1

Board -2022 -Mtg -03 -Doc 10 -Annex A
Report to the Board
7-8 December 2022
Annex A: Impact Modelling
In order to inform Gavi governance deliberations on potential future support for
COVID -19 vaccination in 2024 -2025, the Gavi Secretariat commissioned Imperial
College, London , to generate estimates of the potential impact of COVID -19
vaccination over 2024 -2025 based on several different epidemiological and
programmatic scenarios. As such, this annex leads with their analyses and initial
estimates. We were subsequently able to bring in outputs generated by t he Institute
for Disease Modelling (IDM) from the Bill & Melin da Gates Foundation as a partial
comparator in part to address model uncertainty (noting that their work is based on a
set of similar scenarios and assumptions to Imperial?s, but not an exact match) .
The primary outputs sought from these modelling efforts included cases,
hospitalisations, deaths, years of life lost (YLL) averted as well as cost -effectiveness.
Given th at much of the disease burden is in the elderly, it would be beneficial to
compare DALYs for C OVID -19 vaccines versus other vaccines. Unfortunately , this
was unable to be done given the uncertainties. Instead, YLL was used, which
constitutes the largest po rtion of the DALY s los t. For more details on the specific
scenarios, assumptions and limitations across both Imperial and IDM?s work, technical
summaries have been made available as appendices on Board Effect.
Topline summary based on modelled outputs from Imperial and IDM
Initia l results from both Imperial and IDM suggest the following:
? Modelled estimates from both Imperial and IDM broadly support the proposed
COVID -19 programme in 2024 -2025 being brought for discussion to the Gavi PPC
and Board (yearly boosting of high/highest p riority groups) as laid out in Doc 10 .
Continuing COVID -19 vaccination in 2024 -2025 has benefits, but the overall
expected health impact is lower than that seen earlier in the pandemic.

? Initial projections for the proposed 2024 -2025 programme show deaths averted
ranges comparable to the current Gavi core routine immuni sation portfolio (albeit
on the lower end). However, after incorporating costs , the proposed programme
appears to compare relatively less favourabl y from a value -for -money perspective
than Gavi core supported vaccine programmes.

? While expanding the vaccination programme to include broader population groups
such as all adults, adolescents and children results in greater total health impacts,
it is less efficient in tha t the expected cases and deaths averted per fully vaccinated
person declines when including younger age groups in the program.

? Results are highly sensitiv e across several key uncertainties including:
- Epidemiological evolution
- Assumptions around waning i mmunity and affinity maturation
- Vaccine efficacy assumptions across different vaccine products
- Coverage levels assumed at end of 2023 and for 2024 and 2025
- Cost (both procurement and delivery)

Board -2022 -Mtg -03 -Doc 10 -Annex B 1
Report to the Board
7-8 December 2022

Annex B: Looking Ahead and Uncertainties
There are several uncertainties against which we are planning for a future COVID -19
programme and which will influence how the programme will evolve, including:
? Demand: Our ability to predict future demand for the proposed programme is
limited, with several factors impacting countries? abilities to plan, develop, and
execute long -term immunisation plans. The Secretariat is consulting countries to
better understand their appetite for a future COVID -19 vaccine programme. While
there are indications that some countries are eager to begin a COVID -19
programme - and some have already begun integrating COVID -19 vaccines into
their health systems - global demand has waned over 2022 as the world has shifted
out of the acute phase of the pandemic. The Secretariat has used primary vaccine
coverage projections to estimate demand for a future COVID -19 programme
starting in 2024. However, a better understanding of the demand for a COVID -19
programme will emerge from the det ailed Alliance wide demand planning process
in 2023, and the Secretariat will share updated demand projections at the June
2023 Board meetin g.
? Vaccine Products : Depending on the evolution of the virus, it is unclear whether
the current vaccine products wi ll continue to be effective or that manufacturers will
continue to manufacture them. Further evolution of products and implications on
efficacy (including against transmission), durability, required frequency of
boosters, and programmatic feasibility are a lso uncertain.
? Epidemiology of the virus : Although this programme is designed for the WHO?s
current base -case scenario, there is potential for new variants to emerge that could
be more severe or more immune -escaping against current vaccines. Variants
cou ld affect population groups differently, which could impact which demographics
and population cohorts are prioritised for vaccination by SAGE, including the
potential inclusion of different VCVs. Historically, surges have not followed
predictable patterns or seasonality, making planning difficult.
? Impact : Estimating public health impacts for potential future support is challenging
given the number of variables, assumptions and uncertainties involved. Modelled
estimates are highly sensitive and as such, shou ld be considered with appropriate
caution in view of key evidence gaps that exist. As more evidence is generated in
the coming months, for example on vaccine efficacy, these estimates are likely to
change. The Secretariat will continue to engage impact mod elling groups to
generate updates as needed.
? Non -vaccine tools : As COVID -19 becomes endemic, the potential market for new
therapeutics to treat or prevent the symptoms is expected to grow and with it,
industry investment in innovative therapies. If effort s are taken to make these
accessible and affordable, it is possible that the opportunity cost for a country to

1

Board -2022 -Mtg -03 -Doc 10 -Annex C
Report to the Board
7-8 December 2022
Annex C: Modelling Assumptions
Number of doses per year: The Secretariat is basing calculations for the COVID -19
vaccine programme on one booster dose per year based on the assumption that future
vaccines will give more durable protection , limiting the need for more frequent
vaccination. It is also possible that by 2024 most people globally will have either been
infected with COVID -19 at some point and/ or been vaccinated, and this hybrid
immunity will result in one dose per year being sufficient.
Coverage and demand : The programme should aim to support countries to reach
ambitious targets yet be based on realistic assumptions of coverage. We consid ered
comparable rates of coverage to use as proxies for what we may expect for the
COVID -19 context. Alliance demand planning groups project overall primary coverage
in the AMC 91 to be between 40 and 65 percent by end -2023. A drop off from primary
to boos ter coverage has been assumed using HIC data (~18 percent drop off). The
model, therefore, assumes we can expect countries? additional dose coverage rates
to be somewhere between 35 and 55 percent for the proposed programme.
Procurement cost per dose : Sev eral factors will determine the procurement cost per
dose. For the cost factored into this model, we assume that manufacturing will
continue on an ongoing basis, and therefore there will be predictable supply from a
diverse range of suppliers. Current vacc ine technologies will continue to be used, and
fit-for -purpose vaccines, such as variant containing vaccines, will be well -matched
against circulating variant strains. As we integrate into established Alliance processes ,
we will revert to regular tendering processes through UNICEF. Actual future vaccine
prices may be influenced by volumes contracted/procured, level of competition, new
technologies, product preferences, geographic base of manufacturing networks, and
other factors.
Delivery costing : Delivery costing has been calculated with the support of the Delivery
Costing Working Group (DCWG) in September 2022. The DCWG has members from
CoVDP, UNICEF, BMGF, Harvard School of Public Health, MSH, WHO and Gavi. The
costing encompasses several compo nents, including PPE, hand hygiene, per diem for
service delivery, transportation for outreach, training, planning & coordination, social
mobilization, cold chain maintenance, waste m anagement , vax certificates,
pharmacovigilance. Costing excludes ancilla ries (syringes and safety boxes), TA and
cost of vial.

1



Board -2022 -Mtg -03-Doc 10
Report to the Board
7-8 December 2022
Section A: Executive Summary
Context
COVAX, the Alliance?s emergency vaccine response to COVID -19 is set to sunset
in 2023. This paper considers Gavi?s potential role in providing countries with
access to COVID -19 vaccines starting in 2024. The Gavi COVID -19 Vaccine
Investment Approach, part of Gavi 5.1, considers how a future Gavi -supported
COVID -19 vaccine pr ogramme could be designed and implemented considering
target populations and scope of country support . The investment approach tak es
into account modelling on the estimated impact of future COVID -19 programmes
and potential implications for the broader immunisation landscape while building
on key learnings to date .
The Secretariat is proposing an up -to -investment figure of US$ 1.8 billion for the
first phase of the programme (2 024 -2025) . This would ensure timely ongoing
procurement of vaccines for higher risk groups in AMC countries , with
differentiated support for the Gavi54 - those countries eligible for Gavi support -
and the AMC37 - the never - and former -Gavi eligible countries which received
COVAX support.
The approval requested of the Board at this meeting is ?in principle? reflecting the
inherit uncertainty in underlying assumptions , and yet the need to start planning .
The Secretariat will return to the Board by June 2023 for approval of the financial
envelope , with updated country demand estimates to inform supply volumes , and
an updated delivery approach based on continued learning s from COVID -19
vaccine Delivery Support (CDS) deployment . The Secretariat w ill also return to the
Board and relevant committees should WHO SAGE (Strategic Advisory Group of
Experts on Immunization) guidance and/or the assumptions on which this
investment approach is based deviate significantly from current status . Finally , the
Secretariat will return to the Board in June 2024 as part of the Gavi 6.0 strategy
development process to assess the case for the continuation of the programme
informed by the experience of the first phase, trade -offs with other Gavi 6.0
priorities , and up to date epidemiological considerations for a longer -term
COVID -19 vaccine programme as part of the 2024 Vaccine Investment Strategy
(VIS) .
Key inputs were collected from across the Secretariat and partners (including
WHO, UNICEF, CEPI ( Coalition for Epidemic Preparedness Innovations) ) and
through country consultations. Additionally, the investment approach reflects the
steer provided by Board and Programme and Policy Committee ( PPC ) members
Subject Gavi?s role in a future COVID -19 V accine Programme
Agenda item 10
Category For Decision

Board -2022 -Mtg -03-Doc 11a -Annex A 1
Annex A: Framework for Gavi Funding to Countries


Gavi Alliance
Framework for Gavi
Funding to Countries
Version 1.0

DOCUMENT ADMINISTRATION
VERSION NUMBER OWNER DATE
1.0 Policy Team 8 December 2022

1. Purpose and Scope of Document
1.1 This document serves as an overarching framework for Gavi?s three
programmatic funding policies for Gavi -eligible countries: a) The Eligibility &
Transition Policy; b) The Co -financing Policy; and c) The Health Systems and
Immunisation Strengthening (HSIS) Policy. The purpose of this document is to
set out the objectives, principles and approach for Gavi funding to eligible
countries.
1.2 Gavi supports lower -income countries, to increase the equitable and
sustainable use of vaccines in routine immunisation programmes. This
document describes the policies that outline the scope of Gavi funding available
to Gavi -eligible countries. This funding is intended to support countries as they
increase the equitable and sustainable use of vaccines in routine programmes
and facilitate their successful transition out of Gavi support. It includes the
procurement of vaccines and support to strengthen health systems to extend
routine immunisation services to reach zero dose and missed communi ties, as
well as introduce new vaccines, conduct planned campaigns and other
supplemental delivery strategies, and implement outbreak response
vaccination.
1.3 This document does not cover other Gavi funding through the Partners?
Engagement Framework, the Middle -Income Country?s Approach (the ?MICs
Approach?) for former and select never Gavi -eligible countries, nor other special
initiatives which Gavi might fund from time to time.
2. Principles of Gavi Funding to Eligible Countries
2.1 Country -driven, predi ctable and sustainable: Gavi support is country -driven,
meaning that it bolsters country leadership to sustainably deliver and finance
immunisation. Support is planned and predictable over time. It is directly linked

Board -2022 -Mtg -03-Doc 11a -Annex B 1
Report to the Board
7-8 December 2022
Gavi Alliance
Health Systems and Immunisation
Strengthening Policy
Version 1.0
Annex B: Health System and Immunisation Strengthening Policy






DOCUMENT ADMINISTRATION





VERSION
NUMBER APPROVAL PROCESS DATE
1.0
Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 1 November 2022
Approved by: Board [Full date]
Effective from: 1 January 2023
Next review: At the request of the Board


Board -2022 -Mtg -03-Doc 11a -Annex B 2
Report to the Board
7-8 December 2022
1. Scope & Objective
1.1 The objective of this policy is to ensure that HSIS funding is allocated and
programmed to enable countries to build strong, equitable, sustainable, and
high - quality immunisation programmes. Funding is available for countries to
strengthen and extend immunisation serv ices to regularly reach zero -dose
children and communities using tailored and differentiated strategies to build a
stronger primary health care platform.
1.2 The policy applies to all Gavi -eligible countries; however, in the
implementation of the policy, s pecific considerations for the use of funds, and
the depth of the Alliance?s engagement will vary depending on the country
need, fragility status and other country and local contexts.
1.3 The scope of this policy is Gavi?s Health System and Immunisation
Strengthening support including Health System Strengthening (HSS), the Cold
Chain Equipment Optimization Platform (CCEOP) and support to vaccine
implementation. While this scope does not cover time -limited funding such as
the Equity Accelerato r Funding (EAF) 1, COVID -19 Delivery Support (CDS), or
support through the Partners? Engagement Framework (PEF) Targeted Country
Assistance (TCA) 2, countries are expected to align planning of support through
EAF, PEF/TCA and HSIS funding. The Framework fo r Gavi Funding to
Countries provides an overview of the support and the objectives, principles
and approach for Gavi funding to eligible countries.
2. Principles
2.1 The following principles should be used to prioritise HSIS investment objectives
and lead grant design:
? Country -driven, predictable and sustainable beyond Gavi support:
grants should be designed to focus on system strengthening. Gavi
strongly encourages countries to increasingly take over operational
costs necessary for recurrent activities as they approach exit from Gavi
support.
? Equity: missed communities, first priority: investments should
prioritise reaching zero -dose and under -immunised children and missed
communities as well as mitigate risk of disruption of ongoing routine
immunisation.
? Tailored to context, adaptable and flexible: Proposed interventions
should be aligned with national plans and priorities and adapted to the
local context. Interventions should be tailored to address the specific
1 The Equity Accelerator Fund (EAF) is not covered by the policy as this support is time -limited to Gavi?s 5.0
Strategy Period (2021 -2025). 2 Gavi provides technical assistance to countries through the Partners? Engagement Framework (PEF) to support
countries in introducing vaccines and strengthening routine immunisation programmes through its core partners
[WHO, UNICEF, Centers for Disease Control and Prevention (CDC), and the World Bank] and expanded partners
(including local institutions) via Targete d Country Assistance (TCA).

1


Board -2022 -Mtg -03-Doc 11a

Report to the Board
7-8 December 2022

Subject Funding Policy Review : Context and Health System
Immunisation Strengthening (HSIS) Policy
Agenda item 11a
Category For Decision

Section A: Executive Summary
Context
The aim of the Funding Policy Review is to simplify, streamline and align Gavi?s three
key funding policies: 1) Eligibility and Transition Policy; 2) Co -financing Policy; and 3)
Health System and Immunisation Strengthening (HSIS) Support Framework 1. The
review began in 2019 as part of the op erationalisation of Gavi 5.0. It was paused in
2020 due to the pandemic and restarted in late 2021 with touchpoints at the October
2021 and May and October 2022 meetings of the Programme and Policy Committee
(PPC). An independent evaluation and subsequent consultation and policy analysis
found the policies to have been fundamental to Gavi?s success but recognised that
more nuance and flexibility could improve their implementation.
Questions this paper addresses
Whilst the initial scope of the review sought to comprehensively update the policies,
the scope has since been modified in consultation with Board members and Alliance
partners in recogni tion of the current political and economic environment. As a result ,
the Secretariat has focused on addressing key, urgent issues for the current strategic
period, with a view to address longer -term aspects as part of the operationalisation of
Gavi 6.0. The updat ed focus of the review is on : i) addressing the risk of unsuccessful
transition of countries from Gavi support; ii) ensuring co -financing is not a barrier to
uptake of the malaria vaccine; and iii) ensuring prior Board -approved HSIS Framework
shifts are reflected in a new HSIS Policy.
This paper provides the scope and context of the overarching review and the process
and consultations that have led to the proposed revisions , as well as a reminder of
what shifts have already been approved and implemented to HSIS support. This paper
sho uld be read and discussed in conjunction with Doc 11b, which proposes specific
shifts to the co-financing , and eligibility and transition polices , as well as an approach
to co -financing for malaria vaccine . Additionally, this paper presents the updated
Framework for Gavi Funding to Countries , which outlines the key principles and
interactions between the three policies .


1 The HSIS support framework operates in a similar manner as a Gavi policy, but with a greater level of
detail. The Policy review seeks to resolve this inconsistency with other Board -approved policies.

Board -2022 -Mtg -03-Doc 11b -Annex A 1
Report to the Board
7-8 December 2022
Annex A : Eligibility and Transition Policy


Gavi Alliance
Eligibility and Transition
Policy
Version 4.0



DOCUMENT ADMINISTRATION
VERSION
NUMBER APPROVAL PROCESS DATE
4.0
Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 1 November 2022
Approved by: Board [Full date]
Effective from: 1 January 2023
Next review: At the request of the Board
3.0
Reviewed by: Gavi Programme
and Policy Committee 3 May 2018
Approved by: Gavi Alliance Board 7 June 2018
Effective from: 7 June 2018
2.0
Prepared by: Robert Newman,
Policy and Performance
Reviewed by: Gavi Programme
and Policy Committee 4 and 21 May 2015
Approved by: Gavi Alliance Board June 2015
Effective from: 1 July 2015






Board -2022 -Mtg -03-Doc 11b -Annex A 2
Report to the Board
7-8 December 2022
1. Purpose & Objective
1.1 The purpose of this policy is to set out the criteria and procedures that
determine which countries are eligible for Gavi support and to define the
transition pathway through which this support is phased out, ensuring that Gavi
funding is aligned with its mission to focus support on lower -income countries.
1.2 Further information about the levels of Gavi funding for Gavi -eligible countries
is found in the co -financing policy and Health Systems and Immunisation
Strengthening (HSIS) policy. A dditionally, the Framework for Gavi Funding
to Countries outlines the overall structure of Gavi?s support to countries.
2. Definitions
2.1 Gross National Income per capita (GNI p.c.): GNI is the sum of value added
by all resident producers plus any product taxes (less subsidies) not included
in the valuation of output plus net receipts of primary income (compensation of
employees and property income) from abroad. GNI p.c. is GNI divided by mid -
year population. GNI p.c. in US dollars is converted using the W orld Bank Atlas
Method which smooths exchange rate fluctuations using a three -year rolling
average, price -adjusted conversion factor, calculated by the World Bank.
2.2 Gavi -eligible country: a country which is in one of the three phases of Gavi
support defined by GNI p.c. thresholds. These phases and thresholds are
detailed in section 4 of this policy.
2.3 Penta3 coverage: percentage of infants in a given country that received three
doses of pentavalent (or equivalent) vaccine based on WHO/UNICEF WUENIC
source.
3. Principles
3.1 The following principles guide the application of the Gavi -eligibility and
transition policy:
Country -led, predictable and sustainable: Gavi support is country -driven,
meaning that it bolsters country leadership to sustainably deliver and
finance immunisation. It is predictable over time and directly linked to a
country?s ability to pay and is intended to be catalytic and time -limited and
to incentivise domestic investm ents in health.
Tailored to context, adaptable and flexible: The use of Gavi support is
differentiated to meet the needs of countries as they change over time.
4. Procedures and Thresholds
4.1 Gavi uses GNI p.c. to determine eligibility for Gavi support. T he threshold for
eligibility for Gavi support is US$ 1730 GNI p.c. in 2023. The threshold for
eligibility is updated annually using the inflation adjustments the World Bank
makes annually to its income categories.

Board -2022 -Mtg -03-Doc 11b -Annex B 1
Report to the Board
7-8 December 2022
Annex B: Co -financing Policy


Gavi Alliance
Co -financing Policy
Version 3.0



DOCUMENT ADMINISTRATION
VERSION
NUMBER APPROVAL PROCESS DATE
3.0
Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 1 November 2022
Approved by: Board [Full date]
Effective from: 1 January 2023
Next review: At the request of the Board
Updated
Section 6 and
7.3
Reviewed by: Gavi Programme
and Policy Committee 12 May 2016
Approved by: Gavi Alliance Board 23 June 2016
2.0
Prepared by: Robert Newman,
Policy and Performance
Reviewed by: Gavi Programme
and Policy Committee 4 May 2015
Approved by: Gavi Alliance Board June 2015
Effective from: 1 January 2016







Board -2022 -Mtg -03-Doc 11b -Annex B 2
Report to the Board
7-8 December 2022
1. Purpose & Objective
1.1 The purpose of this policy is to set out the requirements and procedures for
country co -financing of vaccines introduced with Gavi support for use in routine
programmes. Further information on the vaccines for which co -financing
applies can be found in the application guidelines.
1.2 This policy covers vaccine co -financing levels at different phases of the
transition pathway, compliance requirements and exceptions.
1.3 This policy only covers co -financing for vaccine procurement. The Framework
for Gavi Funding to Countries outlines the overall structure of Gavi?s support
to countries and other Gavi funding support is covered in the Health Systems
and Immunisation Strengthening (HSIS) policy.
1.4 The objective of this policy is to facilitate the mobilisation and sustaining of
domestic fin ancing for vaccines introduced with Gavi support.
2. Definitions
2.1 Co -financing share: The co -financing share represents the share of total costs
of co -financed vaccines borne by countries. It may differ from the price fraction
as the price fraction is applied to vaccines costs only, excluding devices and
freight.
2.2 Grace year: first year of preparatory or accelerated transition phase, during
which co -financing rules of the previous transition phase apply.
2.3 Starting fraction: the starting fraction is calculated by dividing a country?s total
co -financing for all co -financed vaccines by t he total cost of all co -financed
vaccines based on the weighted average prices of the presentations used by
the country. The starting fraction shall be calculated in year 1 of preparatory
transition to apply from year 2. The starting fraction will not incl ude the costs of
the malaria vaccine or other specific vaccines for which co -financing follows an
exceptional approach.
2.4 Price fraction: the price fraction applies to countries in preparatory transition
and first year of accelerated transition. It is ca lculated annually by increasing
the previous year?s fraction by 15% (i.e., a factor of 1.15). The price fraction is
applied to the price of a co -financed vaccine to determine the amount that a
country co - finances for that vaccine. Price fraction is also u sed for setting the
co -financing level of vaccines introduced by countries in accelerated transition,
in line with rules set out in section 4.
3. Principles
3.1 The following principles guide the application of the co -financing policy:
? Country -driven, pred ictable and sustainable beyond Gavi support:
Gavi support is country -driven, meaning that it bolsters country

1


Board -2022 -Mtg -03-Doc 11b

Report to the Board
7-8 December 2022

Subject Funding Policy Review: Eligibility and Transition Policy and
Co -Financing Policy
Agenda item 11b
Category For Decision

Section A: Executive Summary
Context
The Eligibility & Transition Policy and Co -financing Polic y are being reviewed as part
of the Funding Policy Review . An independent evaluation and subsequent analysis
and consultation concluded that these policies have been fundamental to the success
of Gavi?s sustainability model, but that some shifts could facilitate their implementation.
Given the current political, economic environment and timepoint in Gavi?s strategic
cycle, the review has shifted to address two urgent issues: 1) countries in accelerated
transition phase (ATP) face financial sustainability challenges that could impede their
successful transition from Gavi support; and 2) the initial high cost of the malaria
vaccine is a barrier to u ptake and public health impact . These issues are exacerbated
by slow economic growth and rising inflation, while the impacts of the pandemic,
ongoing war in Ukraine, and increasing debt burden have created an uncertain and
challenging fiscal and economic environment.
Questions this pap er addresses
This paper proposes to address these two issues via i) updates to the Eligibility &
Transition and Co -financing policies: extending the duration of ATP from five to eight
years and instituting a minimum 35% co -financing thr eshold for countries to move from
preparatory transition to ATP ; and ii) providing an exceptional time -limited approach
for malaria co -financing.
Additionally, the paper proposes two provisions in the co -financing policy: i) following
up from the discussion on the Fragility, Emergencies and Displaced populations policy
approved by the Board, for there to be no co -financing required for refugee
populations; and ii) formalising previous Board decisions which state that no co -
financing is required for outbreak response campaigns.
Conclusions
The Programme and Policy Committee ( PPC ) recommends to the Alliance Board to
approv e the updated Eligibility and Transition policy, the Co -financing policy , as well
as the exceptional time -limited approach for malaria co -financing.
 

1


Board -2022 -Mtg -03-Doc 12
Report to the Board
7-8 December 2022

Subject Report from Audit and Investigations
Agenda item 12
Category For Information
Section A : Executive Summary
Context
The Managing Director, Audit and Investigations (A&I) is required, under A&I?s Terms
of Reference approved by the Board, to report to the Board at least annually and to
confirm to the Board at least annually the organisational independence of A&I.
Questions this paper addresses
How has A&I fulfilled its Terms of Reference in 2022 , to provide an evaluation, through
a risk -based approach, on the effectiveness of governance, risk management, and
internal control to the organisation?s governing body and senior management ?
How does A&I plan to undertake its 2023 activity?
Does A&I report to a level within the organi sation that allows the activity to fulfil its
responsibilities ? Can A&I confirm the necessary organi sational independence ?
Conclusions
A&I has provided risk -based and objective assurance, advice and insight to the
governing body and senior management and has assessed probity in 2022. A&I has
facilitate d the Audit and Finance Committee in executing its responsibility to oversee,
review and monitor the operation of the A&I function, in support of the Board?s
oversight responsibilities .
A&I has prepared, and the Audit and Finance Committee has approved, a work plan
for 202 3. The plan continues the trend for executing more audits which began i n 2022
in response to elevated and continuing risks and starts to gear up to provide the
accountability and counter -fraud services which would be reasonably expected in the
context of Gavi 5.1 and moving towards Gavi 6.0.
A&I reports to the Board, effectin g this through routine reporting to the Audit and
Finance Committee, and to the CEO, and this reporting arrangement allows the activity
to fulfil its responsibilities. A&I confirms the necessary organisational independence.

1


Board -2022 -Mtg -03 -Doc 13

Report to the Board
7-8 December 2022

Subject Committee Chair and IFFIm Board reports
Agenda item 13
To follow