KEYWORDS:
Financial sustainability
Indicators
Developing countries

BACKGROUND:
The Global Alliance on Vaccines and Immunizations requires countries benefiting from its Vaccine Fund to submit financial sustainability plans.

OBJECTIVE(S):
To describe and analyze the indicators of financial sustainability chosen by GAVI.

METHOD(S):
The indicators were developed and refined using a bottom-up approach, complemented by technical analysis. The technical analysis included simulation of proposed indicators and wide circulation of drafts for comment, followed by analysis to respond to the comments received.

RESULT(S):
GAVI chose three indicators. They are: (1) annual national spending on program-specific costs as a share of GDP adjusted for debt service; (2) national spending over the past five years on program-specific operating costs as a share of GDP adjusted for debt service; and (3) donor spending and commitments as a share of actual past and projected future costs.

CONCLUSIONS(S):
The selected indicators appear to be analytically sound. They capture the major elements of the GAVI definition of financial sustainability, excepting efficient use of resources.

LEARNING OBJECTIVES:
1. Understand how and why GAVI chose its financial sustainability indicators.
2. Understand the analytical basis for the indicators.