KEYWORD1:
financing, sustainability, GAVI, Vaccine Fund

BACKGROUND:
The Global Alliance for Vaccines and Immunization (GAVI) and the Vaccine Fund (VF) requires that its beneficiary countries submit a financial sustainability plan (FSP) within two years of receiving assistance. Cambodia was one of the countries receiving support in the first round of applications, and so its FSP was due in November 2002. Technical assistance was required to help Cambodia in preparing its FSP.

OBJECTIVE:
To collect data and facilitate relationships in order to prepare an FSP for the immunization program in Cambodia.

METHOD:
Data was gathered on the cost of the immunization program in 2001 and 2002, the current and planned health sector budget, and anticipated GAVi support. Projections of program costs through 2009 were made based on data on current costs.

RESULT:
The costs of the immunization program are expected to increase significantly over the next seven years, from $4.7 million in 2002 to $7.4 million in 2009. While the secure and probably funding is expected to cover nearly the full cost of the program in 2003, significant funding gaps are projected in future years.

CONCLUSION:
The concept and process of the FSP is a good starting point to help countries better plan and budget for immunization services, but the format of the FSP is time consuming and some sections are not helpful to country planning. The FSP process stimulated high level interest in immunization financing. The existence of a global fund, or multi-year commitments, is useful to protect countries against unforeseen changes in donor funding.
LEARNINGOBJECTIVES:
To describe the FSP process in Cambodia, to provide financing data for the immunization program, and to draw lessons that may be valuable to other GAVI/VF recipient countries and for GAVI and the VF.