A key message in our Sustainable Immunization Financing (SIF) Program work is that countries need to reduce their dependencies by appropriating their routine immunization programs. This will take accelerated capacity building, financial and organizational innovations within and among the three key national institutions (ministries of health and finance, and parliament) and engagement of new domestic stakeholders.

At the same time, the external partners (WHO, UNICEF, GAVI, World Bank, USAID, DFID, others) must also innovate to help reduce the chronic dependencies-- both financial and technical--which "disincentivize" the country appropriation process. They can do this by moving away from meeting recurrent immunization program costs and investing instead further upstream to bolster each country’s capacity to strengthen its own institutions.