Children At Play

What is MACVF?

MACVF stands for Millenium Armenian Children’s Vaccine Fund. It is an ANMF program that will benefit the children of Armenia by helping to control preventable diseases through immunization. It is a program that brings together partner institutions in a comprehensive package of assessment, planning, and coordinated support that aims to achieve the most effective immunization possible in Armenia. A major component of MACVF is ensuring sustainable vaccine supply to Armenia and ensuring that quality and maintenance standards are upheld.

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What is its role in immunization?

Since Armenia is currently still dependent on international aid to procure vaccines and uphold implementation standards, MACVF believes that a consistent source of income as an adjunct to international aid and government resources will ensure that immunization needs are met and sustained. In this context, the MACVF is a revolutionary fund designated and administered by ANMF to provide vaccine procurement and quality assurance financing within the context of the National Immunization Program of the Ministry of Health of the Republic of Armenia and in accordance with international standards. MACVF should not be viewed simply as a financial mechanism but as a small institution with several roles. It is also a member of the National Inter-Agency Immunization Coordinating Committee (ICC) which is comprised of other leading international organizations involved in immunization in Armenia. The Program Advisory Council has also counseled on immunization programs and grant-making issues. MACVF is also plugged-in on a global level to avoid overlooking potential resources. For example, if we are informed that a vaccine manufacturer is announcing in-kind donations of a certain vaccine, MACVF will actively try to seek a portion for Armenia.

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Why is it called MACVF?

It is called the Millennium Armenian Children’s Vaccine Fund because it is a program for the 21st century. We used the year 2000 as a milestone for our fundraising efforts and we continue to carry out the capital campaign for MACVF over many years. MACVF is a social investment for Armenia.

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Is the program geared towards children only?

In theory, controlling preventable diseases in a society requires immunizing other segments of the population in addition to children. For example, when Hepatitis B is prevalent in a country, health workers are an important segment of the population that needs to be immunized. On the other hand, ANMF’s core mission is focusing on women and children. Therefore, MACVF will maintain its application towards children. As the program evolves and achieves its goal, MACVF will assess the potential of immunizing other segments of the population.

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What is the significance of this project?

Every year children in Armenia needlessly get sick with diseases that are preventable through vaccines routinely administered in the West. ANMF believes that immunization is one of the most cost-effective healthcare interventions. ANMF also believes, like many other international agencies, that immunization is a child’s basic right. The lack of finances should not be a deterrent to receiving such preventive care. A small country like Armenia, with an existing healthcare infrastructure, should be able to access capital for vaccines in the 21st century.

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Is this a program funded by your family foundation?

ANMF, along with the Cafesjian Family Foundation, has provided seed funds towards developing the concept of MACVF and forging strategic partnerships. ANMF also designated $400,000 of its own funds towards the capital campaign. However, since the scale of this program is so large and the time horizon is so long (15 years), ANMF called upon its constituents and the Armenian Diaspora to help meet the challenges of reaching its campaign goals. ANMF realizes that laying the groundwork and implementing the plans, fosters confidence in donors (both private and institutional) to support its programs.

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Why do you need a capital fund? Can’t you get annual grants from existing institutions or in-kind donations from pharmaceutical companies?

With a strong immunization program in place today and an excellent track record in immunization coverage, a small capital fund is a reasonable strategy for providing long-term sustainable vaccine procurement capability to Armenia. By its very nature, international aid is not a stable source to supply traditional vaccines. Also, while the government is doing its share in the proper distribution of vaccines to the general population, it is meeting only a fraction of its financial obligations to procure vaccines because of its lack of resources. ANMF strongly believes that opportunistic in-kind donations by large pharmaceutical companies give us tremendous leverage in supplying vaccines to Armenia and save precious financial resources for “rainy days.” However, the issues that remain are reliability and sustainability. In-kind donations may be few and far between. All in all, we feel that our program is well designed and complements alternative sources of financing and in-kind donations. It is a natural formula for a small country like Armenia.

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How can I help?

You can help in a number of ways. ANMF welcomes any experts in the healthcare sector to join the Medical Advisory Board for consultation and help with our programs. We also organize a couple of fundraising events each year to help cover administrative costs, your participation at these events or help in planning and executing these events by serving on the organizing committees is appreciated. For more information on how you can make a donation either online or by check, please visit our Donate Now page. For more information on how you can help by volunteering your services please visit our “How Can I Help” page.

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As a foundation, how are you planning to work with existing organizations?

ANMF is an operating foundation that was set up to fill societal gaps. Its programs are almost always complementary to existing ones although some are in a category of their own. For an immunization program to function efficiently, many factors are necessary. Besides vaccine supplies, Armenia needs technical assistance, cold chain equipment, transportation and much more. ANMF intends to act as a catalyst in this arena over the coming years and continues to cooperate and partner with various organizations to help the cause of preventing diseases through immunization. By working closely with the Armenian Ministry of Health, our activities are implemented within the framework of Armenia’s five year strategic immunization plan. ANMF also coordinates its efforts with UNICEF and other international partners and is involved in the national Interagency Immunization Coordination Committee (ICC).

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Aren’t government agencies usually the ones that donate vaccines?

Aid agencies like USAID usually have an agenda for host country development priorities. USAID allocated funding for vaccine procurement via UNICEF’s supplementary funds. Again, the big question here is to determine the stability of these supplementary funds. By helping Armenia overcome its dependency on international agencies for vaccine supplies, ANMF aims to re-channel the assistance dollars to benefit the other remaining sectors of immunization. ANMF aims to help Armenia transition to a self-sustaining entity in this key area of public health. With its success, ANMF also aims to encourage other nations in a similar predicament to replicate its model.

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Are there disease outbreaks in Armenia today?

The mumps epidemic that occurred in 1999 critically illustrated the dependence of Armenia on international assistance for the maintenance of its immunization program. The Armenian government was fully responsible for covering the cost of the mumps vaccine because mumps was not included on the list of priority Expanded Immunization Program (EPI) targeted vaccine preventable diseases. Between 1995 and 1998, the government did not have the financial resources to procure the vaccine and, as a result, Armenia’s reported cases of mumps rose from 149 in 1994 to 4,679 in 1998 and 11,380 total cases by the end of 1999. In mid-1999, due to the severity of the situation, Armenia’s Ministry of Health requested assistance from UNICEF to fulfill an emergency procurement order of the mumps vaccine. Disease outbreak is often unforeseeable and therefore emphasizes even more the importance of vaccination to safeguard the population from such epidemics.

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Who will carry out the delivery of immunization on the ground?

ANMF has a very close working relationship with the Ministry of Health (MoH). Not only do we have formally signed memorandums of understanding with the MoH in Armenia, but we continue to sign memorandums of understanding with them for participation in new developments in the area of immunization. They continue to have the “lion’s share” in the proper delivery of vaccines to the target population through its polyclinics and its ambulatory centers. Its responsibility also includes project management, organization of trainings, clearance, storage and maintenance, proper distribution of supplies and vaccines, and public education. Additionally, ANMF understands that the government will continue to assign a budget line item for vaccination and take on the responsibility of procuring and including new vaccines in its National Immunization Program as its financial situation improves.

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How does one go about tackling such a large scale project?

One step at a time! By doing a lot of homework, ANMF has designed a logical framework for the project and has a reputable team of partners. By launching a capital campaign for the funds, ANMF showed that it is serious about its mission. By having well defined governance policies and program fundamentals along with good advisors, ANMF hopes to ensure a successful program and thereby a more stable future for the children of Armenia.

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Who is doing all of the work?

ANMF views itself as a charitable start-up. By having a good idea, some seed money, and a passion for its mission, ANMF has world class organizations like USAID to provide technical assistance. MACVF’s qualified Program Advisory Council has done much advising on past projects. The initial project, due diligence, and concept development were all internally created by ANMF.

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What role is MACVF going to play in future new vaccine introduction in Armenia after 2010?

MACVF has always worked closely with the MoH, WHO, UNICEF, GAVI and others and within the framework of partnership in Armenia. This approach has ensured us maximum leverage of resources and optimal outcomes. Our vision since the turn of the century has been to make sure that children in Armenia have access to life saving vaccines, very much like children in developed nations. Our first success at new vaccine introductions was with the MMR vaccine in 2002.

In 2010, as the MoH decided to introduce the Pentavalent vaccine to Armenia, we gladly joined hands with the Ministry and signed a five year grant agreement in the fall of 2010 to co-finance the introduction of this new life saving vaccine in Armenia.

GAVI recently announced a new round of proposals for vaccine support, particularly giving an opportunity for graduating countries such as Armenia with GNI higher than USD 1,500. This round will provide a chance for graduating countries to make plans for new vaccine introduction such as Pneumococcal or Rotavirus vaccines. In this context, and given that GAVI is showing willingness to accept a new round of proposals for vaccine support, MACVF is planning to deploy its resources to catalyze on the Rota vaccine opportunity in 2012. The MoH has already indicated to us that they have plans to introduce the Rota vaccine into Armenia’s National Immunization Program in 2012. We are already engaging in dialogue with our colleagues in the MoH and our partners on the ground.

Post the Rota vaccine introduction, we see ourselves getting involved in the Pneumococcal vaccine introduction before 2015. After 2015, our mandate ends and we will need to assess our role in immunization in Armenia.

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Why does MACVF seem to be stepping away from financing traditional vaccines?

The goal of the MACVF was never to create “dependence” on Diasporan aid, like many foreign aid programs do in emerging countries. We intended to be a “private capital fund” that would strategically make catalytic inputs into the immunization sector in Armenia in order to (a) aid the state in vaccine procurement during the early days after independence (b) facilitate new vaccine introductions along with our partners and (c) empower the state to assume the responsibility of funding 100% of the procurement costs, once these vaccines became affordable and Armenia’s state budget increased.

We are happy to announce that starting in 2010, the procurement of most routine vaccines in the NIP will start getting funded through the state budget resources. This was the result of coordinated policies between our various partners and the MoH over the last few years.

As the state assumes responsibility for routine vaccine procurements, this will free up our funds to direct into new vaccine introductions and other essential activities to improve immunization coverage in Armenia.

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