title: The International Finance Facility for Immunisation: stakeholders' perspectives.
abstract: OBJECTIVE
  To evaluate stakeholders' understanding and opinions of the International Finance Facility for Immunisation (IFFIm); to identify factors affecting funding levels; and to explore the future use of IFFIm.
  
  
  METHODS
  Between July and September 2015, we interviewed 33 individuals from 25 organizations identified as stakeholders in IFFIm. In total 22.5 hours of semi-structured interviews were recorded, transcribed and analysed using a framework method.
  
  
  RESULTS
  Stakeholders' understanding of IFFIm's financing mechanism and its outcomes varied and many stakeholders wanted more information. Participants highlighted that the change in the macro-economic environment following the 2008 financial crisis affected national policy in donor countries and subsequently the number of new commitments IFFIm received. Since Gavi is now seen as a successful and mature organization, participants stated that donors prefer to donate directly to Gavi. The pharmaceutical industry valued IFFIm for providing funding stability and flexibility. Other stakeholders valued IFFIm's ability to access funds early and enable Gavi to increase vaccine coverage. Overall, stakeholders thought IFFIm was successful, but they had divergent views about IFFIm's on-going role. Participants listed two issues where bond financing mechanisms may be suitable: emergency preparedness and outcome-based time-limited interventions.
  
  
  CONCLUSIONS
  The benefit of pledging funds through IFFIm needs to be re-evaluated. There are potential uses for bond financing to raise funds for other global health issues, but these must be carefully considered against criteria to establish effectiveness, with quantifiable pre-defined outcome indicators to evaluate performance.
authors.affiliation: London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, England .
authors.forename: Tim
authors.initials: T
authors.lastname: Crocker-Buque
authors.affiliation: London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, England .
authors.forename: Sandra
authors.initials: S
authors.lastname: Mounier-Jack
mesh_terms: D001294:Attitude to Health; D003906:Developing Countries; D005060:Europe; D006076:Government; D006291:Health Policy; D006293:Health Promotion / Q000191:economics; D006801:Humans; D007114:Immunization / Q000191:economics*; D017589:Immunization Programs / Q000191:economics; D007390:International Agencies; D007407:Interviews as Topic; D014481:United States