Your search found 118 Results
Position statement on condoms and the prevention of HIV, other sexually transmitted infections and unintended pregnancy.
[Geneva, Switzerland], UNAIDS, 2015 Jul 7.  p.Condoms are a critical component in a comprehensive and sustainable approach to the prevention of HIV and other sexually transmitted infections (STIs) and are effective for preventing unintended pregnancies. Male and female condoms are the only devices that both reduce the transmission of HIV and other sexually transmitted infections (STIs) and prevent unintended pregnancy. Condoms have played a decisive role in HIV, STI and pregnancy prevention efforts in many countries. Condoms remain a key component of high-impact HIV prevention programmes. Quality-assured condoms must be readily available universally, either free or at low cost. Programmes promoting condoms must address stigma and gender-based and socio-cultural factors that hinder effective access and use of condoms. Adequate investment in and further scale up of condom promotion is required to sustain responses to HIV, other STIs, and unintended pregnancy. (Excerpts)
Antiviral therapy. 2014; 19 Suppl 3:1.Add to my documents.
New York, New York, United Nations Commission on Life-Saving Commodities for Women and Children, 2012 Sep.  p.The United Nations Commission on Life-Saving Commodities for Women and Children presents a new plan and set of recommendations to improve the supply and access of life-saving health supplies.
The USAID | DELIVER project improves patient access to essential medicines in Zambia. Success story.
Arlington, Virginia, JSI, DELIVER, 2011 Feb.  p.Success story on a logistics system pilot project in Zambia that set out to cost-effectively improve the availability of lifesaving drugs and other essential products at health facilities.
Nature. 2008 Jul 31; 454(7204):551.The fight against AIDS is losing ground, but the current spate of mud-slinging is far from helpful. The global conversation about AIDS is beginning to sound like a high-decibel exercise in finger-pointing and blame. This dangerous trend should be on the minds of the thousands of attendees convening in Mexico City this weekend for the XVII International AIDS Conference. Thirty-three million people around the world are HIV-positive, and more than 6,800 become infected every day. Tests on microbicides and vaccines have failed, and have put some volunteers at greater risk of HIV infection. Yet critics are attacking the very programmes and people trying to solve these problems, with some even calling for an end to government spending on the search for a vaccine. This is an overreaction. As many scientists point out, the search for a malaria vaccine has seen dozens of failed trials, whereas only three AIDS vaccines have so far been tested in efficacy studies. What is needed are better vaccine candidates to test, so it makes sense that the major backers of HIV vaccine trials, including the US National Institutes of Health, are now focusing on the basic research that could help the field move forward. Meanwhile, two books published last year claim that the United Nations AIDS programme, UNAIDS, has led an ineffective, politically motivated response to the disease and has distorted statistics in an effort to garner more money. And critics such as Roger England, who runs a small think tank in Grenada, argue that spending on AIDS has distorted poor countries' priorities and weakened their health systems. England proposes that UNAIDS be shut down, and the money spent on AIDS programmes shifted to general funding for health systems. Amid the debate on these questions, the founding director of UNAIDS, Peter Piot, announced in April that he would step down at the end of this year, throwing the agency into uncertainty at a crucial time. There is no doubt that many poor countries' health systems are struggling, but it is wrong to say that AIDS aid is responsible. In fact, AIDS programmes have shown how poor countries can use new models to deliver needed care, for instance by providing antiretroviral treatments effectively, putting to rest claims that the costly drugs could not be used correctly outside resource-rich nations. It is also wrong to assume that governments will spend money effectively to fight AIDS if given funds to support health systems overall, as England suggests. Today, many strategies for delivering AIDS treatment target groups such as women, homosexuals and intravenous drug users that have been ignored by governments in the past - neglect that fuelled the spread of the disease. More money should be spent on both AIDS and strengthening health-care systems. And this will be possible if donor governments live up to their promises, such as the pledges of general and disease-specific aid to Africa that were repeated this July at the G8 meeting in Japan. On that front, it is heartening that the US House and Senate have reauthorized $48 billion for the President's Emergency Plan for AIDS Relief ($9 billion of which is for fighting malaria and tuberculosis). If President Bush signs the bill as expected, the programme will also permit the US government to reverse the shameful and embarrassing policy that bans travellers with HIV from entering the country. That might serve as an example to other governments that still sanction discrimination against those who are HIV-positive. The world is still far from achieving the goal adopted in 2000 by UN member states, which pledged to provide universal access to AIDS treatment by 2010. Three million people now receive lifesaving antiretroviral drugs, but 70% of those in low- to middle-income countries who need them don't get them. Indeed, the example of wealthy nations themselves shows what happens when they lose focus on AIDS. In the United States, for instance, reports now indicate that HIV infection rates have begun to rise in Latinos and young gay men. The activists and scientists about to meet in Mexico City must demand that leaders keep their eye on the ball. The world now has models for providing treatment and care in the places that sorely need it, and is in a position to make more tangible gains against AIDS. This is no time to backslide, and the Mexico City meeting must deliver this message loud and clear. (full-text)
Washington, D.C., World Bank, Knowledge and Learning Center, 2005 Nov.  p. (Findings Infobriefs No. 118; Good Practice Infobrief)The Mali Multi-sectoral AIDS Project (MAP) began implementation in late 2004 and is in the preliminary phases of the project cycle. This project has been commended by the World Bank's Board for its innovation and the involvement of the private sector to address HIV/AIDS. Mali is one of the poorest countries in the world due to factors such as its limited resource base, land-locked status and poor infrastructure. According to the 2001 Demographic and Health Survey (DHS) published by the Ministry of Health, Mali's HIV/AIDS prevalence rate is estimated at 1.7% in 2001. The project objective is to support the Government of Malis efforts to control the spread of the HIV/AIDS epidemic and provide sustainable access to treatment and care to those infected with or affected by HIV/AIDS. While Mali currently has a low HIV prevalence rate by Sub-Saharan African standards, it runs a high risk of experiencing an increase in prevalence rates. (excerpt)
Health Policy and Development. 2004 Aug; 2(2):131-135.International agencies are beginning a rapid scaling up of antiretroviral distribution programs in Africa. Some are particularly looking for "faith-based organizations" (FBOs) as partners. The new initiatives may offer both unprecedented opportunities and some dangers for FBOs who wish to join in. The opportunities include increasing our capacity to provide not only HIV/AIDS care but other aspects of health care, and a potential for increased communication and cooperation between Christian organizations. The dangers include the likely widespread appearance of antiretroviral resistance; long term sustainability; negative impact on other aspects of HIV care and prevention; indirect costs to FBOs; corruption; encouragement of a culture of money and power, drawing FBOs away from their perceived missions; overextension; and harmful competition among FBOs. Organizations should be aware of the opportunities and dangers, and review their own calling and mission, before embarking on large-scale, externally-funded programs of ARV distribution. (author's)
Journal of Acquired Immune Deficiency Syndromes. 2006 Dec; 43(5):618-623.The number of people on highly active antiretroviral therapy (HAART) in South Africa has risen from < 2000 in October 2003, to almost 200,000 by the end of 2005. Yet South Africa's performance in terms of HAART coverage is poor both in comparison with other countries and the targets set by the government's own Operational Plan. The public-sector HAART ''rollout'' has been uneven across South Africa's nine provinces and the role of external assistance from NGOs and funding agencies such as the Global Fund and PEPFAR has been substantial. The National Treasury seems to have allocated sufficient funding to the Department of Health for a larger HAART rollout, but the Health Minister has not mobilized it accordingly. Failure to invest sufficiently in human resources-- especially nurses--is likely to constrain the growth of HAART coverage. (author's)
Best Practice and Research Clinical Obstetrics and Gynaecology. 2006; 20(3):323-338.Access to modern contraception has become a recognized human right, improving the health and well-being of women, families and societies worldwide. However, contraceptive access remains uneven. Irregular contraceptive supply, limited numbers of service delivery points and specific geographic, economic, informational, psychosocial and administrative barriers (including medical barriers) undermine access in many settings. Widening the range of providers enabled to offer contraception can improve contraceptive access, particularly where resources are most scarce. International efforts to remove medical barriers include the World Health Organization's Medical Eligibility Criteria. Based on the best available evidence, these criteria provide guidance for weighing the risks and benefits of contraceptive choice among women with specific clinical conditions. Clinical job aids can also improve access. More research is needed to further elucidate the pathways for expanding contraceptive access. Further progress in removing medical barriers will depend on systems for improving provider education and promoting evidence-based contraceptive service delivery. (author's)
Bulletin of the World Health Organization. 2006 Sep; 84(9):685-764.The International Medical Products Anti-Counterfeiting Taskforce (IMPACT) aims to put a stop to the deadly trade in fake drugs, which studies suggest kill thousands of people every year. "We need to help people become more aware of the growing market in counterfeit medicines and the public health risks associated with this illegal practice," said Dr Howard Zucker, Assistant Director-General for the Health Technology and Pharmaceuticals cluster of departments at WHO. The taskforce will encourage the public, distributors, pharmacists and hospital staff to inform the authorities about their suspicions regarding the authenticity of a drug or vaccine. In a parallel move, the taskforce will help governments crack down on corruption in the sections of their police forces and customs authorities charged with enforcing laws against drug counterfeiting. Drug manufacturers will be encouraged to make their products more difficult to fake. (excerpt)
Choices. 2001 Dec; 18-19.I don't have any used syringes. Somebody has stolen all, Anka was almost begging. In a worn-out black T-shirt and torn jeans, she looked helpless and desperate, standing in the middle of a vacant square, squeezed between Warsaw's main railway station and a Holiday Inn hotel. "I really don't have any," she repeated. "You know it's an exchange. Go and find some," Grzegorz Kalata said, patiently but firmly. Kalata comes to the square -- a meeting point for local drug users -- almost every evening. He is a streetworker from Monar, Poland's leading chain of non-profit detoxification centres. Under a harm reduction programme, partly sponsored by the United Nations Development Programme (UNDP), Kalata gives disposable syringes and needles, bandages, condoms and antiseptics to drug addicts who meet at the square. In return, he collects used syringes and needles in a plastic container, usually full by the end of his visit. After scouring the grass at the site, Anka came back with four used needles. Kalata gave her seven new ones and a package of bandages. On average, Kalata gives out some 200 needles and 150 syringes during an evening. (excerpt)
Geneva, Switzerland, UNAIDS, 1998 Oct.  p. (UNAIDS Best Practice Collection)The World Health Organization (WHO) estimates that over one-third of the world's population has no guaranteed access to essential drugs. There are various reasons for this lack of access. Worldwide, the most important is affordability (drugs cost more money than is available to pay for them) but legal, infrastructural, distribution and cultural factors are also serious obstacles. The influence of each of these factors is different from country to country, just as frequencies of diseases also vary greatly. Among its activities aimed at improving drug access in developing countries (including technical services such as help in drug procurement and performance of needs estimates), WHO has drawn up a Model List of Essential Drugs, which is updated every two years. The tenth list (1997) has 308 priority drugs that provide safe, effective treatment for the infectious and chronic diseases which affect the vast majority of the world's population. The drugs are selected on the basis of cost-effectiveness within each drug class (e.g. of the dozens of penicillins only eight appear on the Essential Drugs list). With WHO's encouragement, more than 140 countries have developed their own national essential drug lists taking into account local needs, costs and available resources. (excerpt)
Manila, Philippines, World Health Organization [WHO], Regional Office for the Western Pacific, 2002.  p.A 100% condom use programme (100% CUP), targeting female sex workers in entertainment establishments, is important in prevention and control of STIs, including HIV. Monitoring and evaluation to measure the progress of the programme is one of its essential components, and requires appropriate indicators. An indicator is a way in which to quantify or measure the magnitude of progress toward something one is trying to achieve in a programme, whether it is a process, an outcome or an impact. Indicators are just that - they simply give an indication of magnitude or direction of change over time. They cannot tell managers much about why the changes have or have not taken place. While a single indicator cannot measure everything, knowing the magnitude and direction of change in achieving a programme objective is critical information for a manager. A good indicator for monitoring and evaluation needs to be: relevant to the programme; feasible to collect and analyse; easy to interpret; and able to measure change over time. Identifying an indicator to be followed in a 100% CUP also demands attention to how that indicator will be defined, the source of the information needed for it, and the timeframe for its collection and analysis. (excerpt)
International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control. Summary report of the Third Meeting, Geneva, Switzerland, 8-9 December 1997.
Geneva, Switzerland, World Health Organization [WHO], Division of Emerging and Other Communicable Diseases Surveillance and Control, 1998. 21 p. (WHO/EMC/ DIS/ICG/98.1)The Third meeting of the International Co-ordinating Group on Vaccine Provision for Epidemic Meningitis Control (ICG) was held at WHO Headquarters in Geneva on the 8th and 9th December 1997. The meeting was chaired by Dr D. Barakamfitiye, Director, Prevention and Control of Diseases (DDC) of the WHO Regional Office for Africa. Dr M. Hardiman, WHO/EMC, acted as rapporteur. The agenda and list of participants are to be found in the annexes. The Chairman welcomed the participants and outlined the objectives for the meeting. Dr D.L. Heymann, Director EMC, added his welcome and commented that, although meningococcal vaccine was not in such short supply this year, there are still a number of important issues to demand global attention. These include the need to improve the speed of response to epidemic situations, the continued political sensitivity to the issue of meningitis, the relative merits of preventive vaccination versus epidemic response and the impact that the development of a new conjugate vaccine might have on efforts to control meningitis. Dr J.-W.Lee, Director, GPV, in his opening remarks looked forward to the time when preventive actions for meningitis would render epidemic response through the ICG as no longer necessary. (excerpt)
International Coordinating Group on Vaccine Provision for Epidemic Meningitis Control. Summary report. Geneva, Switzerland, 16-17 January 1997.
Geneva, Switzerland, World Health Organization [WHO], Division of Emerging and Other Communicable Diseases Surveillance and Control, 1997. 19 p. (WHO/EMC/ DIS/ICG/97.9)This was the first meeting of the International Coordinating Group (ICG) proposed at the 2-3 December, 1996 meeting of the Ad Hoc Working Group on WHO Strategy for Provision of Meningitis Vaccine for Epidemic Prevention and Control. The meeting was chaired by Dr d'Almeida, DPM, AFRO, and the agenda and list of participants are provided as annexes. The objectives of the meeting were to define terms of reference, agree on the membership of the International Coordinating Group (ICG) and its Executive Sub-Group, to establish the criteria for determining priority distribution of vaccine for epidemic control in the 1997 season, for which only 14 million doses of vaccine would be available, and to consider a strategy for ensuring adequate vaccine supplies in future years. The expected outcome of the meeting was to obtain agreement on the responsibilities of the ICG and its Executive Sub-Group, on the criteria for vaccine distribution in 1997, on a funding mechanism for an emergency stock of vaccines and auto-destruct syringes, and on a strategy to address adequate vaccine and syringe supplies for future years. The meeting met these goals. (excerpt)
Bulletin of the World Health Organization. 2004 Jun; 82(6):474-476.Since its introduction in 1996, highly active antiretroviral therapy (ART) has enabled people with HIV/AIDS in industrialized countries to live healthier, longer lives and to continue to contribute to the social and economic well-being of their families and societies. However, although 95% of the world's 40 million HIV-positive people are living in developing countries, only about 400 000 of the six million people requiring treatment actually received it in 2003. To address this treatment gap, at the UN General Assembly Special Session on HIV/AIDS in 2001, UN Member States unanimously committed to scaling up ART within their national HIV/AIDS programmes. In late 2003, WHO and UNAIDS declared the inequity in access to HIV/AIDS treatment a global public health emergency and launched the initiative, dubbed "3 by 5", which aims to treat three million people living with HIV in developing countries by the end of 2005. In a special interview with the Bulletin, WHO's Director of HIV/AIDS explains the principles behind the strategy, describes the challenges to its success and recounts the progress made towards achieving the target to date. (excerpt)
Boston Globe. 2003 Jul 30; A10.The World Health Organization announced yesterday that it will create a new model to buy antiretroviral AIDS drugs in hopes of dramatically speeding distribution and reducing the cost of the life-saving medication. The plan comes from a collaboration among tuberculosis experts, foremost among them the new WHO director general, Jong-wook Lee. That program, called the TB Drug Facility, purchases drugs in bulk on behalf of countries and then oversees the distribution. (excerpt)
Report to the Prime Minister. UK Working Group on Increasing Access to Essential Medicines in the Developing World. Policy recommendations and strategy.
London, England, Department for International Development [DFID], 2002 Nov 28.  p.This report outlines the discussions and conclusions of the Working Group. It supports specific action on the R&D agenda, and outlines an ambitious international agenda to facilitate a framework for voluntary, widespread, sustainable, and predictable differential pricing as the operational norm1. It proposes, as a short-term goal, to have significant international commitment to an overarching framework for differential pricing in place in time for the 2003 G8 Summit in France. (excerpt)
Geneva, Switzerland, WHO, Action Programme on Essential Drugs, 1993. ii, 87 p. (WHO/DAP/93.1; DAP Research Series No. 7)The WHO Action Program on Essential Drugs has developed and field tested a core set of drug use indicators capable of describing drug use patterns and prescribing behaviors in a country, region, or individual health facility. These indicators can be used to measure the impact of interventions designed to change prescribing practices, detect performance problems, and compare the performance of providers and institutions. Three categories have been developed: 1) prescribing indicators--average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with antibiotic prescribed, percentage of encounters with injection prescribed, and percentage of drugs prescribed from essential drugs list or formulary; 2) patient care indicators--average consultation time, average dispensing time, percentage of drugs actually dispensed, percentage of drugs adequately labelled, and patients' knowledge of correct dosage; and 3) facility indicators--availability of copy of essential drugs list or formulary and availability of key drugs. All data required to measure the core indicators can be derived from medical records or direct observation. Field testing in developing countries such as Nigeria and Tanzania found these measures both feasible to obtain and informative as first-level indicators. Also presented are descriptions of key issues related to study design and sampling, field methods, analysis, and follow up.
Colombo, Sri Lanka, Family Planning Association of Sri Lanka, 1991. , 54,  p.This report describes the accomplishment of the Family Planning Association of Sri Lanka (FPASL) during the 1990-91 year. The report opens with a section describing 1990 highlights, a year that witnessed great strides in clinical, contraceptive retail marketing, rural motivational, and AIDS education activities. In June, FPASL hosted the Regional Council Meeting of the South Asia Region, a meeting attended by IPPF Secretary Dr. Halfdan Mahler, who praised the efforts of the association. Designed to coincide with the regional meeting, FPASL organized a national seminar on "Family Planning Research and the Emerging Issues for the Nineties." IPPF invited FPASL to be one of the 6 countries do develop a new strategic plan for the 1990s. Other FPASL highlights included: increased AIDS education, Norplant promotion campaigns, and the establishment of a counselling center for young people. Following the highlight section, the report provides an overall program commentary. The report then examines the following components of FPASL: 1) the Community Managed Integrated Family Health Project (CMIRFH), which is the associations' major family planning information, education, and communication (IEC) program; 2) the Nucleus Training Unit, established in 1989, whose primary emphasis is to organize and conduct AIDS education programs; 3) the Youth Committee, whose activities include populations and AIDS education; 4) the Clinical Program, whose attendance increased by 15% (this section describes the types of services provided); and 5) the Contraceptive Retail Sales Program. While condom sales increased by 5%, the sales of oral contraceptives and foam tablets decreased -- a declined explained by the turbulent situation of the country.
Report of the Asia-Pacific POPIN Expert Working Group on Population Information Networking, 16-20 October 1986, Beijing, China.
Bangkok, Thailand, [ESCAP], 1987. 54 p. (Asian Population Studies Series No. 83; ST/ESCAP/517; RAS/86/P14)An infrastructure for the collection, analysis, dissemination, and utilization of population data and information has been established in the Asia-Pacific Region to help national planners to formulate effective population policies and monitor family planning programs. At present, there are 13 national population information popin centers in the region. The Asia-Pacific POPIN Expert Working Group on Population Information Networking met in Beijing in October 1986 to consider areas where networking could strengthen national population information centers and services, to identify priority areas for action and development in the coming period, and to recommend modalities for the realization of specific networking activities. Conference participants noted that further emphasis on population information networking would increase the exchange of useful, multidisciplinary information among countries and lead to improvements in the structure and management of various population programs. In view of the important role that each of the subregional, regional, and global POPIN networks plays in information dissemination, it was recommended that the 2-way flow of population information from the national POPIN centers to the subregional networks to the regional and global networks and vice versa should be enhanced. Creation of an advisory committee to suggest ways and means to further institutionalize Asia-Pacific POPIN in terms of coordination, policy formation, and program planning was also recommended. Technical working groups focused on computerization and dissemination were suggested as well. Considering ESCAP's resource constraints, it was recommended that the developed countries and international donor agencies be approached to provide adequate funding support. Finally, each national POPIN center was urged to develop a standardized model for subnational networks suitable to the country's socioeconomic conditions.
Washington, D.C., National Academy Press, 1981. 22 p. (Contract AID/ta-C-1428)2 essential direct interventions in management of acute diarrheal diseases, oral rehydration and continued feeding, are summarized. Recent estimates of the global problem are that more than 500 million episodes of diarrhea occur yearly in infants and children under 5 years of age in Asia, Africa, and Latin America. 5 million deaths from diarrhea have been reported each year. Dehydration is the major cause of the immediate morbidity and mortality of children with diarrhea. Oral rehydration techniques may assist and reverse progression to severe dehydration and thereby are highly efficient in managing diarrheal disease. Formula selection, preparation of ingredients, distribution of oral rehydration solution, economic considerations, and cost-effectiveness of therapy programs are the primary concerns for those using oral rehydration. Formula selection should take into account the quantity of sodium, potassium, bicarbonate, and glucose in the formula. Preparations should be made so they can be done in the household rather than in national agencies. Centralized national packaging is recommended to standardize the salt/sugar mix. Measuring spoons and containers are also important in the packaging. Distribution should be accomplished by government or private agencies. The home preparation is the most economical. The effectiveness of the program is an important consideration. It is recommended that 2 different formulas be introduced into the community: a simpler lower sodium formula for home preparation and the more complex World Health Organization solution for supervised use in the health center. Continuation of feeding is important during and after diarrheal illness. Anorexia, nausea, vomiting, and abdominal cramps, may accompany acute infection. Cow milk may help produce symptomatic fermentative diarrhea, however breastfeeding should be continued. Fruits, vegetables, and sources of protein should also be fed to patients with diarrhea. Deleterious effects may occur if a patient fails to continue eating. A community system of surveillance and education should be developed to control diarrheal disease.
[Geneva, WHO, 1980]. 45 p.As part of a series of WHO-designed training modules on developing a national program (in a developing nation) for the control of diarrheal diseases, this volume teaches how to determine logistical problems of supply and distribution of therapeutic modules for control of diarrheal disease. In this module, the student is expected to learn how to determine the quantity of oral rehydration salts (ORS) necessary in Fictitia, a wholly made up country, data on which is published in another module in this series called "Fictitia" PIP/802686, to recommend a distribution system for Fictitia, to determine the number of ORS packets the program manager needs to stock for proper inventory in Fictitia, to specify a schedule for reordering ORS packets in Fictitia, to determine the cost of local production of ORS in Fictitia, and to recommend whether Fictitia should produce its own ORS by target date 1986 or import the ORS the country needs.
Geneva, Switzerland, WHO, 1980. (WHO Technical Report Series No. 645)In this report of the World Health Organization (WHO) Expert Committee on Specifications for Pharmaceutical Preparation, focus is on the following: 1) quality assurance in pharmaceutical supply systems; 2) revisions of the International Pharmacopoeia (methods of drug analysis, monographs for pharmaceutical raw materials, monographs for dosage forms, monographs for pharmaceutical aids); 3) international chemical reference substances for pharmaceuticals (reports from the WHO Collaborating Center, certificates, secondary reference substances, international cooperation, revision of guidelines); 4) quality requirements for oral dosage forms (tests for solid oral dosage forms, tests for liquid oral dosage forms, guidelines for in-process control of the manufature of some types of dosage forms); and 5) basic tests (basic tests for pharmaceutical substances, simple tests for the absence of gross degradation, basic tests for tablets and capsules, publication of basic tests). The Committee concluded that the term "quality assessment" was appropriate to the activities of governmental agencies who have been authorized to assess by inspection, surveillance and other means how closely manufacturers and distributers comply with drug quality requirements. Manufacturers are considered fully responsible for the quality of their products.
Lancet. 2002 Jun 8; 359:2009.Carol Bellamy, head of UN Children's Fund (UNICEF), warned that immunization programs worldwide are threatened by the gross reduction of routine childhood- vaccines despite the fact that the risk of vaccine-preventable diseases is increasing. Although production of childhood vaccines normally requires about 2 years, countries funding such programs only commit funds for 1 year at a time. This makes it difficult for their poorer counterparts to make multiyear purchase commitments. As a consequence, UNICEF has been unable to sign long-term contracts with vaccine manufacturers. Thus UNICEF has been calling for long- term commitments from donors.