Also, one challenge on adjusting based on discussions with a country’s government or health service is that you’re going to lose some efficiencies/economies of scale. Each country has different priorities and resources, so different programs will be at the margin in each.
Jason, agreed that there are some scale advantages for certain multilaterals. However it could be possible to retain these with a shift to a marginal aid approach. For example, even if countries were to move to support vaccination through domestic financing, Gavi might continue to provide support on pooled procurement.
Also, one challenge on adjusting based on discussions with a country’s government or health service is that you’re going to lose some efficiencies/economies of scale. Each country has different priorities and resources, so different programs will be at the margin in each.
Jason, agreed that there are some scale advantages for certain multilaterals. However it could be possible to retain these with a shift to a marginal aid approach. For example, even if countries were to move to support vaccination through domestic financing, Gavi might continue to provide support on pooled procurement.