1


Board -2025 -Mtg -01-Doc 00a


Gavi Alliance Board Meeting
24-25 July 2025
Global Health Campus, Geneva, Switzerland

Thursday 24 July: 08.30-18.00 Board Meeting Day One
Friday 25 July: 09.00-15.45 Board Meeting Day Two

Quorum: 14

Document List

No. Document
00a Document list
00b Agenda
01a Declarations of interest
01b Minutes from 4-5 December 2024
01c No Objection Consent Decisions
01d Consent Agenda
01e Workplan
0 2a CEO’s Repor t – To follow
02b Gavi 5.1 Strategy, Programmes and Partnerships : Progress, Risks and
Challenges
0 3 Committee Chair and IFFIm Board reports – To follow
04 Update from the Global Summit: Health & Prosperity Through Immunisation
0 5 Financ ial Update, including forecast
06 Funding Policy Review
0 7 Update on Mpox
08 Respiratory Syncytial Virus (RSV) Investment Case
0 9 Alignment of Country Grant Cycles with the Gavi Strategy Cycle
10 Approach to Fragile and Humanitarian Settings
11 Evolution of Gavi’s Partnership Approach

Board-2025-Mtg -0 1-Doc 00b 1

Gavi Alliance Board Meeting
24-25 Ju ly 202 5
Global Health Campus , Geneva, Switzerland

Monday 21 July: Pre -Board meetings
Tuesday 22 July : 09.00-1 7.3 0 Board Retreat Day One
Wednesday 23 July : 09.00 -17.30 Board Retreat Day Two
Thursday 24 July : 08.30 -18.00 Board Meeting Day One
Friday 25 July : 09.00 -15.45 Board Meeting Day Two

Quorum: 14




A genda














Next Board Meeting : 3-4 December 2025
25-26 March 2026 (Board Retreat)
24-25 June 2026
2-3 December 2026


---
Brenda Killen , Director, Governance and Secretary to the Board, +41 22 909 6680, bkillen@gavi.org
Melissa Wolfe, Acting Head, Governance, +41 22 909 7820, mwolfe@gavi.org
Please note that the Board meeting will be recorded and transcripted. Th e recording and transcript will be
used as an aid to minute the meeting.

1

Board -2025 -Mtg -01-Doc 01a

Gavi Alliance Board Meeting
24-25 July 202 5
Global Health Campus, Geneva, Switzerland

Thursday 24 July: 08.30-1 8.00 Board Meeting Day One
Friday 25 July: 09.00 -15.45 Board Meeting Day Two

Quorum: 14
Declarations of Interest
Declarations
Section 5.5 of the Conflicts of Interest Policy for Governance Bodies states “Members involved
in decision-making processes on behalf of Gavi must take appropriate action to ensure
disclosure of Interests and Conflicts of Interest and take the necessary action in respect
thereof.”

Section 6.2 of the Conflicts of Interest Policy for Governance Bodies further states, “The duty
to disclose [in 6.1 above] is a continuing obligation. This means that Members are obliged to
disclose any Interests and/or Conflict of Interest, whenever the M ember comes to know the
relevant matter.”

The following declarations were made by members of the Board on their most recent annual
statements .

Board members:
Member
Organisational Interests Financial/Personal/Advisor Int/
Others







José Manuel Barroso,
Chair


















None












Hult – EF (Education First) (Visiting
Professor and Chair of Advisory
Council) ; Goldman Sachs (Chair of
International Advisors – from 1 April
2023) ; Princeton University School of
Public Policy, LISD (Member of the
Advisory Council –from 1 April 2023) ;
CAPRI, Center for Asia Pacific
Resilience and Innovation (Member of
the International Advisory Council from
1 April 2023) ; Catholic University of
Portugal (Visiting Professor at the
Institute of Political Studies and Director
of the Centre for European Studies) ;
The EUROPEAUM (Board Member) ;
WPL Women Political Leaders
(Advisor y Board Member) ; Jean Monnet
Foundation for Europe (Honorary
Committee Member); Global
Commission on Modern Slavery and

Board -202 4-Mtg -03 1
Minutes

Gavi Alliance Board Meeting
4-5 December 2024
Bali, Indonesia

1. Chair’s report

1.1 Noting that the meeting had been duly convened and finding a quorum of
members present, the meeting commenced at 08:32 Bali time on
4 December 202 4. Prof Jos é Manuel Barroso, Board Chair, chaired the
meeting.

1.2 The Chair welcomed new Board and Alternate members attending their first
Board meeting, namely: Kazuhiko Nakamura, Clarisse Paolini, Ruth Lawson,
and Frode Forland .

1.3 The Chair noted several key meetings that had taken place on 3 December
2024, including: i) an All Chairs Group (ACG) meeting during which the
members discussed the recommendations being brought forward to the Board
at this meeting ; ii) a side event on ‘Leveraging Private Sector Expertise,
Development Finance and Multisectoral Platforms for Immunisation Outcomes ’
supported by Unilever and the World Bank; and iii) a special meeting of the
Gavi Implementing Country Caucus with Ministers of Health from South East
Asia and the Western Pacific , convened by Minister Budi Gunadi Sadikin of
Indonesia.

1.4 Standing declarations of interest were tabled to the Board (Doc 01a in the Board
pack).

1.5 The Board noted its minutes from 6-7 June 2024 (Doc 01b) which were
approved by no objection on 17 September 202 4. They also noted a number of
decisions that had been approved by no -objection consent since the June 2024
Board meeting (Doc 01 c).

1.6 The Chair referred to the consent agenda (Doc 01 d) where seven
recommendations were presented for consideration. At the request of the Chair,
Brenda Killen, Director, Governance and Secretary to the Board , presented the
consent agenda decisions.

1.7 The Chair noted the Board workplan (Doc 01 e).

1.8 The Chair reported that during the closed session on 3 December 2024 , the
Board had discussed a number of matters arising from recent Audit and
Finance Committee (AFC) and Programme and Policy Committee (PPC)
meetings and had agreed to launch the process to recruit the next Board Chair.
He also reported that the Board had heard from the CEO about how the
Secretariat will evolve over the next year in preparation for Gavi 6.0 and had

1


Board-2025-Mtg- 01-Doc 01c

Report to the Board
24-2 5 July 202 5

Subject No -Objection Consent Decisions
Agenda item 01 c
Category For Information

Since the December 2024 Board meeting, eight decisions have been circulated
electronically for approval by no- objection consent in line with Sections 11 and 12 of
the Board and Board Committee Operating Procedures.
1) On 7 February 202 5, Board Members were invited to consider approv al of the
appointment of Board and Committee Members .

No objections were received prior to the end of 1 9 February 202 5 and the following
decision was therefore entered into the record:
In accordance with Section 12.4 of the Board and Board Committee Operating
Procedures, on a no- objection basis, the Gavi Alliance Board:
a) Appointed Anna Halén representing Sweden on the donor constituency
cluster anchored by Norway in the seat formerly held by Karin Berlin of
Sweden, effective immediately and until 31 December 2025;

b) Appointed Ryo Nakamura representing Japan on the donor constituency
cluster anchored by Japan in the seat formerly held by Kazuhiko Nakamura
of Japan, effective immediately and until 31 July 2026; and

c) Appointed Ryo Nakamura (Board Member) to the Governance Committee,
effective immediately and until 31 December 2025.

2) On 4 A pril 2025 , Board Members were invited to consider approval of the
r eappointment of an IRC Member.

No objections were received prior to the end of 16 A pril 2025 and the following
decision was therefore entered into the record:

In accordance with Section 12.4 of the Board and Board Committee Operating
Procedures, on a no- objection basis, the Gavi Alliance Board:

Reappointed Rose Leke as a member of the Independent Review Committee
from March 2026 to March 2029.

3) On 15 A pril 202 5, Board Members were invited to consider approval of the
appointment of a Board Member.

1


Board-2025- Mtg-01-Doc 01d
Report to the Board
24-2 5 July 202 5

Subject Consent Agen da – as at 21 July 202 5
Agenda item 01 d
Category For Decision

Section A : Introduction
Nine recommendations are being presented to the Board under the Consent Agenda
for consideration. Detailed information on the items can be found in the relevant
Committee papers in a dedicated folder on BoardEffect at:
https://gavi.boardeffect.co.uk/workrooms/6459/resources/302786
Section B: Actions Requested of the Board
The Gavi Alliance Board is requested to consider the following recommendations from
the Gavi Alliance Governance Committee, the Gavi Alliance Audit and Finance
Committee , the Gavi Alliance Investment Committee and the Gavi Alliance
Programme and Policy Committee.
Decision One – Board and Committee Appointments
The Gavi Alliance Governance Committee recommends to the Gavi Alliance Board
that it:
Reappoint Yibing Wu, as an Unaffiliated Board Member, effective 1 November 2025
and until 31 October 2026.
Decision Two – Board Committee Chair Appointment
The Gavi Alliance Governance Committee recommends to the Gavi Alliance Board
that it:
Reappoint Yibing Wu, as Chair of the Investment Committee, effective 1 November
2025, and until 31 December 2025.
Decision Three – Board Vice Chair Appointment
The Gavi Alliance Governance Committee recommends to the Gavi Alliance Board
that it:
a) Reappoint Omar Abdi as Vice Chair of the Board with individual signatory authority,
effective 1 January 2026 and until 31 December 2027.
b) Reappoint Omar Abdi as Chair of the Governance Committee, effective 1 January
2026 and until 31 December 2027.

DOCUME
NT ADMINISTRATION
VERSION NUMB APPROVAL PROCESS DATE
1.0
(Whistleblowing
Policy) Prepared by: Governance May 2009
Approved by: Gavi Alliance Board 3 June 2009
Effective from: 3 June 2009
2.0 Revised by: Director of internal Audit (as
requested by Gavi Alliance Board Chair) March 2011
Reviewed by:
Legal
Director of Human Resources
Interim CEO
Executive Team (subgroup on corporate issues)
Staff Council
March-July 2011
Approved by: Executive Team 10 August 2011
Effective from: 1 September 2011
3.0 Updated by: Executive Office (change to
Compliance Officer contact details) 21 January 2013
4.0 Revised by: Legal February 2020
Reviewed by:
MD Audit & Investigations
Director of Governance
Director of Human Resources
CEO
Deputy CEO
Staff Council
Approved by: Gavi Alliance Board
February – June 2020
Effective from: 1 July 2020
5.0
(Speak Up
Policy )
Revised by: Audit and Investigations
Reviewed by:
Legal
HR
ERCO
SMG sub -group of the SLT
Staff Council
SLT
AFC
Approved by: Gavi Alliance Board
March 2025
March 2025
March 2025
April 2025
April 2025
May 2025
May 2025
(planned for June 2025)
[planned for July 2025]
[Effective From: 1 August 2025 ]
Next Review: Every five years or earlier if needed
Gavi Alliance
Speak Up Policy
Version 5.0 Doc 01d - Annex A

DOCUMENT ADMINISTRATION
VERSION
NUMBER APPROVAL PROCESS DATE
1 .0
Prepared by: Finance
Reviewed by:
G avi Investment Committee 23 February 2009
Effective from: February 2009
Next review: By Audit and Finance Committee in
due course
Terminology review update 15 Februa ry 2025 Gavi Alliance
Stock Gift Policy
Version 1.0 Doc 01d - Annex B
2 Gavi Alliance
Stock Gift Policy
1. Purpose and scope
1.1. To provide guidelines as to how gifts of stock should be handled, and what processes
to follow to protect the donor and the G avi Alliance .
2. General Policy Statements
2.1. The G avi Alliance will accept gifts of marketable securities at its discretion from donors
as per the Gift Acceptance Policy 1
. Equities will be transferred from the donor to the
Gavi account at the designated custodial bank set up for this purpose.
2.2. The G avi Alliance will communicate this arrangement to potential donors, and will
encourage the giving of appreciated stock as a means of avoiding capital gains on
appreciated stock, while at the same time providing a larger gift to the G avi Alliance.
2.3. The G avi Alliance will acknowledge the number and description of shares of stock
received, as well as its estimated value based on the average of high and low trading
prices on the day the gift is received.
2.4. It is the G av i Alliance’s policy not to accept anonymous gifts of stock. If a gift is received
without identification, it will be held in the custodial account for a period of five business
days, during which the G avi staff will attempt to identify the donor. After five business
days, all unidentified stocks will be returned.
2.5. It is the policy of the G avi Alliance to liquidate stock gifts by selling the stock through
our custodial account. The G avi Alliance will liquidate stock gifts within 2 business
days of identification and authorisation.
2.6. The G avi Alliance will only accept gifts of stock that conform to its Sustainable
Investment Policy.
2.7. G avi staff will manage this programme with oversight provided by the Audit and
F inance Committee (AFC) of the Board. In addition, the Chief Investment Officer will
manage the designated custodial bank account, including the execution of
transactions to and from the account, with oversight provided by the Investment
Committee.
3. Procedures
3.1. Donors will be encouraged to let G avi staff know in advance when they plan to offer a
stock gift. The donor should be prepared to indicate the name of the stock, the number
of shares, and the expected date of giving.
3.2. G avi staff will communicate with the designated custodial bank and the investment
team, via standardised form, that a stock gift should be expected.
3.3. The donor will be provided with information regarding the designated custodial bank
account, and will transfer the stock directly into that account.
3.4. The designated custodial bank will notify Gavi staff of its receipt of a deposit in the
G avi Alliance’s account via a Notification Form. If the details of the Notification Form
1
The Audit and Finance and Fundraising Committees will review the Gift Acceptance Policy in due course. The
Fundraising Committee will maintain regular oversight of the Gift Acceptance Policy. Doc 01d - Annex B

PPC - 2025 - Mtg - 01 - Doc 04b - Annex C
1 Report to the Programme and Policy Committee
14 - 16 May 2025
Annex C: Overview o f the revised governance pathways

Doc 01d - Annex C

PPC - 2025 - Mtg - 01 - Doc 04b - Annex C
2 Report to the Programme and Policy Committee
14 - 16 May 2025 Report to the Programme and Policy Committee
14 - 16 May 2025
(1): In case the vaccine development timelines are faster than anticipated and the
vaccine is expected to be available before the next Vaccine Investment Strategy ( VIS ) ,
the teams will evaluate the possibility of an ad - hoc VIS assessment considering
information about health benefits, price attractiveness, cost implications, etc.
(2): Exceptionally, Gavi Secretariat could reach out to the Market - Sensitive Decisions
Committee ( MSDC ) for guidance on sensitive information prior to submitting the
investment case to the Board PPC/Board .
In some cases, the Alliance might define specific market conditions that need to be
met before starting to procure the next generation vaccine, to ensure market health
attributes are met (e.g. vaccine availability and price to Gavi countries, number of
prequalified vaccines ). These conditions will be shared with relevant manufacturers
when available.
Doc 01d - Annex C

PPC - 2025 - Mtg - 01 - Doc 08 - Annex A
1 Report to the Programme and Policy Committee
14 - 16 May 2025
A nnex A : Draft Gavi 6.0 Health System s Strategy
Executive S ummary
Gavi’s first - ever Health Systems (HS) Strategy is designed to clarify both what the
Alliance seeks to achieve through its support for health systems and how it i n tends to
do so. The intent is to provide a holistic framework for countries, partners, and the
Secretariat to guide programming , implementation and monitoring of Gavi’s health
systems investments.
The goals of the Alliance’s HS strategy for Gavi 6.0 are to increase the equity
and sustainability of immunisation programmes in service of the overall Alliance
6.0 strategy, in particular Strategic Goals 2 and 3 as well as 1 . In doing so, it seeks to
contribute to strengthening countries’ overall health system s by taking a primary
healthcare (PHC) approach (see box below for how this is being defined) .
The HS Strategy introduc es a new theory of
change (To C ) to clarify how the Alliance will
contribute to these goals . The theory of
change has six priority outcomes that
reflect “ persistent problems” that will
need to be overcome for countries and the
Alliance to achieve the goals of Gavi 6.0 .
These will be addressed through
investments in six pillars which align to
WHO’s health systems building blocks . The
strategy identifies ‘flagship interventions ’
which the Alliance proposes to prioritise to
address these persistent problems and
achieve the TOC outcomes .
The strategy also introduces five key shifts
to deliver on the strategy : more
systematically differentiating its health
systems investments by country context
with the goal of achieving programmatic
sustainability at the point of transition ; c onsolidati ng health systems programming and
funding levers and holistic planning across the continuum of service delivery
strategies ; a more systematic approach to catalys ing innovation ; s trengthen ing
partnerships and collaboration on health systems across and beyond the Alliance ; and
more i ntentional measurement, monitoring and learning of health systems
programming , including a more deliberate approach to support better data quality and
use for decision making in country .
Gavi 6.0 Health System s Strategy
Context
The Gavi 6.0 (2026 - 2030) strategy is the Alliance’s most ambitious to date aiming
to help countries immunise over 500 million people, introduce a broader portfolio of What are the primary opportunities
for Gavi to take more of a PHC
approach ?
1. Support c o - deliver y of
immunisation and other PHC
services , especially as part of
efforts to reach missed
communities
2. Work with other health
programmes to deliver vaccines
outside the EPI target age range
( e.g. antenatal, maternal and
adolescent health programmes )
3. Support coordinated planning ,
implementation, and
management of PHC strategies
and join t investment in cross -
cutting systems elements (e.g.
supply chain, human resources for
health health) with other Global
Health Institutions (GHIs)
Doc 01d - Annex a

PPC - 202 5 - Mtg - 01 - Doc 13 - Annex C
1 Report to the Programme and Policy Committee
14 - 16 May 2025
Annex C: Summary view of Gavi 6.0 mission and strategy performance indicators
Doc 01d - Annex E

Classified as Internal #
Gavi Alliance Board Workplan
Gavi Board Paper July Dec March June Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec
A.Strategy/Performance/Risk/MEL CEO's Report CEO's Report Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion 2021-2025 Strategy Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion Discussion Discussion InnovationTBD Information
Private Sector Engagement TBD Information
Civil Society and Community Engagement Approach TBD
Market Shaping Retrospective Strategy, Programmes and Partnerships: Progress, Risks and Challenges
Information Partners' Engagement Framework ("Foundational Fund" as of 2026) Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Disease Surveillance and Diagnostics in Gavi 5.0TBD Information Risk and Assurance ReportRisk and Assurance Report DecisionDecisionDecisionDecision
2026-2030 Strategy Gavi 6.0 Operationalisation Discussion Decision Discussion Discussion Discussion Discussion Discussion Discussion Funding Policy Review (Eligiblity, Transition & Co-financing, HSIS)Funding Policy Review DecisionDecision
Health Systems strategy Consent Agenda Decision
Approach to Fragile, Conflict & Humanitarian Settings Approach to Fragile and Humanitarian Settings Decision
Measurement Framework (Targets & Indicators) Consent Agenda DecisionDecision
Partnerships Model for Gavi 6.0 Evolution of Gavi's Partnership Approach Decision
Market Shaping Strategy Consent Agenda: Governance Pathways Decision Guidance Decision B.Vaccines & Sustainablity Typhoid TBD Pneumococcal AMC (Advance Market Commitment) TBD Vaccine Investment Strategy Vaccine Investment Strategy Gavi's role in Global Health Security TBD Information Day Zero Facility - First Response Fund TBD Information Information Information Information African Vaccine Manufacturing Accelerator TBD (incl term sheet and use of interest) Decision Information Information Information VaccinesCOVID-19 Vaccine Programme Update Country Programmes Delivery Update Information RSV Investment Case RSV Investment Case Decision Malaria TBD Information Information Information Information Information Information Information Information HPV SPP Paper, Annex Information Information Information Information Ebola TBD Yellow Fever TBD Mpox Update on Mpox Decision Dengue Revised Investment Case Guidance Decision Tuberulosis Revised Investment case Guidance Guidance Decision HepE Revised Investment Case Guidance Decision C.Policy Transparency and Accountability Policy TBD Fragility, Emergencies and Refugees Policy TBD Decision Prioritisation Mechanism for Gavi's Support to Countries TBD Decision Evaluation Policy TBD Decision Speak Up Policy Consent Agenda Decision Sustainable Investment and Investment Policy TBD Decision Donations / Gift Policy TBD Decision Vaccine Procurement Policy TBD - subset of Market Shaping Strategy Guidance Decision Vaccine Donations Policy TBD Guidance Decision D.Country Programmes
Joint Alliance Update on Country Programmes Joint Alliance Update Discussion 15 June briefing Discussion Discussion Discussion Discussion Discussion Discussion NigeriaTBD
Decision
PNG TBD
Decision
Strategic Partnership with India Strategic Partnerships with India Information Fiduciary risk assurance and financial management capacity building Fiduciary risk assurance and financial management capacity building Guidance E.Finance/Audit & Investigations
Annual Accounts Annual Financial Report
No-objectionDecisionDecisionDecision
Financial Forecast Financial Update, including forecastDecisionDecision DecisionDecision DecisionDecision DecisionDecision
Partners' Engagement Framework and Secretariat Budget Financial Update, including forecast DecisionDecisionDecisionDecision
Programme Funding Policy Consent Agenda
Treasury Governance Policy Consent Agenda
Treasury Risk Management Policy Consent Agenda
Independent Auditor Selection and Evaluation Policy Consent Agenda
Audit & Investigations Report Audit & Investigations Report Information Information Information Information F.Governance
Board Chair Appointment Consent Agenda DecisionDecision
Board Vice Chair Appointment Consent AgendaDecision Decision
Committee Chair Appointments Consent Agenda DecisionDecision
Board and Committee Appointments Consent Agenda DecisionDecision
IRC Appointments Consent Agenda
CEO Appointment Consent Agenda Decision
Secretary Appointment Consent Agenda
Treasurer Appointment Consent Agenda
Appointment of MD A&I Consent Agenda
Amendments to Governance Documents (Statutes, By-Laws, Committee Charters) Consent Agenda Decision
Evaluation Advisory Committee (evaluation oversight in 6.0) Consent Agenda Decision
IRC Terms of Reference Consent AgendaDecision
Audit & Investigations Terms of Reference Consent Agenda Decision
Update on collaboration with other Organisations Update on collaboration with other Organisations (TBD) Guidance HR Sub-Committee TBD Decision G.ReportingCommittee Chair Reports Committee Chair and IFFIm Board reports Information Information Information Information Information Information Information Information IFFIm Chair Reports Committee Chair and IFFIm Board reports Information Information Information Information Information Information Information Information Replenishment/Resource Mobilisaton Resource Mobilisation Update Discussion Discussion HR ReportClosed SessionInformationInformation InformationInformation InformationInformation InformationInformation
Annual Report on Implementation of the Gender Policy Annex to Strategy paper InformationInformationInformationInformation
Board and Committee minutes Annex to Board pack/On BE as additional materials Information Information Information Information Information Information Information Information H. Technical Briefing Sessions/Deep Dives
Joint Alliance Update on Country Programmes Jul-25
Evaluations TBC
Joint session Gavi and GPEI Jun-25
2028
2026 2027Last updated - 9 July 2025
Next Board Meetings: 3-4 December 2025
25-26 March 2026 (Retreat)
24-25 June 2026
2-3 December 2026
2025

1


Board-2025-Mtg- 01-Doc 02a-FR
Rapport pour le Conseil d’administration
24- 25 juillet 2025

Rapport de la Directrice e xécutive

Le 16 juillet 2025

Chers membres du Conseil d’administration,

Les six derniers mois ont été décisifs pour Gavi et, plus largement, pour la santé
mondiale. ? l’issue du sommet de reconstitution des ressources couronné de succès
de Gavi, qui s’est tenu le 25 juin dernier, nous disposons, pour notre retraite du 22 au
23 juillet, d’une idée plus précise des ressources disponibles pour les cinq années à
venir. D’importantes délibérations nous attendent maintenant sur la manière de
réajuster la stratégie 6.0 de Gavi à la lumière des résultats du sommet de
reconstitution des ressources et des déficits de financement. Ces délibérations auront
pour toile de fond les changements importants dans le paysage de la santé mondiale
et du développement, ainsi que les nouveaux défis auxquels sont confrontés les pays
soutenus par Gavi. J e suis ravie de vous présenter ce rapport en guise de préambule
à ces discussions.

Depuis que j’ai rejoint Gavi, il y a un peu plus d’un an, j’ai acquis la conviction que vos
compétences et votre engagement en tant que membres du Conseil d’administration
nous permettront de résoudre les problèmes qui se posent à nous et à mettre notre
Alliance du Vaccin sur la voie de nouveaux succès. Une voie qui changera la vie de
millions d’enfants et rendra le monde plus prospère et plus s?r. Je suis i nfiniment
reconnaissante du dévouement et du soutien constants dont vous avez fait preuve
tout au long de ma première année en tant que directrice exécutive. Je voudrais
également souhaiter la bienvenue aux nouveaux membres de notre Conseil
d’administratio n. Je me réjouis de travailler avec vous et d’apprendre à mieux vous
conna?tre dans les jours qui viennent.

Comme vous le savez sans doute déjà, ce rapport, divisé en trois parties, donne un
aper?u général des documents beaucoup plus détaillés que vous aurez à examiner.

Dans la première partie, vous trouverez mes réflexions sur le contexte opérationnel et
les principaux défis auxquels Gavi et les pays soutenus par l’organisation ont été
confrontés au cours des six derniers mois, et notamment quelques brèves remarques
à pr opos de notre sommet de reconstitution des ressources, couronné de succès. La
deuxième partie résume les résultats des programmes de Gavi, ainsi que les risques
auxquels ils sont exposés, sur la base des données disponibles les plus récentes. La
troisième partie traite de l’état d’avancement des réorientations stratégiques et
opérationnelles concernant le Secrétariat de Gavi, notamment l’examen
organisationnel et l’initiative Gavi Leap, qui s’inscrivent dans la préparation de la
stratégie 6.0 et dans la per spective d’une vaste réforme de l’architecture de la santé
mondiale.

1


Board-2025-Mtg- 01-Doc 02a
Report to the Board
24– 25 July 202 5

Report of the Chief Executive Officer

16 July 2025

Dear Members of the Board,

The past 6 months have been pivotal for Gavi , and for global health more broadly .
After a successful replenishment summit on 25 June, w e will meet on 22-23 July for
our retreat with new clarity about the resources available for the coming 5 years .
I mportant deliberations now lie ahead of us about how we recalibrate Gavi’s 6.0
strategy in view of the outcomes of the replenishment summit and funding gap. Th ese
deliberations will take place against the backdrop of wider shifts in the landscape of
global health and development, and the evolving challenges faced by the countries
that Gavi supports . I am happy to share this report to preface those discussions.

As has been the case since I joined Gavi a little over a year ago, y our knowledge and
commitment as Board Members give me confidence that we will resolve the questions
before us , and set our Vaccine Alliance on a new path to success . A path that will
change the lives of millions of children, and make the world a more prosperous , more
secure place. Your dedication and support have been a constant throughout my first
year as CEO , and I thank you all . I also bid a very warm welcome to our new mem bers
of the Board; I very much look forward to working with you and getting to know you in
the days ahead.

As will now be familiar, th is is a report i n three parts , and provides a high-level overview
of the many more detailed Board papers that have been submitted for your
consideration.

The first part of the report contains my reflections on the operating context and key
challenges faced by Gavi and Gavi supported countries over the past six months ,
including my brief thoughts on our successful replenishment summit . The second part
summarizes Gavi’s programmatic results and risks, according to the most recent data
available. The third part discusses the current status of planned strategic and
operational shifts with in the Gavi Secretariat, encompassing the organi sational review
and the Gavi Leap, in preparation for the 6.0 strategy and in the context of calls for
broader reforms to the global health architecture.

The operating context in 202 5: replenishment success against a backdrop of
unprecedented challenges

A major milestone in Brussels
One year ago, w hen we launched what would become the longest replenishment
campaign in Gavi’s history, we knew that the foundations of global health were shifting.
That we would be asking donor governments – by far our largest funders – to commit

Board-2025-Mtg- 01-Doc 02b 1
Report to the Board
24-25 July 202 5

Subject Gavi 5.1 Strategy, Programmes and Partnerships: Progress,
Risks and Challenges
Agenda item 02 b
Category For Information

Executive Summary
This report provides a progress update on the implementation of the Gavi
5.0/5.1 strategy, programmes and partnerships and associated risks 1. As
WHO-UNICEF estimates of national immunisation coverage (WUENIC) for 2024 are
released on 15 July 2025, the paper focuses on quantitative updates of strategy
indicators for which new data is available, as well as a more qualitative perspective
of progress 2. A high- level update of the key results from WUENIC for 2024 will be
provided by the CEO in her presentation to the Board.
Of the strategic goals for which updates are available, the Alliance is largely
on track to reach its targets by the end of Gavi 5.1. Recent cuts in foreign aid
are expected to strain health systems and stretch Partners’ and Ministries’ of Health
capacity in Gavi -supported counties; the Secretariat is closely monitoring the fluid
situation.
Under Strategic Goal (SG) 1, Gavi -supported countries have accelerated the
introduction of new routine vaccines exceeding annual milestones and
offsetting 2023 delays. The number of vaccine- preventable disease outbreaks
remains high, necessitating close monitoring and continued support including for
improved timeliness of detection. The rollout of the malaria programme, one of
Gavi’s programmatic ‘must wins’, is on track with 20 introductions completed to date.
Another ‘must win’, the revitalisation of the human papillomavirus vaccine (HPV)
programme is also on track to reach 86 million girls by the end of 2025.
Under SG2, progress continues on the Alliance’s zero-dose agenda (the third
‘must win’) with nearly all countries having completed full portfolio planning.
However, as discussed at the Board meeting in December 2024, the target to reduce
zero -dose children by 25% by the end of Gavi 5.1 vs. the 2019 baseline continues
to be off-track . Progress has also been made on Gavi’s fourth ‘must win’ , the Big
Catch -Up , with over 7.1 million children estimated to have been reached by the end
of March 2025. While progress on the Big Catch- Up is encouraging in some
countries, there are emerging risks of delayed implementation and lagging
performance that pose a high risk of not reaching t he approximately 25 million
missed children that countries had planned to reach by the end of 2025.


1Associated risks refer to the mid-year update on top risks flagged in the 2024 Risk & Assurance Report. 2 See Appendix 2 for the technical narrative on progress made against each strategic goal indicator.

1


Board-2025-Mtg-01-AFC Committee Chair Report
Report to the Board
24-25 July 202 5

Subject Audit & Finance Committee Chair Report
Category For Information
Section A: Introduction
• This report provides the Board with an overview of the activities of the Audit
and Finance Committee (AFC) since the Committee Chair last reported to the
Board in December 2024.
• Since the last Board meeting, the AFC has convened four times: virtually on 11
Februar y, in Geneva on 12- 13 May , and virtually again on 5 June and 17 July .
During these meetings, the AFC addressed recurring matters in accordance
with the standard workplan for Gavi 5.1, the remaining activities of the Office of
the COVAX Facility and the 6.0 recalibration . Additionally , the AFC discussed
the Secretariat review in closed session.
• I n addition, the chair held several technical briefings mainly in relation to Cash
in Countries with a deep dive on Nigeria, a deep dive on the development of
the AFC financial reporting design, as well as an update on the 6.0 forecast
recalibration.
• Subjects reviewed are noted under Section B and matters to be reviewed in
upcoming meetings are presented under Section C .
• AFC recommendations to the Board are attached as Annex A.
Section B: Subjects reviewed
1. Financial Update
1.1. Management Reporting
• The AFC was presented with an update on financial performance as of
December 2024 as well as with the Q1 202 5 Management reporting .
• The AFC received an update on the financial reporting redesign and is
supportive of the proposed strategy to simplify and automate reporting to
AFC .
1.2. 202 4 Annual Financial Report (AFR)
• The AFC reviewed the AFR and the report of the external auditor (Deloitte)
for the year ended 31 December 202 4 and recommended them for approval
t o the Board.
• No material issues or adjustments were raised by Deloitte who issued an
unqualified audit opinion.

1


Board-2025-Mtg- 01-Doc 03

Report to the Board
24-2 5 July 202 5

Subject Committee Chair and IFFIm Board reports
Agenda item 03
To follow

1


Board -2025 -Mtg -01-EAC Committee Chair Report
Report to the Board
24 -25 July 202 5

Subject Evaluation Advisory Committee Chair Report
Category For Information
Section A: Introduction
• This report provides the Board with an overview of the activities of the
Evaluation Advisory Committee ( EAC ) since the Committee Chair last reported
to the Board in December 2024 .
• The EAC held an in -person meeting on 5 -6 March 2025. The next meeting is
scheduled for 17 -18 September 2025.
• At the 5 -6 March 2025 meeting, the EAC provided guidance on : i) progress on
the commissioned Gavi 5.1 centralised evaluations , including the Zero -Dose
evaluation and the joint COVAX evaluation ; ii) EAC engagement in Gavi 5.1
evaluations; iii) the proposed action s in response to the Evaluation Function
Review (EFR) recommendations ; and iv) the proposed evaluation portfolio to
meet Gavi 6.0 evaluative evidence needs, as part of Gavi 6.0 evaluation work
planning .
• A dissemination event for Phase 2 of the Zero -Dose evaluation was held on
31 March 2025 , bringing together Secretariat colleagues and Alliance partners.
Feedback from key Secretariat business owners highlighted the evaluation’s
design and targeted scope to assess strategic thematic areas in more depth,
as an approach that can generate more specific recommendations , thereby
increasing utility.
• Emerging lessons from the joint evaluation process with COVAX Pillar Partners
for the Joint COVAX evaluation were documented to inform the de sign,
execution, and outcomes of future joint evaluations, and to set a precedent for
how G lobal Health Initiatives (G HIs ) can work together to address complex
challenges collaboratively and effectively. Following completion of the
Evaluation Management Response, a dissemination meeting will be held , likely
in September/October 2025.
• The EAC provided further guidance in relation to the recommendations from
the Evaluation Function Review and MOPAN assessment, including on
developing a vision, strategy and culture for evaluation at Gavi, strengthening
PPC engagement, and options for evaluation quality assurance and oversight.
• W ork is now under way to design an updated Evaluation Policy and a multi -year
evaluation workplan for Gavi 6.0 , fo r consideration, recommendation and
eventual approval in Q3 -4 2025.
• The Evaluation Strategy will be developed and integrated into the broader Gavi
6.0 Measurement, Evaluation and Learning approach aligned with guidance
from the EAC.

1


Board-2025-Mtg-01-GC Committee Chair Report
Report to the Board
24-25 July 202 5

Subject Governance Committee Chair Report
Category For Information
Section A: Introduction

• This report provides the Board with a detailed update on the activities of the
Governance Committee (GC) and key governance- related outcomes since the
last report in December 2024. The Governance Committee has had a very
heavy schedule, which will continue into the second half of the year. The GC
held its most recent meetings on 7 April 2025 in Lisbon, and 3 December 2024
in Bali, Indonesia. Additionally, an informal GC meeting was organised recently
on 16 June 2025, and another informal meeting is scheduled in September
2025 to review progress on various workstreams.

• In addition to routine business, this period marked significant advancements in
governance practices, including the launch of the Board Chair recruitment,
ethics and compliance enhancements, and proposals to improve the
representation of implementing countries in Gavi's governance structur es.

• Numerous Board, Alternate Board, and Committee member appointments were
made including to the Governance Committee, Programme and Policy
Committee, Audit and Finance Committee, and Independent Review
Committee (IRC) .

• The GC also approved a broad set of strategic initiatives including:
- Delegation of Authority Policy
- Independent Review Committee Terms of Reference
- Programme Funding Policy and IRC Waivers for 2025
• At its meeting on 21 July 2025 , the GC will review recommendations on various
Board and Committee nominations, the reappointment of two Committee
Chairs , the reconstitution of the Unaffiliated Recruitment Subcommittee, and a
waiver to IRC ToRs for Secretariat -led exceptional grant extensions approval.
The GC will also receive an update on the Board Chair Search process ,
progress on collaboration with other organi sations, and will be updated by t he
Chief Operating Officer on Human Resources issues
• The GC Chair’s report is attached as Annex A in the form of a presentation.

1


Board-2025-Mtg-01-Investment Committee Chair Report
Report to the Board
24-25 July 202 5

Subject Investment Committee Chair Report
Category For Information
Section A: Introduction
• The first half of 2025 marked a volatile period in financial markets and lent a
strong case for portfolio diversification. The onslaught of tariff announcements
put markets on edge and the uncertainty put a dent in confidence. In the U.S.
equity markets dropped in the first quarter giving back some of their gains from
2024. The near -term contraction came out as a –0. 5% contraction in real gross
domestic product (GDP) as published by the Bureau of Economic Analysis. An
increase in imports (a possible indication of forward purchases in anticipation
of tariffs) and a decrease in government spending were the primary explanatory
factors for the drop in GDP. In comparison, this same figure in Q4 2024 was
+2.4%. On the inflation front, the U.S. Federal Reserve held rates steady in the
first half of 2025 , citing uncertainty on the economic impact of current policies.
• More recently the passage of the U.S. budget reconciliation bill brings more
concern about fiscal discipline. Independent estimates suggest a multi-trillion
dollar increase in the U.S. de bt levels, although this trend has been underway
since the Great Financial Crisis ( GFC). In addition, it is unlikely interest rate
levels will return to almost zero rates , so debt service costs will significantly
increase. E bbing confidence on the U.S.’s ability to maintain fiscal discipline will
require a higher risk premium, another factor that will potentially keep rates
higher and debt more expensive.
• In contrast overseas markets fared better in part because investors sought an
alternative to the U.S. opportunities. European equity markets handily
outperformed U.S. equity markets in 1H 2025 in U.S . dollar terms driven by the
euro’s appreciation . In Europe, fiscal spending also increased, driven by
national defence requirements across NATO members. The enthusiasm for the
defence sector drove European stocks in that sector up 50% in the Stoxx 600
index .
• Elsewhere there was an embrace of fiscal and monetary stimulus to counter
the tariff and geopolitical uncertaint ies. Chinese leadership long followed
fiscally conservative principles but broke their tradition in Q 1 2025 with a fiscal
stimulus package to boost ing consumption, increas ing infrastructure spending
and recapitali sing bank balance sheets . Concurrently China’s central bank
reduced the bank reserve requirement ratios to help inject liquidity into financial
markets.
• The geopolitical challenges coincide with a weaker U.S. dollar. As questions
arose U.S. exceptionalism surface, global investors seek to rebalance their
portfolios, and this is especially true of investors whose liabilities are not in U.S.
dollar s. The Investments team initiated work on the U.S. dollar exposure as an

1 Board-2025-Mtg-01-IFFIm Chair Report
Report to the Board
24-25 July 202 5
Subject IFFIm Chair Report
Category For Information
Overview
•This report provides the Board with (1) an overview of IFFIm’s work to- date
supporting Gavi’s 2021 - 2025 strategic period and (2) a summary of anticipated
future capacity.
• Since the last Gavi Board meeting, IFFIm accessed the capital markets on two
occasions . In April, I FFIm increased its existing US$ 1 billion October bond
issu e by an additional US$ 250 million , bringing the total to US$ 1.25 billion –
its largest issue to date.
• In addition, IFFIm issued a GBP 300 million sterling issue in June. This is
IFFIm’s third bond issue in the UK market.
• Both transactions were met with strong investor demand, contributing to
favourable pricing and an increased transaction size.
• At the replenishment sessions held in Brussels, five donors confirmed further
commitments to IFFIm totalling US$ 800 million. Discussions with current and
prospective donors remain active and additional commitments are expected.
• IFFIm continues to serve as a critical and flexible financing instrument within
Gavi’s broader resource mobili sation strategy. Looking ahead, there is
significant potential to expand IFFIm’s donor base and diversify its role in
supporting Gavi’s mission. Gavi and IFFIm will collaborate with donors and
stakeholders to explore strategic options that ensure IFFIm’s model remains
responsive and impactful throughout the Gavi 6.0 period and beyond.
• Annexed hereto is the IFFIm Chair Report to be presented and discussed
during the forthcoming Gavi Board meeting.
Annexes
Annex A: IFFIm Chair report

1


Board-2025- Mtg-01-PPC Committee Chair Report
Report to the Board
24-25 July 202 5

Subject Programme and Policy Committee Chair Report
Category For Information
Section A: Introduction
• This report provides the Board with an overview of the activities of the
Programme and Policy Committee ( PPC) since the Committee Chair last
reported to the Board in December 2024.
• The PPC held an in person meeting on 14- 16 May 2025. During the meeting,
the Committee discussed a number of important topics for the Alliance and
agreed on recommendations which are being put forward to the Board at its
2 4-25 July 2025 meeting for consideration.
• In accordance with Section 3 of the PPC Charter, at its meeting in May 2025
the PPC d elegated to the PPC Chair and the CEO together the authority to
make a recommendation to the Gavi Alliance Board in July 2025 on the country
foundational functions component of the Partnerships Accountability
Framework (PAF), taking into consideration inputs from the PPC at the meeting
and all other consultations as appropriate (see Agenda Item 11).
• The PPC Chair report is attached in the form of a presentation as Annex A and
the PPC recommendations to the Board are attached as Annex B.
Annexes
Annex A: PPC Chair report
Annex B : PPC recommendations to Gavi Alliance Board (May 2025)

Board-2025-Mtg- 01-Doc 04 1
Report to the Board
24-25 July 202 5

Subject Update from the Global Summit: Health & Prosperity t hrough
Immunisation
Agenda item 04
Category For Information

Executive Summary
Gavi’s Fourth Replenishment Campaign culminated in the 2025 Global Summit,
securing so far over US$ 9 billion in pledges toward a US$ 11.9 billion target for
the 2026–2030 strategic period, despite a particularly challenging geopolitical and
fiscal environment marked by competing global funding priorities. The Summit
brought together over 450 participants, including 10 Heads of State and
Government, 25 Ministers as well as senior leaders from U nited Nations (UN)
agencies, multilateral development banks, the private sector, and civil society.
Existing donors reaffirmed their political support, while several new sovereign
donors pledged to Gavi for the first time. Several donors were unable to pledge at
the Summit due to domestic political or budgetary timelines but gave strong
indications of their intent to pledge soon .
More than US$ 4.5 billion in new financial instruments and partnerships were
announced at the Summit. This includes US$ 3 billion from multilateral
development banks to provide countries with flexible, long- term support as they
transition from aid to self-sustained financing. This also includes US$ 1.5 billion in
frontloading facilities to provide additional liquidity to Gavi for rapid and flexible
access to vaccines. The private sector stepped up with new partnerships totalling
over US$ 149 million , including a US$ 40 million investment towards Gavi ’s future
Innovation Scale- Up Fund and other initiatives supporting digital, supply chain, and
delivery solutions. Price reduction commitments by vaccine manufacturers are
projected to generate savings of over US$ 200 million by 2030. Manufacturers also
made commitments on technology transfer and continued investment in R esearch
& Development (R&D) supported by the African Vaccine Manufact uring
Accelerator (AVMA), while civil society played a vital role in amplifying community
needs and driving demand. The Secretariat is now shifting its focus to lock in new
and remaining pledges, as well as fast -tracking the conver sion of pledges into
secured long- term agreements, especially those in local currencies, to ensure
financial stability and manage currency risks. Strategic engagement with key and
emerging donors and Gavi Champions, as well as increased visibility through high-
level fora such as the UN General Assembly and others, will be key priorities in
the months ahead .
Action Requested of the Board
This report is for information only.

gavi.org
UPDATE FROM THE GLOBAL SUMMIT: HEALTH &
PROSPERITY THROUGH IMMUNISATION
BOARD MEETING
Marie -Ange Saraka -Yao
24 -25 July 2025, Geneva, Switzerland
Unprecedented global support at the Summit
2 Board Meeting, 24 -25 July 2025
p articipants … 450
• Co -hosted by H.E. Ursula von der Leyen, President of the
European Commission, H.E. António Costa, President of
the European Council, and Mr. Bill Gates, Chair of the
Gates Foundation
• Convened 10 Heads of State & Government, and 25
ministers
• 55 countries represented, including 34 Gavi implementing
countries, 21 key donor countries
• 10 CEO, Chair, President of industries & private sector
• 10 top leaders of international & financial institutions
• 10 top leadership of global and local CSOs
• Youth voices and advocates…

Board-2025- Mtg-01-Doc 04-Annex A 1
Report to the Board
24-2 5 July 202 5
Annex A : Global Summit’s Strategic Objectives

Board-2025-Mtg- 01-Doc 05 1
Report to the Board
2 4-2 5 July 202 5

Subject Financial Update, including forecast
Agenda item 05
Category For Decision

Executive Summary
The purpose of this paper is to present the updated Financial Forecast for Gavi 5.1
(2021- 2025) on a consolidated basis, including all approved ongoing programmes
for Gavi Board approval based on the recommendation of the A udit and Finance
Committee (AFC). There are no financial implications from the recommendations
made to the Programme and Policy Committee (PPC) on the Gavi 5.1 financial
forecast. T he latest Gavi 6.0 projections reflecting the outcome and financial
implications of the 25 June Global Summit will be presented to the AFC on 17 July
and then at the 22- 23 July Board retreat. The Gavi 6.0 financial forecast will be
formally presented to the Board for approval at the December 2025 Board meeting.
Since the previous financial forecast there has been a significant increase in
uncertainty with broader changes in international development increasing country
delivery risk for all development actors including the Gavi Alliance with reports of
disruption to vaccination activities and monitoring with countries, Alliance partners
and expanded partners. A s noted to the AFC, the Secretariat is closely monitoring
the risks associated with the current operating context and is actively implementing
mitigating act ions where possible. Nevertheless, t his uncertain context is reflected
in several changes to the financial forecast including the broader range forecast
outlined in the risks and opportunities section with key changes set out below:
• Resources: removal of US$ 300 million donor funds from 2025, in line with the
risk outlined in the prior financial forecast;
• Programmatic expenditure: net reduction of US$ 16 4 million to base expenditure
plans, reflecting reduced COVID -19 (C19) demand / C19 Delivery Support (CDS)
and later phasing of cash- support disbursement timing; and
• Execution risk adjustment: a reduction in country programmatic disbursements
of US$ 214 million to reflect the risk of disbursement delays in 2025 given the
impact of the global health funding context (noting that this adjustment is made
centrally as the specific impacts on individual country delivery is not yet known).
After reflecting the above assumptions, the Gavi 5.1 consolidated financial forecast
confirms financial flexibility with US$ 185 million available for future investment .
As most country plans remain unchanged and the financial results for the half year
reflect strong vaccine demand with vaccine disbursement s ahead of the forecast ,
the Secretariat seeks approval to draw down on these remaining funds should the
aforementioned global health capacity execution risk not materialise.
COVAX AMC: The consolidated Gavi 5.1 financial forecast covers all ongoing
approved programmes, including those funded from repurposed COVAX AMC funds

gavi.org
FINANCIAL UPDATE, INCLUDING FORECAST
BOARD MEETING
François Note
2 4 -25 July 2025, Geneva, Switzerland
Classified as Internal
Gavi 5.1 (2021 - 2025) : Updated Forecast
Qualifying resources (US$ 13.7 bn)
US$ 361 million decrease
• US$ 300 million decrease in allowance for further
direct contributions
• US$ 149 million repurposed resources transferred
to PVP (lower C19/CDS)
• US$ 88m increase in investment income and
CEPI
Expenditure (US$ 13.4 bn)
US$ 386 million decrease
• US$ 149 million lower C19/CDS costs
• Programmatic execution risk US$ 214m
Available for investments (US$ 0.2 bn)
• In the event that lower vaccine demand does not
materialise
Note : The forecast is prepared on a consolidated basis encompassing all approved ongoing programmes, including those funded by re pur posed COVAX AMC funds (C19, CDS, Big Catch Up). Additional programme
detail can be found in Annex A to this Agenda Item , including the reconciliation of the prior forecast (v22, approved at the December 2024 Board meeting) from a source -of-funding basis to a consolidated basis
2 Board Meeting, 24 -25 July 2025 New
Forecast (v22)
Dec 2024 Board
Change
upon updating
estimates
New
Forecast (v22.1)
July 2024 Board
Assured Resources (projected) 13,635 (61) 13,574
Allowance for Further Direct Contributions 300 (300) -
Qualifying Resources 13,935 (361) 13,574
$13.9 bn $13.6 bn
Total Expenditure 13,774 (386) 13,388
$13.8 bn $13.4 bn
160 25 185
$0.2 bn $0.2 bn
2021-2025 Overview of resources to meet
expenditure (US$m)
Available for future investments

Board-2025-Mtg-01-Doc 05-Annex A 1
Report to the Board
24-25 July 202 5
Annex A: Financial Forecast Additional Info
1. Gavi 5.1 Consolidated Forecast restatement ( prior forecast v22, Dec Board)
As the forecast is now prepared on a consolidated basis (consistent with the
basis o f preparation used for the reporting of quarterly actual financial
performance), the table below provides visibility to the Board on the restated
v22 financial forecast (Dec 2024 Board) used as the comparative in financial
tables for this v22.1 forecast update.
Figure 1: Consolidated Gavi 5.1 v22 forecast including programmes funded from repurposing
a b c d e


Note: Opex reflects the cost of Secretariat for the strategic period funded by Gavi 5.1 and COVAX AMC. PEF
Studies & Evaluations is now presented with other PEF programmes.
Further explanation of restatement columns :
a) As presented in Dec ember 20 24: Gavi 5.1 Financial Forecast (excluding
any repurposed funding) approved by the Board in December 2024.
b) COVAX AMC funding: Funding from COVAX AMC repurposed funds to
support ongoing Gavi 5.1 programmes (in line with donor intentions) as
approved by the Board in December 2024. Excludes any repurposed
funding for specific ring- fenced Board approved programmes.
c) Including repurposed: Total expenditure for Gavi 5.1 continuing
programmes including COVAX AMC repurposed funds.
d) COVAX AMC funded programmes: On going Gavi programmes funded by
COVAX AMC funds approved by the Board for specific time or USD
v22 forecast Repurposed v22 forecast v22 forecast Gavi 5.1 2021-25 as-presented
COVAX AMC including Consolidated $M cashflow basis Dec 24 Boardfunding repurposing
C19 BCU CDSAVMAPPPR/DZF Other View
Direct contributions
7,443 7,443 7,443 IFFIm Proceeds2,265 2,265 2,265 Interest & investment income583 583 583 Total Inflows10,291 0 10,291 0 0 0 0 0 0 10,291
Cash & investment reserve 221 221 221 Repurposed funds 818 818 385 290 1,458 10 57 105 3,123 Allowance for future contributions 300 300 300 Qualifying Resources10,811 818 11,629 385 290 1,458 10 57 105 13,935
Routine4,298 4,298 356 4,654 Campaign1,719 1,719 1,719 Outbreak489 489 489 Other (BCU, Portfolio adj) (586) 709 123 269 392 Vaccine procurement 5,920 709 6,629 356 269 0 0 0 0 7,254
Immunisation support (Ops/VIGs/PSG) 667 667 667 HSIS1,569 75 1,644 1,644 PEF1,289 34 1,323 21 1,344 CDS 91 91 1,435 1,526 Other cash programmes 442 442 10 57 509 Cash disbursement 4,059 108 4,167 0 21 1,435 10 57 0 5,690
Opex 673 0 673 29 23 105 830 Total Expenditure 10,651 818 11,469 385 290 1,458 10 57 105 13,774
Net available funds 160 0 160 0 0 0 0 0 0 160
COVAX AMC funded programmes
Outflows
Inflows

Board-2025-Mtg- 01-Doc 06 1
Report to the Board
24-25 July 202 5

Subject Funding Policy Review
Agenda item 06
Category For Decision

Executive Summary
The purpose of this paper is to request the Board approve the revised Eligibility and
Transition Policy (Annex A), the Co- financing Policy (Annex B) and the Health
Systems and Immunisation Strengthening (HSIS) Policy (Annex C) . The revised
policies reflect policy options approved by the Gavi Board in December 2024 as part
of the Funding Policy Review (FPR).
Since December 2024, the FPR has developed aspects of Gavi’s approach to
programmatic sustainability and the guardrail for measles/measles -rubella follow -up
campaigns , as included in the draft HSIS Policy and outlined in this paper .
Consultations on the draft policy documents were held with countries , technical
partners, civil society organisations (CSOs) and other stakeholders such as vaccine
manufacturers. The draft policies were also hosted on Gavi’s website for an open
consultation.
The implementation of the funding policy shifts is a core component of Gavi 6.0
Operationalisation (Doc 09 ) and is aligned with the Gavi 6.0 Health System Strategy
and the Gavi 6.0 Partnership model (Doc 11 ).
The paper also seeks approval from the Board on co -financing for Hepatitis B birth
dose and DPT boosters, as well as other new vaccine introductions .
Action Requested of the Board
The Gavi Alliance Programme and Policy Committee recommended to the Gavi
Alliance Board that it:
a) Approve the revised Eligibility and Transition Policy attached as Annex A to
Doc 06;
b) Approve the revised Co- financing Policy attached as Annex B to Doc 06 , as
amended by discussions at the PPC;
c) Approve the revised Health Systems and Immunisation Strengthening (HSIS)
Policy attached as Annex C to Doc 06 ;
d) Approve a minimum co -financing threshold of US$ 0.20 for the introduction of
Hepatitis B birth dose and DTP booster in countries in preparatory and
accelerated transition.

gavi.org
FUNDING POLICY REVIEW
BOARD MEETING
Marta Tufet Bayona
Emmanuel Bor
2 4 -25 July 2025, Geneva, Switzerland
Gavi’s funding policies revised to ensure fit - for -
purpose in 6.0 – final stage of Funding Policy Review
Gavi’s Funding
Policies
Vaccine procurement,
safeguards and exceptions
Co -financing Policy
Eligibility and Transition Policy
Sustainable progress:
readiness, criteria and
progress
Sustainable and
equitable immunisation,
system -wide support
Health Systems and
Immunisation Strengthening
Policy
The Middle -Income Countries
(MICs) Approach integrated into
Gavi’s core model as the new
Catalytic phase
Board Meeting, 24 -25 July 2025 2

Board-2025-Mtg-01-Doc 06-Annex A

Gavi , the Vaccine Alliance
Eligibility and Transition Policy




DOCUMENT ADMINISTRATION



VERSION
NUMBER APPROVAL PROCESS DATE
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
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
4.0 Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 1 November 2022
Approved by: Board 8 December 2022
Effective from: 1 January 2023
Next review: At the request of the Board
5.0 Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 16 May 2025
Approved by: Board [Full date]
Effective from: [Full date]
Next review: At the request of the Board




Board -2025- Mtg-01-Doc 06-Annex A

Gavi , the Vaccine Alliance
Eligibility and Transition Policy

1. Purpose and Objective
1.1. The objective of this policy is to set out the criteria and procedures that determine
which countries
1 are able to receive Gavi support and to define the transition
pathway through which this support is phased out . The purpose is to ensur e 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 these countries is found in
the Co-financing policy, the Health Systems and Immunisation Strengthening
(HSIS) policy, as well as other context -specific funding approaches . Additionally,
the Framework for Gavi Funding to Countries outlines the overall structure of
Gavi’s support to countries.
2. Definitions
• Countries able to receive Gavi support: Countries that are in one of Gavi’s
four transition phases: initial self -financing, preparatory transition, accelerated
transition, and catalytic. These phases and thresholds are detailed in section 4
of this policy. A country’s phase has implications on t he type and level of support
a country can receive. The ability to receive support does not imply an
entitlement.
• Gavi -eligible country: a country which is in initial self -financing phase,
preparatory transition phase, or accelerated transition phase.
2
• Gross National Income per capita (GNI p.c.) : GNI is the gross national income,
converted to U.S. dollars using the World Bank Atlas method, divided by the
midyear population. 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.
• Small Island Developing States (SIDS): A distinct group of States and
Associate Members of United Nations regional commissions that face unique
social, economic and environmental vulnerabilities as defined by the United
Nations .
3. Principles
3.1. The following principles guide the application of the Gavi -eligibility and transition
policy:
• Country led, sustainable: Gavi support is country led , meaning that it bolsters
country leadership to sustainably prioritise , deliver and finance immunisation. It
is directly linked to a country’s ability to pay and is intended to be catalytic and
time -limited and to incentivise domestic i nvestment in health.

1 In this document, the term ‘countries’ is used to denote both countries and economies. Gavi’s
engagement does not imply the expression of any opinion whatsoever on the part of Gavi concerning
the legal status of any country, territory or area or of its authorities, or concerning the delimitation of
frontiers or boundaries.
2 F or added clarity, a country which is in the catalytic phase is not Gavi -eligible

Gavi , the Vaccine Alliance
Co-financing Policy




DOCUMENT ADMINISTRATION




VERSION
NUMBER APPROVAL PROCESS DATE
Prepared by: Robert Newman, Policy
and Performance
2.0 Reviewed by: Gavi Programme and
Policy Committee 4 May 2015
Approved by: Gavi Alliance Board June 2015
Effective from: 1 January 2016
3.0 Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 1 November 2022
Approved by: Board 8 December 2022
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
4.0 Prepared by: Marta Tufet, Head,
Policy
Reviewed by: PPC 16 May 2025
Approved by: Board [Full date]
Effective from: [Full date]
Next review: At the request of the Board




2

Gavi , the Vaccine Alliance
Co -financing Policy
1. Purpose and Objective
1.1. The objective 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 Gavi’s operational guidelines. The purpose of this policy is to
facilitate the mobilisation and sustaining of domestic financing for vaccines
introduced with Gavi support .
1.2. This policy covers:
1.3. Vaccine co-financing levels for Gavi -eligible countries as defined in the eligibility
and transition policy. [ For countries in the catalytic phase, there are no country co-
financing requirements for vaccine support as these countries are expected to fully
finance the vaccines they introduce while in this phase (except for potential vaccine
catalytic financing equi valent to 50% of a first, single age cohort) ]. Vaccine support
for countries in each transition phase is outlined in the Framework for Gavi Funding
to Countries 1, and the Gavi’s operational guidelines 2.
1.3.1. Compliance requirements, and
1.3.2. Exceptions
1.4. 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 the Health Systems and Immunisation Strengthening (HSIS)
Policy defines Gavi’s HSIS support as well as support available for countries the
Catalytic phase .
2. Definitions
• Co -financing share: T he share of total cost of co- financed vaccines - including
the cost of devices and freight – that are covered by countries.
• Grace year: first year of preparatory or accelerated transition phase. During this
year, the co -financing rules of the previous transition phase apply .
• Price fraction: The proportion of a vaccine's price that is used to calculate the
amount a country must co-finance for that vaccine.
3. Key Principles [and Commitments]
3.1. The following principles guide the application of the co- financing policy:
• Country led, sustainable: Gavi support is country -led , meaning that it bolsters
country leadership to sustainably prioritise, deliver and finance immunisation. It
is directly linked to a country’s ability to pay and is intended to be catalytic and
time -limited and to incentivise domestic investments in health.

1 https://www.gavi.org/programmes -impact/programmatic -policies 2 https://www.gavi.org/our -support/guidelines

Board-2025-Mtg-01-Doc 06-Annex C

Gavi , the Vaccine Alliance
Health Systems and Immunisation
Strengthening Policy



DOCUMENT ADMINISTRATION



VERSION
NUMBER APPROVAL PROCESS DATE
Prepared by: Marta Tufet, Head,
Policy
1.0 Reviewed by: PPC 1 November 2022
Approved by: Board 7-8 December 2022
Effective from: 1 January 2023
Next review: At the request of the Board
Prepared by: Marta Tufet, Head,
Policy
2.0

Reviewed by: PPC 16 May 2025
Approved by: Board [Full date]
Effective from: 1 January 2026
Next review: At the request of the Board




Board -2025- Mtg-01-Doc 06-Annex C

Gavi , the Vaccine Alliance
Health Systems and
Immunisations Strengthening

1. Purpose
1.1. The purpose of this policy is to define Gavi’s Health Systems and Immunisation
Strengthening (HSIS) support for countries in the initial self -financing, preparatory
transition, and accelerated transition phases, as well as programmatic support
available for countries that have transitioned out of the accelerated transition phase
and in the catalytic phase. The policy :
• Establishes the principles that guide Gavi’s HSIS support

• Defines the composition of an HSIS grant including its investment
requirements

• Outlines the allocation methodology that determines funding levels for
countries in the initial self -financing, preparatory transition, and accelerated
transition phases, and

• Sets out how Gavi’s funding levers are designed to promote programmatic
sustainability
2. Scope
2.1. The policy applies to all countries able to receive Gavi support as defined in
Gavi’s Eligibility and Transition Policy
1; however, the use of the support and how it
is accessed differs according to a country’s transition phase. Gavi’s HSIS support
can be accessed by countries in the initial self-financing phase, preparatory
transition phase and accelerated transition phase
2 through an HSIS grant 3
(section A) .
2.2. For countries in the catalytic phase, the policy guides Gavi’s support for the
sustainable and equitable introduction of high- impact vaccines, and to prevent and
mitigate backsliding in vaccine coverage (section B) .
2.3. In addition, countries able to receive Gavi support can access funding for chronic
fragility, emergencies and hosting displaced populations through Gavi’s Fragility,
Emergencies and Displaced Populations (FED) Policy .
2.4. The Framework for Gavi Funding to Countries provides an overview of the
objectives , principles and approach for all Gavi support to countries .

1 Countries that are in one of Gavi’s four transition phases: initial self -financing, preparatory transition,
accelerated transition, and catalytic. The term Gavi -eligible country refers to a country which is in Initial Self -
Financing phase, Preparatory Tra nsition phase, or Accelerated Transition phase, as outlined in Gavi’s Eligibility
and Transition Policy.

2 A country in the Accelerated Transition phase at risk of unsuccessful programmatic transition may apply for five
years of additional targeted HSIS support which could be provided after the country has transitioned out of the
AT phase. Small Island Developing States (SIDS) remain in the Accelerated Transition (AT) phase for a total of 12
years with continued access to HSIS support.

3 In Gavi’s 6.0 Strategic period, a consolidated cash grant to countries replaces the following 5.0 individual funding
levers: Health Systems Strengthening (HSS), Equity Accelerator Funding (EAF), operational support for preventive
campaigns including Measles/Measles -Rubella follow -up campaigns and other preventive campaigns (Ops),
Vaccine Introduction Grants (VIGs), switch grants , Innovation Top-Up, Cold Chain Equipment Optimisation
Platform (CCEOP) and Partnership Engagement Framework (PEF) Targeted Country Assistance (TCA).

Board-2025- Mtg-01-Doc 06-Annex D 1
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24-2 5 July 202 5
Annex D : Framework for Gavi Funding to Countries

1. Purpose, Scope and Rationale

1.1 This document serves as an overarching framework for Gavi’s three
programmatic funding policies for countries able to receive Gavi support: a)
Eligibility & Transition Policy; b) Co -financing Policy; and c) Health Systems and
Immunisation Strengthening (HSIS) Policy.

1.2 Gavi supports low and lower -middle income countries to increase the equitable
and sustainable use of vaccines in routine immunisation programmes, whilst
also ensuring successful transition from Gavi support and long- term
sustainability. Funding can include vaccine procurement including financial and
technical support for the introduction of new vaccines, planned campaigns and
other supplemental delivery strategies, as well as to strengthen health systems,
and efforts to extend routine immunisation services to reach zero -dose and
missed communities. This document sets out the objectives, principles and
approach for Gavi funding to countries able to receive Gavi support as defined
in the Eligibility and Transition policy.

1.3 This document does not cover Gavi’s outbreak response for certain outbreak
and epidemic -prone diseases, support or special initiatives which Gavi might
fund from time to time. Gavi supports global stockpiles and other outbreak
response mechanisms, through which Gavi eligible countries can access fully
funded vaccines.

1.4 The principles of Gavi funding are outlined in each of the policy documents: a)
country -led, sustainable ; b) equity ; and c) differentiated, transparent and
predictable.

2. Gavi Funding to Countries: Introduction
2.1 Countries transition through Gavi’s support phases as their ability to
domestically finance their immunisation programmes increases. Gavi’s support
is divided into four phases: (i) initial self -financing, (ii) preparatory transition, (iii)
accelerated transition and (iv) catalytic, determined by GNI per capita as a
proxy for ability to pay (see Figure 1). As countries transition through these
phases their needs change and countries adjust the use of Gavi funding to meet
those needs. It is expected that Gavi funding will decrease over time, but that
countries will continue to adhere to core principles of equity and sustainability. 
2.2 Gavi encourages countries in initial self -financing, preparatory transition and
accelerated transition phases to plan all their Gavi funding needs in an
integrated manner when planning their HSIS grant which takes a 5 -year view
of country support and for w hich countries apply for in the first two years of a
strategic period. In doing so, countries are encouraged to utilise funding to the
fullest extent, establish clear priorities, and pursue greater efficiencies.   

Board-2025- Mtg-01-Doc 06-Annex E 1
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24-2 5 July 202 5
Annex E : Risk implication and mitigation including for countries and the Alliance 

This annex outlines the risks and proposed mitigation measures associated with the
implementation of the revised funding policies through the Funding Policy Review. The
risks and mitigations are based on Secretariat analysis and consultations with Alliance
partners and countries.
Key risks and mitigation measures are outlined in the table below:  
Risk    Mitigation measures  
Outcome of a potential
recalibration of Gavi
6.0 priorities post
Gavi’s replenishment
The policy shifts approved by the Board in
December 2024 through the Funding Policy
Review, aimed to maximise objectives of
sustainability, health impact, equity, and market
shaping. However, uncertainty about replenishment
outcomes and potential need to r ecalibrate priorities
could put some of these objectives at risk, for
example if funding is reduced for ELTRACO shifts
and/or the catalytic phase and/or the overall cash
available to support the Health Systems and
Immunisation Strengthening (HSIS) grants.

Furthermore, specific details of the policies,
depend on any potential recalibration of Gavi 6.0
priorities by the Board after the replenishment,
including a) nominal caps and floors for the HSIS
grant, b) on programmatic sustainability, eligibility
thresholds for countries nearing transition and but
f acing persistent programmatic challenges level of
consequence for non- payment of CJI, and c)
options for addressing the pace of change in co-
financing in PT countries.
Country capacity:
countries may face
challenges in the
planning,
prioritisation,
management and
implementation of a
single 5- year HSIS
grant.

Gavi is developing tailored guidance to support
countries through the application and planning
process as part of the Funding and Programme
Guidelines. These will include flexibilities for
reprogramming and adjustments as priorities evolve
and processes to ensure disbursements reflect
agreed upon milestones and plans, as well as
reporting structures that allow Gavi to follow the
implementation of key interventions. Pilots under
the grant management reform will inform broader
implementation
including Alliance roles and
responsibilities at country level.
Guardrails to
safeguard critical
Guardrails have been kept to a limited, well -defined
set of critical areas based on extensive consultation.

Board-2025-Mtg-01-Doc 06-Annex F 1
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24-25 July 202 5
Annex F: Integration of Board decisions (Dec 2024) into ELTRACO policies   

Decision 9: ELTRACO, including Catalytic Phase 

Decision Eligibility Policy Co - Financing Policy Comments
Shift A        
Under Shift A,
approved:   

i. Directly
linking country
co- financing
contribution to
the price of the
vaccines for
specific vaccine
markets for
Initial Self -
Financing
Countries,
where certain
conditions are
met (as outlined
in Annex B to
Doc 06bii);   
 
n/a   4. Procedures
and Funding
Levels for
Routine
Vaccines
 

4.2 Initial self -
financing 
4.2.1 Countries in
the initial self -
financing phase
are required to
contribute US$
0.20 per dose,
with no annual
increase. For
specific vaccines
that meet specific
conditions and
are approved by
the Board, a price
fraction applies.
Further details on
specific
conditions at
vaccine level can
be found in the
Gavi’s
operational
guidelines.  
To be
reflected in
the Gavi
Funding
Guidelines.
 
Under Shift A,
approved:   

ii. Determining
the percentage
of the vaccine
price that the
country will pay
n/a   n/a   For reference
when
determining
specific price
fractions for
vaccine
programmes

Board-2025-Mtg- 01-Doc 07 1
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2 4-2 5 July 202 5

Subject Update on Mpox
Agenda item 07
Category For Decision

Executive Summary
The purpose of this paper is to provide an update on the ongoing mpox response,
with a focus on the Gavi Secretariat’s actions, and on the potential establishment of
a global mpox vaccine stockpile for outbreak response. This update and the
investment case have been informed by guidance from Alliance partners and builds
on the consultative process of the Vaccine Investment Strategy leading to the June
2024 in-principle approval of a global mpox stockpile .
Action Requested of the Board
The Gavi Alliance Programme and Policy Committee recommended to the Gavi
Alliance Board that, contingent on financial resources being made available for the
Gavi 6.0 strategic period, it:
a) Approve the opening of a funding window for the establishment of an mpox
programme through an emergency stockpile for i) reactive vaccination in an
outbreak setting and ii) potential repurposing of stockpile doses at risk of expiring
for preventive vaccination in at- risk groups contingent on SAGE
recommendations;
b) Note ongoing efforts to address data gaps, including the stockpile sizing learning
agenda and the collaborative design of the global stockpile, shaping the final
programme and financial estimates.
Next steps/timeline
If approved, taking into consideration any potential recalibration of Gavi 6.0 priorities
by the Board and contingent on financial resources being made available, the Gavi
Secretariat will initiate the programme planning and design phase in consultation
with the ICG and Alliance partners. This phase is expected to last approximately
9- 12 months with an expected earliest availability of vaccines through a stockpile in
H2 2026.
Previous Board Committee or Board deliberations related to this topic
In May 2025 Programme and Policy Committee folder : Doc 15 - Update on mpox
In December 2024 Board meeting book : Doc 07 - Gavi’s response to mpox
In June 2024 Board meeting book : Doc 11 - Vaccine Investment Strategy 2024 -
Proposed shortlist

gavi.org
UPDATE ON MPOX
BOARD MEETING
Emanuele Capobianco
24 -25 July 2025, Geneva, Switzerland
Context : mpox outbreak and response
2
*Data source: World Health Organisation. Confirmed cases and deaths only. Data as of 06 July 2025.
2024 -2025 numbers in Africa*
Total confirmed cases 44,776
Total confirmed deaths 166
Active outbreak continues to affect multiple
countries in the African region (with DRC the
epicentre ), with exported cases reported globally
With continental and global public health emergency
declarations extensions until Sept 2025, Gavi continues to
support vaccine response as part of cross partner efforts
• Progress in access to vaccines and vaccine roll -out :
o Seven countries vaccinating with two more expected
• Country challenges : Global and domestic including
conflict and resource limitations in health systems,
surveillance and testing
• Gavi engaged in learning efforts :
o Both internal & cross -partner led learning and
monitoring of progress and results
o Collaborating with partners to integrate learnings
Board meeting , 24-25 July 2025

Board-2025-Mtg- 01-Doc 07 -Annex A 1
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24- 25 July 202 5
Annex A : Risk and impact
A.1. Key risks and mitigations associated with the Gavi Secretariat ’s
current response to mpox outbreak
Key risks and
challenges
Risk
rating pre
mitigation
Proposed mitigations Risk
rating
post
mitigation
Delivery funding:
Timelines for
disbursement of delivery
funding from Gavi have
been longer than desired
for an outbreak (for a mix
of reasons – some linked
to Gavi disbursement
processes and others
linked to delays in
country acceptance of
doses / development of
national plans/submission
of requests for funding to
Gavi)
High
WHO and Africa CDC are
providing technical assistance to
countries for the development of
national plans / preparation for
delivery funding applications.
The Secretariat has a tracker in
place to identify process delays,
and country teams are
prioritising mpox applications as
well as permitting the use of
available in- country funds where
feasible. While mpox delivery
funding has gone out quicker
compared to routine
disbursements from Gavi (and in
some cases, faster than COVID -
19 delivery funding), learnings
from mpox are being integrated
into grant management
transformation workstreams in
preparation for Gavi 6.0 to
further identify improvements in
disbursement processes. No
further delivery funding
applications are now expected ?
which means focus will be on
disbursing as swiftly as possible
over coming weeks.
Low
Supply and funding
gaps: There will likely be
gaps in supply / funding
between current support
(funded by Gavi FRF and
others ) and the global
mpox stockpile (subject
to Board approval). This
may reduce the overall
impact / sustainability of
Very high
Dose sparing / fractional dose
strategies, approved for use by
WHO SAGE are being
discussed by partners and
countries. Targeted
redeployment of doses from
certain countries may also take
place to ensure stock availability
in countries of greatest need and
there is close scrutiny on t he
High

gavi.org
OUTBREAK OVERVIEW &
GLOBAL MPOX STOCKPILE
INVESTMENT CASE -ANNEX B
BOARD MEETING
24-25 July 2025, Geneva, Switzerland
Contents
2
1.Outbreak overview - June 2025
2. Rationale for investment in a global mpox
stockpile
3. Learning agenda on stockpile sizing and
health impact
4. Vaccine policy & market shaping
considerations
5. Financial estimates and stockpile
assumptions
6. Evaluation framework Appendix I: Additional Context on
Outbreaks and Mpox Stockpile
A.
Glossary​
B. Disease overview​
C. SAGE / WHO 2024
recommendation
D. Implementation considerations
and Health System
Strengthening needs​
E. Experts & Sources
Board Meeting, 24- 25 July 2025

Board-2025-Mtg- 01-Doc 08 1
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2 4-2 5 July 202 5

Subject Respiratory Syncytial Virus (RSV) Investment Case
Agenda item 08
Category For Decision

Executive Summary
Respiratory Syncytial Virus (RSV) is the leading cause of pneumonia and infant
hospitalisation, and the second leading etiology of infant deaths . In 2018, Gavi’s
Board approved, in -principle, through the Vaccine Investment Strategy (VIS), RSV
immunisation products contingent on key conditions, now met with a licensed,
WHO-prequalified, and SAGE -recommended maternal RSV vaccine to protect
infants, with its manufacturer committed to offering terms for Gavi access .
The purpose of this paper is to present an update on RSV’s high burden, the
vaccine’s health and economic impact, and request Board approv al to open a
funding window for a potential RSV maternal vaccine programme.
This investment case was informed by guidance from an RSV Working Group with
representatives from partners including WHO, UNICEF, Africa Centres for Disease
Control (CDC) , the Gates Foundation, and consultations with countries,
independent experts, and vaccine manufacturers .
Action Requested of the Board
The Gavi Alliance Programme and Policy Committee recommended to the Gavi
Alliance Board that, contingent on financial resources being made available for the
Gavi 6.0 strategic period, it:
a) Approve the opening of a funding window for the establishment of an RSV
maternal vaccine programme to protect infants;
b) Note that the initial cost estimates associated with the above approval for the
period 2026- 2030 are US$ 14.8 million. Future financial forecasts will reflect
potential changes in the underlying assumptions of these estimates.
Next steps/timeline
If approved, taking into consideration any potential recalibration of Gavi 6.0
priorities by the Board and contingent on financial resources being made available,
Gavi would begin a 12– 18-month planning phase to co- develop implementation
strategies with partners and launch a market shaping roadmap. With WHO
prequalification of the multidose vial expected by late 2026, the first application
window could open in late 2027, with introductions starting in 2028.

gavi.org
RESPIRATORY SYNCYTIAL
VIRUS (RSV) INVESTMENT
CASE
BOARD MEETING
Marta Tufet Bayona
2 4 -25 July 2025, Geneva, Switzerland
2 Board Meeting, 24 -25 July 2025
Maternal
vaccine
• Licensed and introduced in many HICs & MICs, no LICs yet.
• SAGE -WHO recommendation for global use
• WHO Prequalification: Single -dose vial. Multi -dose vial expected
2026
• Meeting 2018 financial assumptions
The maternal vaccine to protect infants has now met
original VIS 2018 investment conditions
• This investment case focuses on the maternal vaccine to protect infants
• Focusing specifically on the multi -dose vial presentation of the maternal vaccine

Board-2025-Mtg-01-Doc 08-Annex A 1
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24-25 July 202 5
Annex A : Implications and Anticipated impact
Scenario assessed : Investment in a maternal vaccine to protect infants
against RSV .
Risk of Inaction
Strategic
- Gavi’s core mission is to expand access to life -saving
vaccines. Not investing in RSV immunisation would result in a
significant gap in addressing one of the major causes of severe
respiratory illness and deaths
in infants. This inaction may
weaken Gavi’s ability to achieve its strategic goals related to
child mortality reduction.
High
Programmatic
- RSV is the leading cause of acute lower respiratory infections
(ALRI) in infants, leading to hospitalisations and deaths.
Without investment, RSV - related mortality will remain high,
particularly in Lower Middle- Income Countries (LMICs) where
access to advanced care is limited.
Very
High


- Without Gavi support, RSV vaccines will not be widely
introduced in LMICs, exacerbating health inequities. Countries
may face challenges in independently procuring RSV
immunisation products at comparable prices and potentially
resulting in delays to implementation.

High
Financial
- RSV hospitalisations generate substantial costs for countries,
including inpatient care, oxygen therapy, and intensive care
unit admissions. Without prevention efforts, these costs will
remain high, diverting already limited resources away from
other health priorities .
Very
High
Market
- Without Gavi’s investment, manufacturers may focus on high-
income country markets, reducing incentives for the
development of affordable, scalable RSV products tailored to
LMIC needs.
There is an important need to clarify the
magnitude of the potential Gavi demand as soon as possible
to ensure the manufacturer can plan capacity to align with the
expected materiali sation of demand.
This could slow
innovation and hinder access to lower -cost options .
High
Reputational -
Gavi has been instrumental in shaping global vaccine markets
and expanding equitable access. A failure to act on RSV
-
despite prior signaling to manufacturers, an in- principle Board
decision, the known RSV burden, and the availability of
effective interventions— could not only weaken Gavi’s
reputation as a global health organisation, but also undermine
the effectiveness of its market shaping approach enabling
High

gavi.org
Respiratory Syncytial Virus(RSV)
Investment Case –Annex B
BOARD MEETING
24-25 July 2025, Geneva, Switzerland
Contents
1. Executive summary
2. Previous decisions & key updates
3. Vaccine pipeline & programmatic timeline
4. Updated demand forecast
5. Updated health impact
6. Updated costs
7. Evaluation framework
8. Country perspective Appendix:
A. Glossary of terms
B. Disease overview
C. SAGE / WHO 2024 recommendation
summary
D. Supplementary information on
quantitative analysis methodology
E. Vaccine evaluation scorecards &
additional analysis
F. Implementation considerations and
Health System Strengthening needs
G. Experts & Sources
2 Board Meeting, 24-
25 July 2025

gavi.org
ALIGNMENT OF COUNTRY
GRANT CYCLES WITH THE
GAVI STRATEGY CYCLE
BOARD MEETING
Johannes Ahrendts
2 4 -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
C onsolidated 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

Board-2025-Mtg- 01-Doc 09 1
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Subject Alignment of Country Grant Cycles with the Gavi Strateg y Cycle
Agenda item 09
Category For Guidance

Executive Summary
This paper seeks Board guidance on the proposed approach to move to fixed
country grant cycles aligned with the Gavi five- year strategy cycle (‘grant
cycle alignment’) through a two- year window at the start of Gavi 6.0. This is a
central element of Gavi’s grant management reform, which aims to make it easier
for countries to work with Gavi and to ensure the Secretariat works as efficiently as
possible as envisioned by the Gavi Leap and the Gavi 6.0 strategy. Build ing on the
December 2024 Board decision to consolidate multiple cash grants into a single
cash grant , grant cycle alignment is part of the first strategic shift of the grant
management reform ( ‘creat ing a consolidated and aligned funding architecture’ ). 1
G rant cycle alignment will enable countries to plan for their full five years of Gavi
support early in the Gavi 6.0 strategy period, strengthening predictability of their
planning processes, ensuring alignment of their plans with Gavi’s strategy and own
priorities, decreas ing financial transaction cost across the Alliance and enabling a
stronger focus on implementation and course correction. It also presents an
opportunity to better synchronise the Gavi’s and The Global Fund’s funding models
as of their funding periods starting in 2026/2027, reducing administrative burden on
countries, and foster ing an integrated approach to programme planning and
implementation at country level .
Countries will transition into fixed grant cycles through one of two pathways in
2026- 2027: either by submitting a single holistic application (~60% of countries) or
by consolidating existing grants into a single aligned cash grant (~40% of countries) .
The proposed approach has been informed by consultations with countries, Alliance
partners and Gavi Secretariat teams.
Action Requested of the Board
The Gavi Alliance Board is requested to provide guidance on the proposed
approach to move to fixed country grant cycles aligned with the Gavi five -year
strategy cycle (‘grant cycle alignment’) .


1 The other elements to deliver on this shift consist of a. single cash grant and single holistic application for Gavi
support, inclusive of all vaccine support (as approved by the Board in December 2024); b. application of a “use- it-
or -lose -it” policy for the consolidated cash grant ; c. leverage opportunities for alignment with The Global Fund in
line with the Lusaka Agenda and the Gavi Leap

Board-2025- Mtg-01-Doc 09-Annex A 1
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24-2 5 July 202 5
Annex A: Transition Pathways to New Grant Cycles

1. Summary grant transition plan

2. Interaction of different scenarios for country planning (i.e. NIS) with grant
cycles

1


Board- 2025-Mtg-01-Doc 10
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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
GAVI 6.0 FRAGILE AND
HUMANITARIAN APPROACH
BOARD MEETING
Amy LaTrielle
Johannes Ahrendts
2 4 -25 July 2025, Geneva, Switzerland
2 Board Meeting, 24 -25 July 2025
2
4. Provide responsive
support for fragility,
emergencies and
outbreaks
3. Strengthen
humanitarian
partnerships
Priority interventions Outcomes
Immunisation coverage
is maintained or increased
2. Provide
differentiated health
system support
1. Focus on context -
appropriate vaccines
Missed communities
and zero -dose children
reached
Immunisation is embedded
in humanitarian
programming
Continuity of
immunisation despite
shocks
SG2: Strengthen
health systems to
increase equity in
immunisation
SG1: Introduce and
scale up vaccines
SG3: Improve
programmatic &
financial
sustainability
• Systematic advocacy for
immunisation, equity imperative,
and access to vaccines
• Harmonised policies and
operationalised differentiated
risk appetite
• Responsive and timely access
to vaccines and funding
• Flexible grant programming for
proven partners
• Established skillset at
Secretariat for fragile and
humanitarian settings
• Intentional engagement with
humanitarian sector
• Timely and relevant data for
decisions and accountability
Levers
Theory of Change outlines clear levers of influence,
interventions, outcomes and goals for the F&H approach
Goals

1gavi.org
Gavi 6.0 Fragile &
Humanitarian (F&H)
approach -Annex A
BOARD MEETING
24-25 July 2025, Geneva, Switzerland
2
Topics
• Theory of Change
• F&H measurement related extract of Gavi
6.0 execution framework
• Gavi Resilience Mechanism
• Breakdown of costs and health impact

Board-2025- Mtg-01-Doc 10-Annex B 1
Report to the Board
24-2 5 July 202 5
Annex B : Gavi 6.0 approach to Fragile and Humanitarian settings
1. Theory of Change for the F&H approach
a. The Theory of Change (ToC) articulates the tailored approach for driving
impact towards Gavi 6.0 strategic goals in F&H settings. It is closely aligned
to the 6.0 Health Systems Strategy ToC. The ToC is accompanied by an F&H
measurement framework that is integrated into the broader Gavi 6.0 Execution
Framework and will be further refined (see Annex A).

2. Key shifts for the F&H approach
The F&H approach entails six key shifts. The funding is part of the Gavi 6.0
indicative strategic cost estimate except where called out.
Shift 1: Focus on context -appropriate vaccines including ‘traditional’
vaccines . Gavi 6.0 will prioritise equitable coverage increases with a country’s
current portfolio of vaccines over new vaccine introductions, recognising the
challenge of doing both simultaneously is particularly pronounced in F&H
settings. To achieve this, the All iance will strengthen vaccine prioritisation and
optimisation support. Moreover, in humanitarian settings Gavi will prioritise a
pragmatic routine and catch- up immunisation package. Context -appropriate
vaccines may include ‘traditional’, non -Gavi funded va ccines
1 in
exceptional circumstances. Only countries with co- financing waivers will be
eligible to request Gavi support for traditional vaccines. This approach
minimises the risk of displacing domestic financing and ensures prudent use of
Gavi resources. This aligns with PPC feedback that any Gavi support for
traditional vaccines should be exceptional and not displace existing resources.
Providing this additional support is estimated to cost US$ 40- 90 million. The
impact of this investment translates to >250- 600k lives saved during the 2026-
203 0 period. Additionally, where Gavi engages directly with humanitarian
partners and traditional vaccines from the national vaccine supply cannot be
made available, Gavi will provide support for traditional vaccines and work with
the Alliance to enable acces s by these partners.
a. Shift 2: Drive new programmatic approaches to reach missed
communities and zero- dose children including catch- up immunisation
Provide differentiated support to health systems to reach and meet the
needs of missed communities and zero -dose children. The effort to
increase coverage in missed communities in F&H settings requires agile and
resilient health systems. As highlighted by the PPC, community health
workforce, community engagement and cold chain must be tailored to the
specific needs of each community to help overcome barriers.
1 Non -Gavi supported vaccines, e.g. BCG, OPV, maternal Td or vaccines part of Gavi portfolio but country not
eligible for support (e.g., MCV1)

Board-2025-Mtg- 01-Doc 11 1

Report to the Board
24- 25 July 2025


Subject Evolution of Gavi ’s Partnership Approach
Agenda item 11
Category For Decision

Executive Summary
The Alliance model brings together the collective force of partners at the
global, regional and country level to help accelerate immunisation outcomes
in Gavi- supported countries , in line with Gavi’s five -year strategies. The
Partners ’ Engagement Framework (PEF) , introduced in Gavi 4.0, marked a
significant evolution in the way Alliance partners work together and included three
funding levers: Targeted Country Assistance (TCA), Foundational Support (FS) and
special investments in Strategic Focus Areas (SFA) 1. In Gavi 5.0/5.1, the
partnership model expanded with diversification of the partner base to meet the
Alliance’s ambitious priorities .
The Alliance is at an important junction as it prepares for Gavi 6.0. The Board
therefore requested a review of the partnership model to ensure it is fit for purpose
for the new strategic period, including a request for a stronger accountability
mechanism . As noted by the Gavi Programme and Policy Committee ( PPC), the
evolution of the model is even more critical in the context of the profound impact of
current geopolitical shifts on the global development ecosystem with many countries
and partners experiencing significant funding reductions that may impact delivery of
immunisatio n programmes . Closely aligned with the direction of the Gavi Leap,
this paper lays out four principles (country ownership, differentiation, context
appropriate partnerships, focus on results) and two key levers (funding model
and accountability framework) to implement these. The approach has been
recommended for approval by the PPC and has been informed by consultations with
countries, partners and donors including the Alliance Partnerships and Performance
Team (APPT) , a dedicated Cross -Alliance Working Group (CAWG) , targeted
country and regional consultations . It builds on key learnings from Gavi 5.0/5.1,
independent evaluations and a benchmarking exercise conducted by an external
firm . In May 2025, the PPC delegated authority to the PPC Chair and CEO to make
a recommendation to the Board on the country foundational functions component of
the Partnerships Accountability Framework (PAF), taking into consideration inputs
from the PPC ’s 14 -15 May 2025 meeting as well as additional consultations.


1 TCA: technical assistance to Gavi -supported countries; FS: Longer term funding at the global and regional level
to support essential functions of Core Partners in developing global immunisation normative guidance and
standards; SFA: Project based funding at global and regional level, for all partners, to accelerate progress and
address critical gaps through new global goods, learning agendas and to establishing proof of concept for
innovative tools and approaches at country level.

gavi.org
EVOLUTION OF GAVI’S
PARTNERSHIP A PPROACH
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 11-Annex A 1
Report to the Board
24-25 July 202 5
Annex A: Overview of implementation pathway
This annex provides a detailed overview of the implementation pathway for
programming the Foundational Fund and developing the Partnership Accountability
F ramework . It outlines the steps and processes involved, ensuring alignment with the
broader objectives , principles and approach discussed in the Doc 11 ‘Evolution of
Gavi’s Partnership Approach’ .
Programming of the Foundational Fund
Programming of the Foundational Fund will build on lessons from Gavi 5.0/5.1,
balancing simplicity with robust planning and approvals.
Country Foundations
Programming of C ountr y Foundations will follow a five -step process , open to WHO
and UNICEF and, in select countries where contextually applicable, other country -
selected partners . This will be programmed after any potential recalibration of Gavi 6.0
priorities by the Board following replenishment , thus requiring extension of ongoing
funding of six months to avoid gaps in funding. This support will continue through to
the end of each country’s consolidated cash grant, facilitating integrated planning at
the country level in Gavi 7.0
1.
Figure 1. Overview of key steps to programme country foundations (including funding extensions)

As outlined in Figure 1, the k ey steps to programme country foundations are :
• Step 1: Funding guidelines development . In July 2025, the Board will
endorse functions, results, indicators, funding envelope for country foundations
and countr y foundations component of the Partnerships Accountability
1 Funds cannot be committed beyond 2030 but can be programmed to end afterwards, alongside each country’s
consolidated cash grant.

Board-2025-Mtg-01-Doc 11-Annex B 1
Report to the Board
24-25 July 2025
Annex B: Overview of key risks and mitigation actions
This annex provides a high- level overview of key risks and proposed mitigation
measures related to the shifts outlined in Doc 11: The Evolution of the Partnerships
Approach in Gavi 6.0.
Note: In line with the Operational Risk Register Guidance, t hese are defined as the
risks with a high residual level, reflecting the probability of a potential risk occurring
and the consequences of the risk event . The listed mitigation actions lower the risk
residual from high to moderate. Risks and mitigation measures related to funding
allocation and programming of the consolidated cash grant —particularly the potential
deprioritisation of partner support —are detailed in Annex E of Doc 6, which addresses
the risks and implications of the Funding Policy Review, including the consolidation of
cash funding levers.
Key risks Mitigation measures
01. Funding model
Potential adjustment to
level of funding in
Foundational Fund
(should post -
replenishment
recalibration be
necessary) •
In line with the Alliance Partnerships and
Performance Team ( APPT) guidance, the amounts
proposed in the Board paper preserve country -level
funding at 100% of their Gavi 5.1 levels (including
both Country Foundations and the share of PEF
TCA funding now consolidated in the cash grants) ,
while any required reductions are absorbed at the
global and regional levels
• Depending on potential recalibration of Gavi 6.0
priorities by the Board after the replenishment , the
overall scope of partner support may need to be
revisited in the programming process. Pending
Board guidance, a ny adjustments would maintain
the focus on protecting country -level investments
Insufficient funding for
country foundations •
The proposed funding amount ensures funding to
countries via the TA in the consolidated cash grant
remains the largest share, in- line with the principle
of country ownership, and is grounded in extensive
analysis
• F unding guidelines for country foundations will
provide guidance on what constitutes good
technical assistance. This approach ensures a
focus on both the quantity and quality of assistance,
thereby enhancing its effectiveness and impact

Board-2025- Mtg-01-Doc 11-Annex C 1
Report to the Board
24-2 5 July 202 5
Annex C: Partnerships Accountability Framework (PAF) – country foundations
component
1. Purpose and objectives of the PAF
The Partnerships Accountability Framework (PAF) allows countries to hold
partners
1 accountable at an institutional level for the support they provide in
achieving Gavi’s strategic goals and priorities. It is anchored in functions the
partners carry out at country, regional and global levels and includes areas of
work and indicators to track progress for each of these functions. This
document focuses on the foundational functions, areas of work and indicators
at the country level . The global and regional components will be finalised in
the second half of 2025.

The purpose of the PAF is to link the support for partners’ foundational functions
to measurable results associated with the Gavi 6.0 Execution Framework , while
ensuring cross -portfolio learning and predictability of funding. It builds upon
experience from Gavi 5.1 and 5.0, including independent evaluations of partner
support, to incorporate good practices and lessons learned.

The country component of the PAF outlines the areas of work and associated
indicators for each agreed country level function: a) immunisation programme
support – including planning, advocacy, implementation, issue escalation, risk
monitoring/resolution and coordination, b) vaccine and cold chain
management, c) data, d) demand, and e) outbreak and preparedness
response. The foundational functions have been defined as those that are
required to sustain and maintain functioning immunisation programmes at
count ry level. They speak to the comparative advantages of core and other
partners – while WHO and UNICEF will be primary core partners for these
functions, countries have the flexibility to select other partners with strong
technical capacity and in country pr esence depending on context. All functions
aim to contribute to skills transfer and country capacity strengthening to ensure
long- term sustainability.

2. Integration of the PAF into Gavi’s 6.0 Execution Framework
The PAF will be embedded within the Gavi 6.0 Execution Framework that will
bring together, in one place, programmatic flagships as well as Secretariat
policy and operational reforms necessary to achieve Gavi’s 6.0 strategic goals
and objectives. Indicators and targets, evaluations and learning agendas will
be organised within this framework. For monitoring, the Execution Framework
will provide indicators, targets, and clear accountabilities for delivery,
consolidating metrics from different Gavi 6.0 sub- strategies and approaches,
including the PAF. At country level, the PAF will align with the country grant
monitoring framework, strengthening national ownership, government visibility
and oversight of partner inputs. It aims to create transparency on partner
1 Core WHO, UNICEF, World Bank, USCDC and others such as civil society organi sations.

Board-2025-Mtg- 01-Doc 11- Annex D 1

Report to the Board
2 4-25 July 202 5
Annex D: Overview of Partnership s Approach
1. Gavi’s Partnership Approach in Gavi 6.0
1.1 Four principles help guide the Partnership Approach for Gavi 6.0, which
would be implemented mainly through two levers – an updated funding model
and new Partnerships Accountability Framework. The principles of the new
Partnership Approach are aligned with the December 2024 Board decision to
combine parts of country level technical assistance (TA) alongside other
Gavi cash funding levers into a consolidated cash grant. While closely linked
to the funding model for the Partnership Approach, this reform is further
elaborated in the Gavi 6.0 Health System Strategy and Policy (see Docs 01d and
06) and referenced below as relevant.
1.2 Principles
1.2.1 Country ownership - rebalance towards a country centric approach.
Country ownership of TA investments and their results can differ greatly and are
not always well -coordinated with other Gavi country -level cash grants. In Gavi
6.0, as PPC guidance provided in May 2025, there will be a stronger focus on
country ownership, in line with the Lusaka agenda, by:
• Operationalising the December 2024 Board decision to consolidate most
country -level TA with Gavi cash funding levers (see Doc 06 ), increasing
country decision- making over financial resources;
• Including foundational long- term country support functions (‘Country
Foundations’) that are programmed in line with country needs as part of
the new Foundational Fund (see Section 2.3.1); and
• Increasing transparency and country ownership of results through the new
Partnerships Accountability Framework (see Section 2.3.2).
1.2.2 Differentiation – partner contributions better aligned with 6.0 priorities
based on country context. Historically, PEF support focused on ongoing
priorities rather than adopting new Alliance strategic priorities or tailoring support
to country contexts. Additionally, partner support has not sufficiently transferred
skills to strengthen country capacity an d ensure sustainability of support. In Gavi
6.0, partner support will be better aligned with Gavi 6.0 priorities and tailored to
each country's context, in line with the differentiated approach outlined in Gavi
6.0 Health Systems Strategy (Doc 01d ). This will see an increasing shift of TA
from gap- filling to capacity strengthening as countries progress through the
transition continuum. It will be implemented by the levers outlined in 2.3.
1.2.3 Context appropriate partnerships – systematically select partners based
on their comparative strengths. This is not yet implemented systematically in
Gavi 5.0/5.1, despite partner diversification. In Gavi 6.0, partner selection will be
more deliberately informed by past performance, established presence and
ability to deliver results. This will include partn ers within and beyond

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

gavi.org
COLLABORATION WITH THE
GLOBAL FUND TO FIGHT
AIDS, TUBERCULOSIS AND
MALARIA (‘THE GLOBAL
FUND’) AND OTHER
ORGANISATIONS
BOARD MEETING
Johannes Ahrendts
Hannah Burris
2 4 -25 July 2025, Geneva, Switzerland
2 Board Meeting, 24 -25 July 2025
Three areas to translate the Gavi LEAP into action
Gavi LEAP , grounded
in 4 principles
• Country -centricity
• Country sovereignty
• Focused mandates
• Finite lifespans
CEO commitments at the
Global Summit
1. Gavi’s internal reforms
2. Merger at the last mile
3. The Global Health Leap
Focus of discussion

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

Annex A: Additional information on the JCWG work, the Global Fund, GPEI and
other partnerships
This annex provides additional information on the Joint Committee Working Group
(JCWG ), the recent developments specific to the collaboration with The Global Fund,
and updates on the collaborations with the Global Polio Eradication Initiative (GPEI) ,
Africa Centers for Disease Control (ACDC) and the Coalition for Epidemic
Preparedness Innovation (CEPI) .
1. Additional information on JCWG and collaboration with Global Fund
1.1 As an outcome of the JCWG’s work, a significant number of existing joint
initiatives in technical areas have been mapped, potential new areas of
collaboration have been assessed and prioritised for impact and scalability;
support is being provided to five Wave 1 countries to address priority
constraints they have identified in working with the GHIs and there have been
in -depth discussions on how to coordinate malaria interventions at country
level. An overview of short -term collaboration opportunities was brought
forward at the Programme and Policy Committee (PPC) meeting in May (Annex
B) . While malaria was the primary focus, the PPC expressed broad support for
moving ahead with all the proposed short -term opportunities.
1.2 Figure 1 provides an overview of these ongoing efforts, which reflect meaningful
early progress toward deeper collaboration. These include, for example,
initiatives to improve country -level coordination and governance.
Figure 1: Examples of initiatives implemented/ in progress across workstreams

1.3 In response to the calls for deeper and faster collaboration , both organisations
have committed to accelerating efforts through a suite of joint initiatives (see

Document Classification : Internal
July 2024
Joint Committee Working Group on Collaboration
betwe en Gavi , GFF , and the Global Fund
Terms of Reference (TOR)
Purpose:
The Joint Committee Working Group (JCWG) is established as a time - limited working
group of Board and Committee members across Gavi, the Global Financing Facility, and
t he Global Fund to support the organizations in establishing a common vision for
collaboration across the three global health institutions (GHIs) and to support the
Secretariats in identifying opportunities in operationalizing three high impact workstreams
focused on : malaria, health systems strengthening and country engagement. This includes
keeping long - term impact for countries and communities at the center of the collaboration
efforts with a focus on how the GHIs work and collaborate with each other and w ith
countries, ensuring the efforts are country led and demand driven . This document outlines
the TOR for the Joint Committee Working Group deve loped jointly between the Global
Fund, Gavi and GFF.
Context:
The Future of Global Health Initiatives (FGHI) 1
process identified ways to ensure global
health initiatives (GHIs) are more effective, efficient, and equitable in complementing
domestic financing to strengthen health system capacities and deliver health impact, as
part of country - led processes and towards universal health coverage (UHC). The FGHI
process culminated in a statement of the Lusaka Agenda 2
in 2023 and identified five long -
term shifts, near - term priorities, and priority actions for GHIs to take forward. This included
a recommendation to establish joint oversight by a J oint Committee Working Group
comprised of members from relevant Board and Committees .
The 3 GHIs have a strong foundation of existing collaboration and partnership across
numerous areas . This collaboration has received additional attention with the FGHI
process and publication of the Lusaka Agenda . In October 2023, Gavi and the Global
Fund , and later GFF, began intensified focus centered around 4 workstreams: malaria,
health systems strengthening, country engagement, and business enabling functions.
Additionally , each of the three GHIs initiated a process for discussion about a potential
1
Future of Global Health Initiatives (2024). https://futureofghis.org/
2
Lusaka Agenda (2024). https://d2nhv1us8wflpq.cloudfront.net/prod/uploads/2023/12/Lusaka - Agenda.pdf

Board-2025-Mtg-01-Doc 12-Annex B

Board-2025-Mtg -01-Doc 12-Annex C 1
Report to the Board
24-2 5 July 202 5
Annex C: Terms of Reference (ToR) – Joint Gavi / Global Fund Taskforce
1. Background
The global health funding ecosystem is undergoing a period of reflection and
redefinition. Amid shifting political and financial landscapes — including
reduced external financing, the growing emphasis on country ownership and
self -reliance, emerging regional health institutions, and increasing scrutiny on
impact and efficiency —there is broad consensus on the need for global health
institutions (GHIs) – and indeed the broader health landscape – to adapt. Gavi
and the Global Fund have established a joint internal Taskforce, chaired by the
Gavi CEO and Global Fund ED, to examine how the institutions can evolve their
ways of working together more ra dically to better support countries and respond
to a changing environment, while simultaneously advancing already agreed
areas of collaboration.
2. Objectives and Principles
Objectives of the effort:
1. Drive greater impact, efficiencies, and effectiveness at country -level to
achieve our respective missions
2. Identify efficiencies at HQ levels
Principles on which the work should be grounded:
1. Country -centricity – meeting country priorities and needs, and empowering
national leadership and communities in decision- making
2. Mission – recognizing each organization’s distinct mandate and retaining
accountability to our governance bodies and the communities we serve
3. Country self -reliance – acknowledging the long- term goal of sustainable, full
domestic financing
3. Composition + supporting groups
• Sponsors/ chairs: Sania Nishtar, Gavi CEO and Peter Sands, Global Fund
ED
• Taskforce members: Small, agile working group composed of individuals
internal to Gavi and the Global Fund who will meet on a regular basis to
drive progress across all areas of engagement and across both the
near/medium term work areas and the longer -term structural elements (the
latter supported by an external firm). Taskforce members are expected to
coordinate closely with their internal working teams to ensure timely input
and data- sharing that informs joint discussions.
o Gavi: Chief of Staff (Hannah Burris), Director Strategy Design & Delivery
(Johannes Ahrendts)

1


Board-2025-Mtg- 01-Doc 13

Report to the Board
24-2 5 July 202 5

Subject Review of decisions
Agenda item 13
No paper

1


Board-2025-Mtg- 01-Doc 14

Report to the Board
24-2 5 July 202 5

Subject Any other business and Closing remarks
Agenda item 14
No paper

Board-2024-Mtg -03 1
Minutes
Gavi Alliance Board Meeting
4-5 December 2024
Bali, Indonesia
1. Chair’s report
1

.1 Noting that the meeting had been duly convened and finding a quorum of
members present, the meeting commenced at 08:32 Bali time on
4 December 202 4. Prof Jos é Manuel Barroso, Board Chair, chaired the
meeting.
1

.2 The Chair welcomed new Board and Alternate members attending their first
Board meeting, namely: Kazuhiko Nakamura, Clarisse Paolini, Ruth Lawson,
and Frode Forland.

1.3 The Chair noted several key meetings that had taken place on 3 December
2024, including: i) an All Chairs Group (ACG) meeting during which the
members discussed the recommendations being brought forward to the Board
at this meeting ; ii) a side event on ‘Leveraging Private Sector Expertise,
Development Finance and Multisectoral Platforms for Immunisation Outcomes ’
supported by Unilever and the World Bank; and iii) a special meeting of the
Gavi Implementing Country Caucus with Ministers of Health from South East
Asia and the Western Pacific, convened by Minister Budi Gunadi Sadikin of
Indonesia.
1

.4 Standing declarations of interest were tabled to the Board (Doc 01a in the Board
pack).
1

.5 The Board noted its minutes from 6- 7 June 2024 (Doc 01b) which were
approved by no objection on 17 September 202 4. They also noted a number of
decisions that had been approved by no- objection consent since the June 2024
Board meeting (Doc 01c).
1

.6 The Chair referred to the consent agenda (Doc 01 d) where seven
recommendations were presented for consideration. At the request of the Chair,
Brenda Killen, Director, Governance and Secretary to the Board, presented the
consent agenda decisions.
1

.7 The Chair noted the Board workplan (Doc 01 e).
1

.8 The Chair reported that during the closed session on 3 December 2024, the
Board had discussed a number of matters arising from recent Audit and
Finance Committee (AFC) and Programme and Policy Committee (PPC)
meetings and had agreed to launch the process to recruit the next Board Chair.
He also reported that the Board had heard from the CEO about how the
Secretariat will evolve over the next year in preparation for Gavi 6.0 and had

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
CONSENT AGENDA
BOARD MEETING
24-25 July 2025, Geneva, Switzerland
Decision 1: Consent Agenda: Board and Committee
Appointment
2 Board Meeting, 24-25 July 2025
The Gavi Alliance Governance Committee recommends to the Gavi Alliance Board that it:
• Reappoint
Yibing Wu, as an Unaffiliated Board Member, effective 1 November 2025 and
until 31 October 2026.

1


Board -2025 -Mtg -01-EAC Committee Chair Report
Report to the Board
24 -25 July 202 5

Subject Evaluation Advisory Committee Chair Report
Category For Information
Section A: Introduction
• This report provides the Board with an overview of the activities of the
Evaluation Advisory Committee ( EAC ) since the Committee Chair last reported
to the Board in December 2024 .
• The EAC held an in -person meeting on 5 -6 March 2025. The next meeting is
scheduled for 17 -18 September 2025.
• At the 5 -6 March 2025 meeting, the EAC provided guidance on : i) progress on
the commissioned Gavi 5.1 centralised evaluations , including the Zero -Dose
evaluation and the joint COVAX evaluation ; ii) EAC engagement in Gavi 5.1
evaluations; iii) the proposed action s in response to the Evaluation Function
Review (EFR) recommendations ; and iv) the proposed evaluation portfolio to
meet Gavi 6.0 evaluative evidence needs, as part of Gavi 6.0 evaluation work
planning .
• A dissemination event for Phase 2 of the Zero -Dose evaluation was held on
31 March 2025 , bringing together Secretariat colleagues and Alliance partners.
Feedback from key Secretariat business owners highlighted the evaluation’s
design and targeted scope to assess strategic thematic areas in more depth,
as an approach that can generate more specific recommendations , thereby
increasing utility.
• Emerging lessons from the joint evaluation process with COVAX Pillar Partners
for the Joint COVAX evaluation were documented to inform the de sign,
execution, and outcomes of future joint evaluations, and to set a precedent for
how G lobal Health Initiatives (G HIs ) can work together to address complex
challenges collaboratively and effectively. Following completion of the
Evaluation Management Response, a dissemination meeting will be held , likely
in September/October 2025.
• The EAC provided further guidance in relation to the recommendations from
the Evaluation Function Review and MOPAN assessment, including on
developing a vision, strategy and culture for evaluation at Gavi, strengthening
PPC engagement, and options for evaluation quality assurance and oversight.
• W ork is now under way to design an updated Evaluation Policy and a multi -year
evaluation workplan for Gavi 6.0 , fo r consideration, recommendation and
eventual approval in Q3 -4 2025.
• The Evaluation Strategy will be developed and integrated into the broader Gavi
6.0 Measurement, Evaluation and Learning approach aligned with guidance
from the EAC.

gavi.org
GOVERNANCE COMMITTEE CHAIR REPORT
BOARD MEETING
Omar Abdi
24-25 July 2025, Geneva
Routine (recurring) work
Board and Committee nominations ongoing and completed in timely manner-Board and Committee refresh process to commence second half of 2025
Monitoring of the GC Action Sheet and Workplan ongoing
Monitoring of Governance Risk Matrix ongoing
2 Board Meeting, 24- 25 July 2025, Geneva

gavi.org
INVESTMENT COMMITTEE
CHAIR REPORT
BOARD MEETING
Yibing Wu
24-25 July 2025, Geneva, Switzerland
Annex A
Portfolio Performance
2
Exposure Vs. Benchmark5 Yrs 1 YTD 2024 202320222021 2020
Fixed Income 4.9%2.7%6.0% 9.6%(8. 1%) 5.4% 6.5%
High Quality 1.0%2.4%2.3% 5.7%(8.7%) 1.0% 7.3%
Yield Seeking 8.7%2.8%8.8%13.9% (7.2%) 10.2% 9.8%
Bloomberg Multiverse (1.1%) 5.3%(1.3%) 6.1%(16.0%) (4.5%) 9.0%
Equity 11.9%4.4%14.2% 19.7%(17.7%) 15.6%21.4%
MSCI ACWI IMI 13.1% 5.1%16.4% 21.6%(18.4%) 18.2%16.3%
Diversifiers 4.7%(4.4%) 4.2%8.8%3.2%4.2% 8.0%
CS Multi-Strategy 7.6% 3.9%8.7% 8.0%1.3%7.0%
5.6%
Private Assets N/A(1.2 %) 23.3% 22.9% N/AN/A N/A
Private Markets Benchmark N/A 3.3%
11.1% N/AN/AN/A N/A
Long-term portfolio 7.4%2.1%9.4%13.2% (8.3%) 7.8%
10.4%
Policy Index
5.3%5.0% 7.8%11.8%(12.4%) 4.0%9.9%
Difference 2.1%(2.9%) 1.6%1.4%4.1%3.8% 0.5%
Data as of 31 May 2025.
(1) Annualised
Board Meeting, 24- 25 July 2025
Annex A

gavi.org
IFFIM CHAIR REPORT
BOARD MEETING
Kenneth Lay
24-25 July 2025, Geneva, Switzerland
Annex A
IFFIm contribution to Gavi’s funding requirements
• In the 2021-2025 period IFFIm can provide US$ 3.3 billion for core programmes and COVAX
AMC support:
 US$ 2.3 billion for core funding
 US$ 975 million for COVAX AMC
• Through March 2025, IFFIm has provided US$ 2.8 billion
 US$ 1.8 billion for core funding
 US$ 975 million for COVAX AMC
• A further US$ 440 million will be provided to Gavi before the end of the year
• Assured resources for the 6.0 period are US$ 655 million
• IFFIm has provided c. 15% of Gavi resources to countries since 2006
 Frontloaded resources resulted in 142 million children being immunised ahead of the receipt of donor
contributions
2 Gavi Board Meeting, 24- 25 July 2025
Annex A

gavi.org
PROGRAMME AND POLICY COMMITTEE CHAIR REPORT
BOARD MEETING
Anne Schuchat
24-25 July 2025, Geneva, Switzerland
Annex A
PPC Meeting, 14-16 May 2025
Discussion, Guidance and Information Items
• CEO Update, including Strategy, Programmes and Partnerships and Gavi 6.0 Leap
• Read out from the Audit and Finance Committee ( Short information item)
• Joint Alliance Update on Country Delivery
• Gavi 6.0: i) Gavi 6.0 Execution Framework; ii) Alignment of Country Grant Cycles with the Gavi
Strategy Cycle
• Report of the Independent Review Committee
• Update on Collaboration with Other Organisations – Collaboration with the Global Fund on Malaria
• Market Shaping Update: Retrospective
• Country Delivery: Nigeria and Papua New Guinea
2 Board Meeting, 24- 25 July 2025
Annex A

gavi.org
UPDATE FROM THE GLOBAL SUMMIT: HEALTH &
PROSPERITY THROUGH IMMUNISATION
BOARD MEETING
Marie -Ange Saraka- Ya o
24- 25 July 2025, Geneva, Switzerland
Unprecedented global support at the Summit
2 Board Meeting, 24-25 July 2025
participants… 450
• Co- hosted by H.E. Ursula von der Leyen, President of the
European Commission, H.E. António Costa, President of
the European Council, and Mr.BillGates, Chair of the
Gates Foundation
• Convened 10 Heads of State & Government, and 25
ministers
• 55 countries represented, including 34 Gavi implementing
countries, 21 key donor countries
• 10 CEO, Chair, President of industries & private sector
• 10 top leaders of international & financial institutions
• 10 top leadership of global and local CSOs
• Youth voices and advocates…

Board-2025-Mtg- 01-Doc 05 1
Report to the Board
2 4-2 5 July 202 5

Subject Financial Update, including forecast
Agenda item 05
Category For Decision

Executive Summary
The purpose of this paper is to present the updated Financial Forecast for Gavi 5.1
(2021- 2025) on a consolidated basis, including all approved ongoing programmes
for Gavi Board approval based on the recommendation of the A udit and Finance
Committee (AFC). There are no financial implications from the recommendations
made to the Programme and Policy Committee (PPC) on the Gavi 5.1 financial
forecast. T he latest Gavi 6.0 projections reflecting the outcome and financial
implications of the 25 June Global Summit will be presented to the AFC on 17 July
and then at the 22- 23 July Board retreat. The Gavi 6.0 financial forecast will be
formally presented to the Board for approval at the December 2025 Board meeting.
Since the previous financial forecast there has been a significant increase in
uncertainty with broader changes in international development increasing country
delivery risk for all development actors including the Gavi Alliance with reports of
disruption to vaccination activities and monitoring with countries, Alliance partners
and expanded partners. A s noted to the AFC, the Secretariat is closely monitoring
the risks associated with the current operating context and is actively implementing
mitigating act ions where possible. Nevertheless, t his uncertain context is reflected
in several changes to the financial forecast including the broader range forecast
outlined in the risks and opportunities section with key changes set out below:
• Resources: removal of US$ 300 million donor funds from 2025, in line with the
risk outlined in the prior financial forecast;
• Programmatic expenditure: net reduction of US$ 16 4 million to base expenditure
plans, reflecting reduced COVID -19 (C19) demand / C19 Delivery Support (CDS)
and later phasing of cash- support disbursement timing; and
• Execution risk adjustment: a reduction in country programmatic disbursements
of US$ 214 million to reflect the risk of disbursement delays in 2025 given the
impact of the global health funding context (noting that this adjustment is made
centrally as the specific impacts on individual country delivery is not yet known).
After reflecting the above assumptions, the Gavi 5.1 consolidated financial forecast
confirms financial flexibility with US$ 185 million available for future investment .
As most country plans remain unchanged and the financial results for the half year
reflect strong vaccine demand with vaccine disbursement s ahead of the forecast ,
the Secretariat seeks approval to draw down on these remaining funds should the
aforementioned global health capacity execution risk not materialise.
COVAX AMC: The consolidated Gavi 5.1 financial forecast covers all ongoing
approved programmes, including those funded from repurposed COVAX AMC funds

Board-2025-Mtg- 01-Doc 06 1
Report to the Board
24-25 July 202 5

Subject Funding Policy Review
Agenda item 06
Category For Decision

Executive Summary
The purpose of this paper is to request the Board approve the revised Eligibility and
Transition Policy (Annex A), the Co- financing Policy (Annex B) and the Health
Systems and Immunisation Strengthening (HSIS) Policy (Annex C) . The revised
policies reflect policy options approved by the Gavi Board in December 2024 as part
of the Funding Policy Review (FPR).
Since December 2024, the FPR has developed aspects of Gavi’s approach to
programmatic sustainability and the guardrail for measles/measles -rubella follow -up
campaigns , as included in the draft HSIS Policy and outlined in this paper .
Consultations on the draft policy documents were held with countries , technical
partners, civil society organisations (CSOs) and other stakeholders such as vaccine
manufacturers. The draft policies were also hosted on Gavi’s website for an open
consultation.
The implementation of the funding policy shifts is a core component of Gavi 6.0
Operationalisation (Doc 09 ) and is aligned with the Gavi 6.0 Health System Strategy
and the Gavi 6.0 Partnership model (Doc 11 ).
The paper also seeks approval from the Board on co -financing for Hepatitis B birth
dose and DPT boosters, as well as other new vaccine introductions .
Action Requested of the Board
The Gavi Alliance Programme and Policy Committee recommended to the Gavi
Alliance Board that it:
a) Approve the revised Eligibility and Transition Policy attached as Annex A to
Doc 06;
b) Approve the revised Co- financing Policy attached as Annex B to Doc 06 , as
amended by discussions at the PPC;
c) Approve the revised Health Systems and Immunisation Strengthening (HSIS)
Policy attached as Annex C to Doc 06 ;
d) Approve a minimum co -financing threshold of US$ 0.20 for the introduction of
Hepatitis B birth dose and DTP booster in countries in preparatory and
accelerated transition.

gavi.org
UPDATE ON MPOX
BOARD MEETING
Emanuele Capobianco
24-25 July 2025, Geneva, Switzerland
Context: mpox outbreak and response
2
*Data source: World Health Organisation. Confirmed cases and deaths only. Data as of 06 July 2025.
2024 -2025 numbers in Africa*
Total confirmed cases 44,776
Total confirmed deaths 166
Active outbreak continues to affect multiple
countries in the African region (with DRC the
epicentre), with exported cases reported globally With continental and global public health emergency
declarations extensions until Sept 2025, Gavi continues to support vaccine response as part of cross partner efforts
• Progress in access to vaccines and vaccine roll-out:
o Seven countries vaccinatingwith two more expected
• Country challenges: Global and domestic including
conflict and resource limitations in health systems,
surveillance and testing
• Gavi engaged in learning efforts :
o Both internal & cross- partner led learning and
monitoring of progress and results
o Collaborating with partners to integrate learnings
Board meeting, 24-25 July 2025

Board-2025-Mtg- 01-Doc 08 1
Report to the Board
2 4-2 5 July 202 5

Subject Respiratory Syncytial Virus (RSV) Investment Case
Agenda item 08
Category For Decision

Executive Summary
Respiratory Syncytial Virus (RSV) is the leading cause of pneumonia and infant
hospitalisation, and the second leading etiology of infant deaths . In 2018, Gavi’s
Board approved, in -principle, through the Vaccine Investment Strategy (VIS), RSV
immunisation products contingent on key conditions, now met with a licensed,
WHO-prequalified, and SAGE -recommended maternal RSV vaccine to protect
infants, with its manufacturer committed to offering terms for Gavi access .
The purpose of this paper is to present an update on RSV’s high burden, the
vaccine’s health and economic impact, and request Board approv al to open a
funding window for a potential RSV maternal vaccine programme.
This investment case was informed by guidance from an RSV Working Group with
representatives from partners including WHO, UNICEF, Africa Centres for Disease
Control (CDC) , the Gates Foundation, and consultations with countries,
independent experts, and vaccine manufacturers .
Action Requested of the Board
The Gavi Alliance Programme and Policy Committee recommended to the Gavi
Alliance Board that, contingent on financial resources being made available for the
Gavi 6.0 strategic period, it:
a) Approve the opening of a funding window for the establishment of an RSV
maternal vaccine programme to protect infants;
b) Note that the initial cost estimates associated with the above approval for the
period 2026- 2030 are US$ 14.8 million. Future financial forecasts will reflect
potential changes in the underlying assumptions of these estimates.
Next steps/timeline
If approved, taking into consideration any potential recalibration of Gavi 6.0
priorities by the Board and contingent on financial resources being made available,
Gavi would begin a 12– 18-month planning phase to co- develop implementation
strategies with partners and launch a market shaping roadmap. With WHO
prequalification of the multidose vial expected by late 2026, the first application
window could open in late 2027, with introductions starting in 2028.

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