Prioritizing Emergency Polio Eradication Activities

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Prioritizing Emergency Polio Eradication Activities Managing the Financing Gap the other half of the Emergency Hamid Jafari

GPEI Financing 2012-13: Budget = $2.23 b - Confirmed contributions = $1.14 b G8 10% JICA Loan Conversion Japan Canada USAID USCDC UK Russian Federation EC India Domestic Resources 19% UNICEF Nepal WHO Multilateral Sector 5% IFFIm World Bank Bill and Melinda Gates Foundation Private Sector 14% Rotary International 2012-13 Funding Gap: US$1.09 B of $2.23 B budget Angola Australia Luxembourg Monaco Non-G8 OECD/ Other 2% As of 31 January 2012

Context There is a > $1Billion (50%) shortfall in funding for 2012-13 The shortfall has already forced cuts in planned activities for 2012 This presentation is to alert SAGE on: The funding crisis Cancelled or postponed activities Planned additional cuts Balancing risks associated with cuts Strategies to reduce the shortfall

Major Categories of Activities Core costs: Surveillance & Lab support Personnel (technical assistance) Emergency Surge Outbreak response Supplementary Immunization (SIAs) costs Vaccine Operations Social Mobilization

GLOBAL POLIO ERADICATION INITIATIVE Summary of external resource requirements by major category of activity 2012-2013 (all figures in US$) Core Costs 2012 2013 2012-2013 Emergency Response (OPV) $22,000,000 $20,000,000 $42,000,000 Emergency Response (Ops) $40,000,000 $25,000,000 $65,000,000 Emergency Response (Soc Mob) $12,000,000 $6,000,000 $18,000,000 Surveillance and Running Costs (Incl. Security) $62,423,360 $64,357,731 $126,781,091 Laboratory $11,031,768 $11,225,651 $22,257,419 Technical Assistance (WHO) $148,067,410 $136,571,838 $284,639,248 Technical Assistance (UNICEF) $38,683,273 $37,311,747 $75,995,020 Certification and Containment $5,000,000 $5,000,000 $10,000,000 Product Development for OPV Cessation $10,000,000 $10,000,000 $20,000,000 Post-eradication OPV Stockpile $12,300,000 $0 $12,300,000 Supplementary Immunization Activities 2012 2013 2012-2013 Oral Polio Vaccine $313,853,241 $285,631,848 $599,485,089 NIDs/SNIDs Operations (WHO-Bilateral)) $344,760,618 $248,388,533 $593,149,151 NIDs/SNIDs Operations (UNICEF) $31,492,275 $28,151,088 $59,643,363 Social Mobilization for SIAs $96,919,559 $93,680,410 $190,599,969 Subtotal $1,148,531,505 $971,318,845 $2,119,850,350 70% of the costs in 2012 for SIAs 16% for technical assistance Programme Support Costs (estimated) $59,756,791 $52,490,265 $112,247,057 GRAND TOTAL $1,208,288,296 $1,023,809,110 $2,232,097,406 Contributions $803,000,000 $340,000,000 $1,143,000,000 Funding Gap $405,288,296 $683,809,110 $1,089,097,406 2012 Funding Gap: $405 M Funding Gap (rounded) $405,000,000 $685,000,000 $1,090,000,000

Prioritization for Funding Personnel plus emergency surge for 12 months Surveillance and Lab 9 months SIAs in priority countries 6 months Nigeria, Pakistan, Afghanistan Chad, DRC Outbreak response 3 months Highest risk countries recurrent infection

2012 SIA Calendar as of April 2012 (grey = cancelled due to lack of funds in first half of 2012) 2012 Region/Country J F M A M J J A S O N D Endemic countries Afghanistan 40 41 30 10 30 10 Pakistan 66 60 30 30 30 30 Nigeria 60 60 60 60 30 30 India 16 50 50 50 Countries with re-established transmission DR Congo CHD 18 8 8 10 48 50 30 30 Chad CHD 50 50 Angola CHD 30 30 50 Sudan 50 50 50 50 South Sudan 50 50 50 50 Countries with recurrent importations West Africa Niger 61 21 50 50 Cote d'ivoire Guinea CHD 75 Mali Liberia Burkina Faso Sierra Leone CHD Ghana Mauritania Senegal Benin Gambia Guinea Bissau CHD 92 Togo Cape Verde Horn of Africa Yemen CHD Kenya 35 65 35 65 Somalia CHD Uganda 35 65 CHD 35 65 Ethiopia 20 30 20 30 Djibouti Eritrea SIAs maintained in all countries reporting CHD 49 Central Africa Central African Republic Congo Gabon* Cameroon transmission within the last 12 months 44 CHD 44 20 30 20 30 Burundi CHD 89 Rwanda CHD Other importation-affected countries Southeast Asia Nepal CHD 20 CHD 60 CHD 20 Myanmar CHD Bangladesh Europe Russian Federation* Tajikistan Uzbekistan 50 50 50 50 50 50 50 50 Georgia* Ukraine 50 50 Not Conducted due to lack of funds Kyrgyzstan 50 50 50 50 Kazakhstan Not Conducted for other reasons Turkmenistan *self-financing and not included in the FRR costing Countries with poliovirus within the last 6 months Countries with poliovirus between 6 and 12 months Countries with no poliovirus for more than 12 months New activities proposed since January

2012 SIA Calendar if further prioritization required (grey = cancelled due to lack of funds full year) 2012 Region/Country J F M A M J J A S O N D Endemic countries Afghanistan 40 41 30 10 30 10 Pakistan 66 60 30 30 30 30 Nigeria 60 60 60 60 30 30 India 16 50 50 50 Countries with re-established transmission DR Congo CHD 18 8 8 10 48 50 30 30 Chad CHD 50 50 Angola CHD 30 30 50 Sudan 50 50 50 50 South Sudan 50 50 50 50 Countries with recurrent importations West Africa Niger 61 21 50 50 Cote d'ivoire Guinea CHD 75 Mali Liberia Burkina Faso Sierra Leone CHD Ghana Mauritania Senegal Benin Gambia Guinea Bissau CHD 92 Togo Cape Verde Horn of Africa Yemen CHD Kenya 35 65 35 65 Somalia CHD Uganda 35 65 CHD 35 65 Ethiopia 20 30 20 30 Djibouti Eritrea CHD 49 Central Africa Central African Republic 1 Congo Gabon* Cameroon 44 CHD 44 20 30 20 30 Burundi CHD 89 Rwanda CHD Other importation-affected countries Southeast Asia Nepal CHD 20 CHD 60 CHD 20 Myanmar CHD Bangladesh Russian Federation* Tajikistan 50 50 50 50 Europe Uzbekistan 50 50 50 50 Countries with poliovirus within the last 6 months Countries with poliovirus between 6 and 12 months Countries with no poliovirus for more than 12 months Georgia* 50 50 Not Conducted due to lack of funds Ukraine Kyrgyzstan 50 50 50 50 Not Conducted for other reasons Kazakhstan New activities proposed since January Turkmenistan With these cuts in 2012, shortfall reduced by $105 M

Countries with recent poliovirus transmission SIAs during 1 st half 2012 Countries with PV within last 6 months Countries with PV between 6-12 months Endemic / Re-established transmission Countries with 1-2 SIAs Countries with 3 SIAs Data at WHO/HQ as of 03 April 2012 Disputed territories

Countries with SIAs cancelled or scaled back due to lack of funds 1st half 2012 2nd half 2012 Countries with 1 SIA cancelled Countries with scale-back in SIA Data at WHO/HQ as of 03 April 2012 Disputed territories

Shortfall Budget Summary USD millions 2012 2013 12-13 TOTAL Total Budget $1,208 $1,024 $2,232 Available Funds $803 $340 $1,143 Funding Gap $405 $684 $1,089 New Funding Since Jan 2012 $40 $2 $42 Updated Funding Gap $365 $682 $1,047 75% Likely Prospects $135 $102 $237 Updated Funding Gap $230 $580 $810 Budget Cuts to Date (Jan to Jun) $50 $00 $50 Updated Funding Gap $180 $580 $760 Planned Budget Cuts (Jul to Dec) $55 $00 $55 Updated Funding Gap $125 $580 $705

Strategies to Manage the Funding Crisis Cut or postpone activities Realize 75% likely commitments Scrutinize budget and cut further Complete Value for Money initiative by BMGF, WHO & UNICEF Enlist and re-engage new and past donors

Strategies to Manage the Funding Crisis - 2 Success of Rotary s new challenge Develop innovative financing Partner with GAVI and other immunization groups

Summary $1.09 B shortfall in 2012-13 Of this, $405 M in 2012 Financing prioritized to TA/emergency surge, surveillance, SIAs in priority countries & outbreaks SIAs curtailed and scaled back in 24 countries in 1st half of 2012 ($ 50 M in cuts) Additional cuts in 24 countries in 2 nd half 2012 ($55 M) reduce total year shortfall by $105 M Even with additional confirmed and 75% likely funding, shortfall in 2012 of $125 M

Summary - 2 If the funding gap for 2012 is not filled, the next series of cuts proposed affect: SIAs in Chad, DRC, Sudan Pakistan, Nigeria and Afghanistan Surveillance Gaps in 2013 will affect funding of staff $110 M needed by December 2012

Question to SAGE Does SAGE concur with the suggested order of priorities for activities in response to the financing gap?