gavi.org
REVIEW OF DECISIONS
BOARD MEETING
24-25 July 2025, Geneva, Switzerland
Decision 1: Consent Agenda: Board and Committee
Appointments
The Gavi Alliance Board:
Reappointed
Yibing Wu, as an Unaffiliated Board Member, effective 1 November 2025 and until
30 October 2026.
Board Meeting, 24- 25 July 2025 2

gavi.org
ALIGNMENT OF COUNTRY
GRANT CYCLES WITH THE
GAVI STRATEGY CYCLE
BOARD MEETING
Johannes Ahrendts
24-25 July 2025, Geneva, Switzerland
As part of grant management reform, moving towards a
consolidated and aligned Gavi funding architecture
2 Board Meeting, 24-25 July 2025
Solutions Challenges
Country programming lagging behind the Gavi
five-year strategy period Consolidated
cash grant & holistic application
for Gavi support
Fixed country grant cycles aligned with the Gavi five-
year strategy cycle (‘grant cycle alignment’)
Lack of clear adherence to grant start and end
dates
Misaligned grant cycles with other global health
funders Application of a “use
-it -or -los e-it” principle for the
consolidated cash grant
1.
2.
3.
Leverage opportunities for alignment with The Global
Fund in line with Lusaka Agenda and Gavi Leap
4.
Multiple funding levers increase transaction costs
and impede strategic planning
Deep dive

1


Board- 2025-Mtg-01-Doc 10
Report to the Board
24- 25 July 2025

Subject Approach to Fragile and Humanitarian Settings
Agenda item 10
Category For Decision

Executive Summary
The purpose of this paper is to request approval of the approach to Fragile
and Humanitarian (F&H) settings for Gavi 6.0.
F&H settings represent a growing share of Gavi - supported countries, with
persistently low coverage levels and high numbers of zero- dose children. In
response to the Board’s guidance, a dedicated approach has been developed to
address these challenges.
This paper outlines the context, Board- endorsed challenges and seven strategic
shifts embedded in a theory of change. It is informed by lessons from Gavi 5.0/5.1
and closely aligned with the direction of the Gavi Leap and the Gavi 6.0 Health
Systems Strategy. The shifts include:
1. Focus on context -appropriate vaccines including traditional vaccines ;
2. Drive new programmatic approaches to reach missed communities and zero-
dose children including catch- up immunisation ;
3. Institute new ways to direct immunisation resources to missed communities and
zero-dose children;
4. Support sub- national fragile settings in non- fragile countries and fragile &
humanitarian settings in countries in the catalytic phase;
5. Establish immunisation as humanitarian health practice;
6. Create a dedicated ‘Gavi Resilience Mechanism ’ (GRM) 1; and
7. Ensure a better equipped Gavi Secretariat
The F&H approach is projected to save over ~ 2. 8-3.2 2 million lives over the Gavi 6.0
strategic cycle , with an estimated cost of US$ 3. 7-3. 8 billion , of which
US$ 48 5 - 575 million reflects the additional cost to fully deliver on the new ambition
vs. previous ways of working 3. It has been developed with a recognition of the very
1 Proposed scope of the Gavi Resilience Mechanism includes i) Newly arising needs in chronically fragile countries
and sub- national pockets; ii) Emergencies including disease outbreak support not covered through existing
mechanisms ; iii) Settings requiring humanitarian programming; and iv) Catalytic phase countries facing fragility or
emergencies (see shift 4).
2 Of the ~ 2.8–3.2 million lives saved, an estimated ~0.4 -0.8 million would be achieved through the new ambition
captured in the F&H theory of change.
3 Of the US$ 485-575 million, US$ 195 million was already included in the June 2024 Gavi 6.0 strategic cost estimate
– of which US$135 million for FED and ZIP like investments and US$ 60 million for Diphtheria and Typhoid outbreak
responses. The additional US$ 290- 380 million are included in the updated Gavi 6.0 financial forecast, taking the
mid -point of the ranges in this paper, for discussion by the Audit and Finance Committee at its meeting on 17 July
2025. These updated costs will also be used as the basis of the Board recalibration exercise.

gavi.org
EVOLUTION OF GAVI’S
PARTNERSHIP APPROACH
BOARD MEETING
Marta Tufet Bayona
Quentin Guillon
24- 25 July 2025, Geneva, Switzerland

Principles
Levers
Four principles guide the partnership approach,
implemented through two levers
Key shifts in 6.0
Country
ownership Rebalance towards
a country -centric model
Differentiation Align TA with Gavi 6.0 top priorities, based on country context,
including
deliberate focus on country capacity building where relevant
Context
appropriate
partnerships Systematically
leverage comparative strengths of core & other context
appropriate partners
Focus on
results Move to a simplified but rigorous
performance management process that
focuses on learning and improving results
Funding model Optimise partner support through a streamlined funding model
Partnerships
Accountability
framework Mutual accountability
aligned with roles and responsibilities, captured in a result-
focused accountability framework
Board Meeting, 24- 25 July 2025 2

Board- 2025-Mtg- 01-Doc 12 1
Report to the Board
2 4-2 5 July 202 5

Subject Collaboration with The Global Fund to Fight AIDS, Tuberculosis
and Malaria (‘The Global Fund’) and other organisations
Agenda item 12
Category For Guidance

Executive Summary
Gavi has launched the Gavi Leap , a bold transformation initiative designed to
prepare the Alliance to deliver on the ambitious goals of its next five- year strategy.
Based on a set of agreed principles, the Gavi Leap is driving deep reforms across
the organisation. These include internal changes to simplify operations, as well as
concrete actions to merge efforts at the last mile in line with the Lusaka Agenda
– working more effectively with partners to align delivery at country level. Initial
commitments reflecting this direction were announced at the Global Summit: Health
& Prosperity through Immunisation in June and can be found on Gavi’s website 1.
One of the key actions already underway within the “merger at the last mile” element
of the Gavi Leap is Gavi’s strengthened collaboration with the Global Fund.
Guided by the Joint Committee Working Group (JCWG), there has been strong
progress across key joint initiatives in three workstreams (incl. in five Wave 1
countries ) that is coupled with strong intent and growing alignment . In response to
clear calls for faster and deeper collaboration, both organisations have committed
to accelerating efforts through a suite of joint initiatives, combining actions to be
implemented immediately, with more structural , transformative possibilities . Th e
initiatives identified are focused in four key areas :
• Strateg y, Policy and Programmes (including Malaria, RSSH/HSS and country
engagement );
• Enabling functions ;
• Resource mobilisation; and
• Governance
S ome examples of immediate initiatives include the synchronisation of the start of
the Global Fund Grant Cycle 8 and Gavi 6.0 for m alaria and Health Systems
Strengthening (HSS) support for key countries , and opportunities for shared
services and enabling function integration. More transformative options , such as the
alignment of start and duration of grant cycles more broadly or structural
opportunities at Secretariat level , will be analysed further and supported by an
external provider . Work across near-term opportunities for collaboration and
initiatives for further analysis will be guided by a new joint Taskforce co -led by the
Gavi CEO and Global Fund Executive Director .
In the context of the “merger at the last mile” element of the G avi Leap progress has
also been made in the collaboration with the Global Polio Eradication Initiative

1 https://www.gavi.org/news/media -room/gavi-statement -global -health-architecture

This document aims to address: 1. Introduce real-time monitoring approaches and how RTM can strengthen vaccination campaigns and routine immunization programmes; 2. Provide guidance to decision-makers and planners on the key considerations enabling implementation of real time approaches and digital solutions in order to strengthen vaccination campaigns and routine immunization programmes, thereby enhancing immunization service delivery; 3. Elaborate on implementation aspects related to realtime monitoring technologies.

This country technical brief presents three use cases of Real-Time Monitoring (RTM) approaches used in Rwanda for 1) COVID-19 surveillance 2) Vaccination Delivery and Monitoring and 3) COVID-19 case management. Good practices and lessons learned by Rwanda are also highlighted in the brief.