobilization and Financial Sustainability: Common challenges in preparing for the Gavi transition – Cote d’Ivoire

In Côte d’Ivoire, the transition away from Gavi financing represents one of the most significant programmatic and financial challenges facing the national immunization programme. Having benefited from Gavi support since 2001, the country entered the accelerated transition phase in late 2022, with a target of full self-financing by 2030. This transition implies a more than fourfold increase in the country’s co-financing obligation — from approximately US$6.2 million in 2023 to US$32 million in 2029 — compounded by the recent introduction of the malaria vaccine into the co-financed portfolio. Preparation efforts have followed a phased approach since 2016, encompassing government advocacy through budget conferences and cabinet sessions, a formal government attestation for advance vaccine procurement, progressive budget increases for vaccine purchasing, and the operationalisation of the Abidjan Declaration — a joint commitment with nine transition-phase countries to shift toward sustainable domestic vaccination financing. Key assets include a secured budget line for vaccines in the national budget, an integrated health fund spanning HIV, malaria, tuberculosis, and EPI, and a dedicated secretariat for Abidjan Declaration follow-up. Opportunities include a memorandum of understanding with UNICEF providing access to the Copenhagen procurement hub and a US$5 million overdraft facility under the Vaccine Independence Initiative. Risks include persistent shortfalls between projected and allocated budgets, delays in fund transfers that risk stockouts, and the structural challenge of financing six months of vaccines in advance — a prerequisite for sustained supply security.

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