Gavi, the Vaccine Alliance, has played a critical role in helping African countries secure lifesaving COVID-19 vaccines. It has also supported national efforts to maintain vaccination campaigns for other vaccine-preventable diseases during the pandemic. Dr Marthe Sylvie Essengue Elouma, Regional Head for Francophone Africa at Gavi, shares challenges, lessons learned from the pandemic and how to build back better health systems.

What worked well when your organization was supporting countries to respond to COVID-19 pandemic?

 We supported countries in many areas including quick access to funding, technical assistance, Cold Chain equipment and others. To each this objective, Gavi improved its internal processes of accessing funding by introducing more flexibility and simplification in the application, review and disbursement processes.

We also worked with expanded programme of immunization (EPI) in countries to introduce flexibility for them to reallocate 10% of the Health System Strengthening funding in order to respond to the pandemic and protect routine immunization services. Countries were also allowed to reallocate in-country funds or funds not yet disbursed by Gavi to specific activities to maintain, restore and strengthen routine immunization.

In our experience several things worked very well. This includes quick access to funding, complementarity with other funding sources and leveraging existing innovations to support Covid 19 response. We worked well with other partners to build synergies and avoid duplication of efforts in our support to country programs.  In addition, countries where a digitalized data system was in place have integrated Covid data in this system to enable them to have data that could help them to better plan, implement and track the response to COVID-19.

 What challenges did you face?

Our major working contact in countries, the EPI had too many competing priorities that often they struggled to absorb the funding flexibility that we introduced for them to access more funding to support the response.  In addition, the EPI team wasn’t involved in the decision-making process thus wasn’t able to influence decisions related to Covid-19 based on their experience in the field. Because of speed of execution of the response in most cases it was difficult to measure the impact. The EPI teams with weak capacity also delayed implementing key immunization activities.

 What is your advice as Africa is strategizing on building back better?

 Being focused on actions that could bring tangible and sustainable results is key for countries’ preparedness. This requires prioritization and resources allocated accordingly in order to be successful. Donors and partners need to prioritize their support in areas of their competitive advantage.

 Government and partners need to jointly prepare the system beforehand. As Gavi, we think it is important for countries to leverage all existing funding in the country including Covid-19 resources to build resilient health systems. We should assist countries in building information systems that capture good quality data for decision making, building a surveillance system that will facilitate early detection of outbreaks, supporting countries put in place robust financial management systems that can ensure the efficient transfer of funds from the central to the community level to facilitate implementation. Moreover, procurement systems should be improved to facilitate access to goods including during a pandemic. Similarly, EPIs should be strengthened with managerial and communication capacities to influence decision making at high level. We can also respond better if we have better coordination, better methods of measuring results.