1


Board -2023 -Mtg -02 -Doc 00a


Gavi Alliance Board Meeting
26 -27 June 202 3
Global Health Campus , Geneva, Switzerland
Monday 26 June: 08.30 -18.00 (Board meeting Day One)
Tu esday 27 June : 09.00 -18.00 (Board meeting Day Two )
Wedne sday 28 June : Post -Board meetings
Quorum: 14
Document List

No. Document
00a Document list
00b Agenda
01a Declarations of interest
01b Minutes
01c No Objection Consent Decisions
01d Consent Agenda
01e Workplan
02 a CEO?s Report ? To follow
02b Strategy, Programmes and Partnerships: Progress, Risks and Challenges
03 Country Programmes Delivery Presentation ? No paper
04 COO and Financial Update, including forecast
05 Approach for Gavi 6.0 Strategy Design and the Road to Replenishment
06 Hexavalent Investment Case
07 COVAX Update and Gavi?s Role in a future COVID -19 Vaccine programme
08 Gavi?s Role in Pandemic Prevention, Preparedness and Response
09 Vaccine Investment Strategy 2024: longlist and evaluation frameworks
10 Committee Chair and IFFIm Board reports ? To follow
11 Review of decisions ? No paper
12 Closing remarks ? No paper

Board -202 3-Mtg -02-Doc 00b 1

Gavi Alliance Board Meeting
26 -27 June 2023
Global Health Campus , Geneva, Switzerland

Monday 26 June : 08.30 -18.00 (Board meeting Day One)
Tuesday 27 June : 09.00 -18.00 (Board meeting Day Two)
Wednesday 28 June: Post -Board meetings

Quorum: 14



A genda

















Next Board Meeting : 6 -7 December 2023 , Ghana
17 -18 April 2024 (Board Retreat)
26 -27 June 2024
4-5 December 2024
---
Brenda Killen , Director, Governance and Secretary to the Board, +41 22 909 6680, bkillen@gavi.org
Joanne Goetz , Head, Governance, +41 22 909 6544, jgoetz@gavi.o rg
Please note that the Board meeting will be recorded. This recording will be used as an aid to minute the
meeting. A transcription of the full proceedings will not normally be made. Should a transcription be made it
will be used only as an aid to minute the meeting.

1

Board -2023 -Mtg -02 -Doc 01a

Gavi Alliance Board Meeting
26-27 June 202 3
Global Health Campus , Geneva, Switzerland
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 a ction 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 Member 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













Jos? 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 Princeton
School of Public Policy, LISD (Member
of the Advisory Council from 01 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 St udies) ;
The EUROPEAUM (Board Member) ;
WPL Women Political Leaders
(Advisory Board Member) ; Jean Monnet
Foundation for Europe (Honorary
Committee Member) ; European Centre
for Culture, (Honorary Co -President) ;
Portuguese Diaspora Council
(Chairman of the Gen eral Assembly
and Chairman of the EurAfrican
Forum ); Bilderberg Meetings (Steering
Committee Member) ; Concordia
(Member of the Leadership Council) ;

Board -2022 -Mtg -03 1

Minutes


Gavi Alliance Board Meeting
7-8 December 20 22
Hilton Geneva Hotel and Conference Centre, Geneva, Switzerland

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 09.05 Geneva time on 7
December 2022. Prof Jos ? Manuel Barroso, Board Chair, chaired the meeting.

1.2 The Chair welcomed Deena Shiff, attending for the first time as a new
Unaffiliated Board Member. He also welcomed Kenneth Lay, IFFIm Board
Chair, and other directors of the IFFIm Board as well as David Sidwell, in his
capacity as member of the CEO Recruitment Search Committee .

1.3 He recognised two recent achievements of the CEO , firstly Dr Berkley?s
appointment as a member of the US National A cademy of Medicine and the
honorary degree bestowed on him by Makerere University in Uganda . He also
noted the awar d of the 2021 North -South prize of the Council of Europe to
COVAX.

1.4 The Chair presented a short summary of the All Chairs Group (ACG) meeting
held on 6 December 2022 during which the ACG had discussed the Board
agenda as well as outcomes of recent Board Committee meetings. He
highlighted the importance of the work by the Committees in bringing forward
recommendations to the Board and reminded Board members that they are
welcome to attend Committee meetings as observers .

1.5 He noted that the closed session of the Board held on the previous day had
included an update on the CEO search process, the annual human resources
update, and an update on CO VAX. He also noted that during that session, he
had stepped out to enable the Board to consider his re appointment, a dding that
he was humbled and honou red to be reappointed and to continue his service
to the Board.

1.6 The Chair reported on the panel he had facilitated on 6 December 2022 which
had discussed the global geopolitical, macroeconomic and financial context
and the implications of these uncertainties for health, and for Gavi. Attendees
heard how geopolitical frictions across multiple concurrent crises a re affecting
global consensus and cooperation and driving greater complexity in Gavi? s
operating environment. He noted the economic downturn would have
budgetary implications for both donor and supported countries.

1.7 Noting that the unfolding path of the COVID -19 pandemic remains uncertain,
the Chair commended the achievements of the AMC countries in delivering
4 billion vaccine doses as unprecedented , and evidence of the Alliance?s pivotal
role. He underscored the importance of reflecting on the number of lives saved

1


Board -2023 -Mtg -02 -Doc 01c

Report to the Board
26 -27 June 2023

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


Since the December 2022 Board meeting, four decisions have been circulated
electronically for approval by no -objection consent in line with Section 11 of the Board
and Board Committee Operating Procedures.
1) On 10 February 2023 , 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 22 February 2023 and the following
decision was therefore entered into the record:

In accordance with Section 11.3 of the Board and Board Committee Operating
Procedures, on a no -objection basis, the Gavi All iance Board:

a) ?Appointed Bruce Aylward as Board Member representing WHO in the seat
currently held by Zsuzsanna Jakab, effective immediately and until his
successor is appointed

b) ?Appointed Greg Widmyer as Alternate Board Member representing the Bill &
Mel inda Gates Foundation in the seat currently held by Alaa Murabit effective
immediately and until his successor is appointed

c) Appointed the following to the Market -Sensitive Decisions Committee effective
immediately:
? Greg Widmyer (Alternate Board Member) un til 31 December 2023

d) Appoint ed the following to the Governance Committee effective immediately:
? Kate O?Brien (Alternate Board Member) until 31 December 2023

2) On 28 March 2023 , Board Members were invited to consider approv al of the
appointment of an Audit and Finance Committee and an Evaluation Advisory
Committee Member .

No objections were received prior to the end of 11 April 2023 and the following
decision was therefore entered into the record:


In accordance with Section 11.3 of the Board and Board Committee Operating
Procedures, on a no -objection basis, the Gavi Alliance Board:

1


Board -2023 -Mtg -02-Doc 01d

Report to the Board
26 -27 June 2023

Subject Consent Agen da ? as at 25 June 2023
Agenda item 01d
Category For Decision

Section A : Introduction
Six 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/230527
Section B : Actions Requested of the Board
The Gavi Alliance Board is requested to consider the following recommendations f rom
the Gavi Alliance Governance Committee and the Gavi Alliance Audit and Finance
Committee.
Decision One ? Board and Committee Appointments

The Gavi Alliance Governance Committee recommend s to the Gavi Alliance Board
that it:

a) ?Appoint Sai Prasad as Board Member representing the vaccine industry
developing countries in the seat currently held by Mahima Datla effective 1 July
2023 and until 30 June 2026

b) Reappoint Beth Arthy as Board Member representing the United Kingdom on the
donor constituency cluster anchored by the United Kingdom, effective 1 September
2023 and until 31 August 2024

c) Reappoint the following to the Market -Sensitive Decisions Committee and to the
Programme and Policy Committee eff ective immediately:
? Beth Arthy (Board Member) until 31 December 2023

d) Appoint the following to the Governance Committee effective 1 July 2023:
? Sai Prasad (Board Member) until 31 December 2023
 

Gavi Alliance
Board Travel Policy
Version 5.0



DOCUMENT ADMINISTRATION



VERSION
NUMBER APPROVAL PROCESS DATE
1.0 Prepared by: Legal and Governance
Reviewed by:
Gavi Governance Committee 20 March 2013

Reviewed by: G avi Alliance Board
and referred to the Governance
Committee for further consideration
11-12 June 2013
Policy options reviewed by:
Gavi Governance Committee 26 September 2013
Reviewed and recommended by:
Gavi Governance Committee 4 November 2013
Approved by:
Gavi Alliance Board
21-22 November 2013
Effective from: 1 Jan uary 2014
2.0 Reviewed and recommended by:
Gavi Governance Committee 16 February 2016
Approved by:
Gavi Alliance Board
22 June 2016
Effective from: 1 July 2016
3.0 Reviewed and recommended by:
Gavi Governance Committee 5 December 2016
Approved by:
Gavi Alliance Board
7 December 2016
Effective from: 1 January 2017

4.0 Reviewed and recommended by:
Gavi Governance Committee 26 November 2018
Approved by:
Gavi Alliance Board
28 November 2018
Effective from: 1 January 2019

5.0
Reviewed and recommended by:
Gavi Governance Committee 22 June 2023
Approv ed by:
Gavi Alliance Board 26-27 June 2023
Next review: As and when requested

Gavi Alliance
Independent Auditor Selection
and Evaluation Policy
Version 2.0





DOCUMENT ADMINISTRATION


VERSION
NUMBER APPROVAL PROCESS DATE

1.0
Prepared by: Barry Greene, Managing
Director, Finance and
Operations

Reviewed by: Gavi Audit and Finance
Committee 9 November 2012
Approved by: Gavi Board 4 December 2012
Effective from: 1 January 2013

2.0 Updated by: Financial Reporting Team 19 January 2023
Reviewed by: Gavi Audit and Finance
Committee
14 February 2023

Approved by: Gavi Alliance Board XX June 2023
Gavi Alliance
Independent Auditor Selection
and Evaluation Policy
2



1. Definitions

1.1. The following definitions and acronyms shall apply:
? ?AFC ? ? Gavi Audit and Finance Committee.
? ?Board ? ? Gavi Alliance Board of Directors, or the Gavi Executive Committee
acting on behalf of the Board of Directors.
? ?IFFIm ? ? International Finance Facility for Immunisation
? ?IFRS ? ? International Financial Reporting Standards.
? ?Incumbent Gavi Auditor ? ? the public accounting firm engaged to perform
the audit of the consolidated financial statements of Gavi .
? ?Incumbent IFFIm Auditor ? ? the public accounting firm engaged to perform
the audits of the financial statements of the International Finance Faci lity for
Immunisation.
? ?Records ? ? all documents, reports, diagrams, correspondence, emails, and
other physically or electronically stored material, and other business records
regardless of where they are located or stored, including those stored in a desk
drawer, office, file cabinet, record center, hard drive, personal computer or lap -
top, or off -site location.
? ?US GAAP ? ? United States Generally Accepted Accounting Principles.
? ?UK GAAP ? ? United Kingdom Generally Accepted Accounting Principles.

2. Appointment of Independent Auditor

Appointment of Audit Firm
2.1. As per Gavi?s Statutes t he Board shall appoint a reputable firm of independent
auditors ("Auditors") to conduct an annual audit of the accounts of the Gavi
Alliance .

Term of Appointment
2.2. An Incumbent Gavi Auditor may serve a first term of up to five consecutive financial
years.
2.3. After completion of its first term, an outgoing Incumbent Gavi Auditor may submit
a request to be considered for appointment to a second term of up to five
consecutive financial years.
2.4. No Incumbent Gavi Auditor may serve more than two consecutive five -year terms.
After completion of an Incumbent Gavi Auditor?s second consecutive five -year
term, the Board shall appoint a different public accounting firm t o serve as Gavi?s
independent auditor.

Request for Proposals by Audit Firms
2.5. While the World Bank serves as Treasury Manager to IFFIm , Gavi will aim to
appoint the auditor from the same firm in Switzerland that has been appointed to
serve as the World Ban k Auditor in the US to serve as Gavi?s next independent
auditor. Prior to the end of the last financial year of the current Incumbent Gavi
Auditor?s five -year term, as described in 2.2 to 2.4 above, the Secretariat will
request a proposal from the prospective accounting firm.
2.6. If the World Bank no longer serves as Treasury Manager to IFFIm and in

Gavi Alliance
Treasury Governance Policy
Version 2.0
DOCUMENT ADMINISTRATION
VERSION
NUMBER APPROVAL PROCESS DATE
1 .0 Prepared by: Treasury T eam
Reviewed by:
Director, Finance & Chief Accounting
Officer 4 August 2021
Reviewed by:
Treasury Risk Management
Committee 30 September 2021
Reviewed and recommended by:
Gavi Audit and Finance Committee 19 October 2021
Approv ed by:
Gavi Alliance Board 2 December 2021
Effective from: 2 December 2021
2.0 Reviewed and recommended by:
Gavi Audit and Finance Committee 11 May 2023
Approved by: Gavi Alliance Board XX June 2023
Effective from: 28 June 2023
Next review:
As and when required
Doc 01d - Annex 00030026





2 Gavi Alliance
Treasury Governance Policy
1. Purpose
1.1. The purpose of this Treasury Governance Policy ( the ? Policy ? ) is to strengthen the
management of treasury - related activities at the Gavi Alliance (?Gavi?). The Policy
provides key guiding principles and defines primary roles and responsibilities for
the execution of these guidelines.
2. Scope
2.1. This Policy shall apply to all business units within Gavi which are undertaking or
are engaged in decisions impacting treasury - related activities in the areas of:
2.1.1. Cash and liquidity management;
2.1.2. Cash flow forecasting;
2.1.3. Financial risk management;
2.1.4. Financial guarantees;
2.1.5. Bank relationship management;
2.1.6. Treasury technology including bank connectivity.
2.2. The Treasury function spans across Gavi?s business activities . Therefore, the
Policy is applicable to current a nd future Gavi programmes.
3. Policy Statements
3.1. Treasury T eam shall be ultimately responsible for recommending the treasury
improvement plan and operationally executing activities belonging to its remit.
3.2. The main Treasury T eam? s objectives are to :
3.2.1. Manage security, liquidity and yield (SLY princ ip l es ) i n order to fulfil Gavi?s
financial obligations in a timely and cost - effective manner;
3.2.2. Identify financial risks and measure financial exposures to protect Gavi
against negative financial impact by recommending and implementing
suitable risk management strat egies;
3.2.3. Define and maintain an efficient banking landscape to accommodate Gavi?s
business requirements, minimise operational complexity and maximise
flexibility;
Establish strict segregation of duties and controls to minimise operational
risks within treasu ry activities involving financial transactions;
Based on these primary objectives, detailed objectives are further
formulated in individual treasury policies.
3.3. The treasury governance framework is structured in three layers:
3.3.1. This Policy provides guiding principles and as sign s responsibility to
different organisational units to execute the treasury mandate; Doc 01d - Annex B

Gavi Alliance
Treasury Risk Management Policy
Version 2.0
DOCUMENT ADMINISTRATION
VERSION
NUMBER APPROVAL PROCESS DATE
1 .0 Prepared by: Treasury Team
Reviewed by:
Director, Finance & Chief Accounting
Officer 4 August 2021
Reviewed by:
Treasury Risk Management
Committee 30 September 2021
Reviewed and recommended by:
Gavi Audit and Finance Committee 19 October 2021
Approv ed by:
Gavi Alliance Board 2 December 2021
Effective from: 2 December 2021
2.0 Reviewed and recommended by:
Gavi Audit and Finance Committee 11 May 2023
Approved by: Gavi Alliance Board XX June 2023
Effective from: 28 June 2023
Next review:
As and when required
Doc 01d - Annex D





2 Gavi Alliance
Treasury Risk Management Policy
1. Purpose
1.1. The purpose of the Treasury Risk Management Policy (the ?Policy? ) is to define
how the Treasury team manages financial risks to which the Gavi is exposed,
namely, financial counterparty credit risk, sovereign counterparty credit risk ,
foreign exchange (FX) risks and l iquidity risks .
1.2. Financial risk management is defined as the process of identification,
measurement, mitigation and reporting of financial risks. The Policy defines the
objectives, guiding statements and responsibilities with regards to counterparty
credit and FX risks.
2. Objectives
2.1. The objectives of the Policy are to:
2.1.1. Provide maximum predictability of funding when Gavi engages in
programmes. Gavi shall apply currency hedging to reduce its exposure to
potential decreases in the value of future net cash inflows due to exchange
rate fluctuations ;
2.1.2. Identify, measure and manage counterparty credit risks with approved
financial counterparties against approved counterparty credit limits to
safeguard the value of financial assets and minimise potential losses from
coun terparty defaults ; and
2.1.3. Minimise Gavi?s risk to sovereign counterparties by implementing effective
risk mitigation mechanisms, including but not limiting to financial
guarantees or letter of credit.
2.1.4. Manage liquidity in order to fulfil Gavi?s financial oblig ations in a timely and
cost - effective manner .
3. Risk Assessment
3.1. FX risk. Gavi receives contributions and other inflows in a variety of currencies.
Gavi?s programme expenditures for vaccine purchases and cash grants are mainly
incurred in USD. Business plan expenditures for staff costs, office facilities and
other services are incurred mainly in USD and CHF. Because FX rates fluctuate,
the value in a given currency of future cash flows denominated in another currency
will vary over time, resulting in increases or decreases in th e value of these future
cash flows . These variation s may be substantial, especially in periods of high FX
volatility.
3.2. Permitted hedging instruments (as defined in Section 8.1 ) enable reduction of the
ris k of decreases in the value of future net cash inflows. This provides greater
certainty of the value of future cash flows in the currency to which they will
ultimately be converted.
3.3. Financial counterparty credit risk . This is the risk that a financial coun terparty
will fail to meet its obligations. It applies whenever Gavi is exposed to a default by
financial counterparties. Financial transactions at Gavi include cash on bank
accounts, term deposits, money market investments, financial guarantees, FX
deriva tives and collateral payments. The credit exposure per financial counterparty
is measured by aggregating the following items:
Doc 01d - Annex D

Gavi Alliance Board Workplan
2023
Gavi Board Paper Type Dec Apr June Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec
A.Strategy/Performance/Risk/MELCEO's Report CEO's Report Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion 2021-2025 Strategy Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion Discussion Discussion Discussion Discussion Discussion Discussion 2021-2025 Strategy Gavi 5.0 Decision Measurement Framework (Targets & Indicators) Strategy, Programmes and Partnerships: Progress, Risks and Challenges Decision Innovation TBD Information Information Information Private Sector Engagement TBD Information Information Information Information Civil Society and Community Engagement Approach TBD Information Information Partners' Engagement Framework Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Disease Surveillance and Diagnostics in Gavi 5.0 TBD Decision Discussion Risk and Asurance Report Risk and Assurance Report Decision Decision Decision Decision Decision Decision 2026-2030 Strategy TBD Decision Guidance Decision Discussion Discussion Discussion Discussion Funding Policy Review TBD Decision Guidance Decision Measurement Framework (Targets & Indicators) TBD Decision Guidance Decision B.Vaccines & SustainablityTyphoid TBD Information Pneumococcal AMC (Advance Market Commitment) TBD Information Malaria Co-financing TBD Decision Decision Vaccine Investment Strategy Vaccine Investment Strategy Decision Decision Decision COVID-19 Vaccine Programme Update COVAX/COVID-19 Vaccine Programme Decision Information Information Gavi's role in Pandemic Prevention, Preparedness and Response Gavi's role in Pandemic Prevention, Preparedness and Response Decision Decision Information Gavi's role in support to Regional and African manufacturing Gavi's role in Pandemic Prevention, Preparedness and Response Decision Decision C.PolicyTransparency and Accountability Policy Decision Decision D.Country ProgrammesNigeria TBD Information Information Information Information PNG TBD Information Information Strategic Partnership with India Strategic Partnerships with India Information Post-Transition Support (e.g. Angola, Timor-Leste) TBD Information Fiduciary risk assurance and financial management capacity building Fiduciary risk assurance and financial management capacity building Decision Information Middle-Income Countries approach TBD Information Information E.Finance/Audit & Investigations Annual Accounts Annual Financial Report Decision Decision Decision Decision Decision Financial Forecast Financial Update, including forecast Decision Decision Decision Decision Decision Decision Budget Financial Update, including forecast Decision Decision Decision Decision Decision Decision Programme Funding Policy Consent Agenda Decision Treasury Governance Policy Consent Agenda Decision Treasury Risk Management Policy Consent Agenda Decision Independent Auditor Selection and Evaluation Policy Consent Agenda Decision Audit & Investigations Report Audit & Investigations Report Information Information Information Information Information Information F.GovernanceBoard Chair Appointment Consent Agenda Decision Decision Board Vice Chair Appointment Consent Agenda Decision Decision Decision Decision Committee Chair Appointments Consent Agenda Decision Decision Decision Decision Board and Committee Appointments Consent Agenda Decision Decision Decision Decision IRC Appointments Consent Agenda Decision CEO Appointment Consent Agenda Decision Decision Secretary Appointment Consent Agenda Decision Treasurer Appointment Consent Agenda Decision Appointment of MD A&I Consent Agenda Decision Amendments to Governance Documents (Statutes, By-Laws, Committee Charters) Consent Agenda Decision IRC Terms of Reference Consent Agenda Decision Audit & Investigations Terms of Reference Consent Agenda Decision Delegation of Authority Policy Consent Agenda Decision G.ReportingCommittee Chair Reports Committee Chair and IFFIm Board reports Information Information 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 Information Information Replenishment/Resource Mobilisaton Resource Mobilisation Update Discussion Discussion Discussion Discussion HR Report Closed Session Information Information Information Information Information Information Information Information Information Information Annual Report on Implementation of the Gender Policy Annex to Strategy paper Information Information Information Information Information Information CEPI Progress Report Annex to Board pack/On BE as additional materials Information Information Information Information Information Information Information Information Information Information Board and Committee minutes Annex to Board pack/On BE as additional materials Information Information Information Information Information Information Information Information Information Information H. Technical Briefing Sessions/Deep DivesEvaluation Discussion Discussion Discussion Discussion Discussion
2026 2027
Last updated - 12 June 2023
Next Board Meetings: 6-7 December 202317-18 April 2024, Retreat26-27 June 20244-5 December 2024
2024 2025

1


Board -2023 -Mtg -02-Doc 02a FR
Rapport pour le Conseil d?administration
26 -27 juin 202 3

Rapport du Directeur ex?cutif

Le 19 juin 2023
Chers membres du Conseil d?administration ,

En r?digeant ce rapport - le dernier d'une s?rie de 24 - je repense aux 12 ann?es
extraordinaires qui viennent de s'?couler. Je suis impressionn? par tout ce qu?on t
r?alis? les pays avec lesquels nous travaillons, les partenaires de l'Alliance et le
personnel du Secr?tariat , dont je salue la comp?tence et le d?vouement . Cela a ?t?
un v?ritable honneur pour moi que de contribuer ? un travail d?une telle importance
aux c?t?s de coll?gues aussi motiv?s . Je tiens ?galement ? remercier tout
particuli?rement notre Conseil d'administration, pour la confiance qu?il a accord?e ?
l'Allianc e, au Secr?tariat et ? moi -m?me au cours de toutes ces ann?es. Je vous suis
profond?ment reconnaissant pour toutes les ann?es pass?es ici avec vous tous, et je
suis particuli?rement optimiste pour l'avenir de Gavi. Je me r?jouis d'accueillir
officiellement en personne le Dr Muhammad Pate lors de notre r?union qui va se tenir
dans une semaine.

Depuis sa cr?ation, Gavi a permis de vacciner plus d'un milliard d'enfants. Si l'on
ajoute le soutien accord? directement aux pays par Gavi pour la vaccination de
routine, les campagnes de vaccination pr?ventive, la constitution de stocks de vaccins
pour la riposte aux ?pid?mies et les vaccins distribu?s par le biais de COVAX, Gavi a
permis plus de 6 milliards de vaccinations compl?tes et particip? ? plus de
700 introductions de vaccins - ce qui a permis de r?duire de 70 % le nombre de d?c?s
?vitables par la vaccination chez les enfants des pays soutenus par Gavi, et contrib u?
? r?duire de plus de 50 % la mortalit? des enfants de moins de cinq ans. Sur la base
des donn?es 2011 -2022 (celles 2022 ?tant toutefois pr?liminaires), les pays soutenus
par Gavi ont vaccin? plus de 741 millions d'enfants rien que sur les douze derni?res
ann?es , ce qui a permis d??viter ? terme 13,5 millions de d?c?s et de g?n?rer des
b?n?fices ?conomiques d?un montant de 177,7 milliards de dollars am?ricains. Par
ailleurs , 19 pays ont cess? de b?n?ficier du soutien de Gavi. Mais cela n'a pas ?t?
facile. Chaque vaccin, chaque programme, chaque d?cision a fait l?objet d?analyses et
de discussions , tout en sachant que le principal risque , c?est le plus souvent l'inaction.

? cet ?gard , et comme il est d'usage, je profiterai de ce rapport pou r faire le point sur
les six derniers mois, qui ont ?t? tr?s charg?s. C?est encore une ann?e cruciale pour
Gavi. Certains d'entre nous l'appellent l'ann?e des r?sultats , et lors de la derni?re
r?union du Conseil d'administration elle a ?t? ?galement qualifi?e d'ann?e du
renouveau . C?est ?videmment aussi une ann?e de transition importante, et nous
avons proc?d? ? d'importants recrutements pour parvenir ? une organisation plus
stable apr?s la p?riode de travail intense que nous avons connue au cours des trois
derni?res ann?es . Nous avons notamment accueilli deux nouveaux directeurs
g?n?raux, Derrick Sim qui a pris la t?te du d?partement March ? des vaccins et s?curit?
sanitaire et, ce mois -ci, Kelechi Ohiri pour le d?partement Soutien ? la politique, ? la

1


Board -2023 -Mtg -02 -Doc 02a

Report to the Board
26 -27 June 202 3

Report of the Chief Executive Officer
19 June 2023
Dear Board members,
As I write this report ? my last of 24 such reports ? I am reflecting on the past 12
extraordinary years. I am humbled by the incredible accomplishments of the countries
with which we work, the Alliance partners, and our talented and dedicated staff here
in the Secretariat . It has been the hono ur of my professional life to contribute to this
important work alongside such ins pirational colleagues . I also want to thank you, our
Board, for the trust you have put in the Alliance , the Secretariat and me over these
years. I am deeply grateful for my time here and with you all , and I have tremendous
excitement and optimism for Gavi? s future. I am looking forward to welcoming
Dr Muhammad Pate officially and in person at our meeting in a week?s time.
Since its inception, Gavi has helped vaccinate more than 1 billion unique children. And
if we add up Gavi's support to countries for routine immunisation, preventive
campaigns, stockpiles for outbreak response and through COVAX, Gavi has
supported over 6 billion completed vaccinations and more than 700 vaccine launche s
? which has led to a 70% reduction in vaccine -preventable child deaths in Gavi -
supported countries , contributing to a more than 50% reduction in under -five child
mortality. Over the course of the past 12 year s alone , based on data from 2011 -2022
(noting 2022 data is preliminary) , Gavi -supported countries have vaccinate d over 741
million unique children, avert ed 13.5 million future deaths , and yield ed economic
benefits of US$ 177.7 billion. In addition, 19 countries have transitioned out of Gavi
support. But it has not been easy. Each vaccine, each programme, each decision was
analysed and debated ? but with the understanding that often the biggest risk was the
one posed by inaction.
On that note, and as is customary, I will use this report to dive into the busy past six
month s. This is another critical year for Gavi. Some of us call it ?the year of delivery?,
and it was also referred to at our last Board meeting as ?the year of renewal?. This
year is also obviously an important year of transition, and we have been making
import ant appointments as we move to a more steady -state organisation following our
intense work period over the last three years ? including welcoming two new Managing
Directors : Derrick Sim for Vaccine Markets & Health Security ; and, just this month,
Kelechi Ohiri for Policy, Programme Design & Delivery Support . We have also
elevated and redefined two key roles as part of our operational excellence journey,
welcoming Laura McKeaveney as Chief People & Experience Officer and Maria
Thestrup as Chief Risk Officer.
With the Public Health Emergency of International Concern (PHEIC ) ended for both
COVID -19 and mp ox, a transition to this more steady state is welcome. However, this

1


Board -2023 -Mtg -02-Doc 02b

Report to the Bo ard
26 -27 June 202 3
Subject Strategy, Programmes and Partnerships: Progress, Risk s and
Challenges
Agenda item 02b
Category For Decision
Section A : Executive Summary
Context
In December 2022 the Gavi Board approved the update of the Gavi 5.0 strategy into
Gavi 5.1. Gavi 5.1 reaffirms the Gavi 5.0 core priorities such as catching -up on missed
children, reaching zero -dose children, and ensuring introductions of priority vaccines at
pace, including relaunching the human papillomavirus ( HPV ) vaccine and accelerating the
malaria programme launch. It also includes targeted additions from the pandemic and its
learnings with a potential COVID -19 vaccine programme from 2024 and an evolu tion of
Gavi?s role in Pandemic Prevention Preparedness and Response (PPPR). This report
provides a progress update on the implementation of Gavi 5.0/5.1 and associated
risks 1. As WHO -UNICEF estimates of national immunisation coverage (WUENIC) for 2022
wi ll be released in July, the paper provides quantitative updates on a limited number of
strategy indicators for which new 2022 data is available, as well as a more qualitative
perspective of progress. A holistic overview of performance is also captured in t he
Balanced Scorecard (See Annex A) . In addition to this bi -annual paper, the Secretariat is
looking into opportunities to share other existing information on country progress with the
Board on an on -going basis 2.
Questions this paper addresses:
? How is the Alliance performing against its strategic goals and indicators for Gavi
5.0/5.1? What progress has been made against priorities?
? What are the key risks and challenges across the Alliance?s strategic performance,
programmes and partnerships, and what actions are being taken to address these?
? Should the timeline for disbursements of the Equity Accelerator Fund (EAF) be
extended to end 2027 as per the recommendation from the Programme and Policy
Committee (PPC) , recognising that the COVID -19 pandemic has had adverse impact
on design and implementation of EAF grants?
? What are the programmatic items with financial implications for Gavi 5.1 and 6.0 at
this Board meeting?

1 Associated risks refer to the top risks in the Risk & Assurance Report 202 3 which will be submitted for approval to the
Board in December 2023. 2 This includes the addition of a dedicated presentation by the Secretariat and core Partners on country programmes
delivery at the last PPC meeting as well as a technical briefing on country programmes to the Board at the upcoming
meeting .

Gavi Balanced Scorecard
J U N E 2023 ? B E T A V E R S I O N Doc 02b - Annex A
A balanced scorecard is a key tool for transparent &
systematic overview of Gavi?s performance
Provide a holistic, systematic,
high - level view of performance
with deep - dive modules for
governance fora ( incl. Board,
PPC, AFC) and partners
engagement to support
discussion and decision makingRoom to improve consistent,
holistic and systematic review
of performance across key areas
of priority for Gavi, both internally
and with governance bodies Context & Problem - statement Key objectives
? Doc 02b - Annex A

Board -2023 -Mtg -02-Doc 02b -Annex B 1
Report to the Board
26 -27 June 202 3
Annex B: Gavi Human Papillomavirus Measurement Framework
The Gavi HPV Measurement Framework was developed to provide a comprehensive
way to monitor progress of Gavi Secretariat and Alliance partners against the goals of
the revitali sation of the Gavi HPV program that was approved by the Gavi Board in
December 20 22.
The HPV Measurement Framework includes two sets of indicators, both of which are
outlined in this Annex:
1) The primary set of indicators for reporting on progress of the HPV program to the
PPC and Board, known as the HPV Scorecard. HPV Scorecard indicat ors are
noted in pink in the below diagram.
2) An expanded set of operational HPV indicators and operational forecasts for
detailed tracking purposes and to inform the narrative of the Scorecard. The
operational indicators are noted in grey in the below diag ram.
The indicators included in the HPV Measurement Framework are largely aligned with
existing Gavi measures including in the Gavi 5.0 Measurement Framework and Gavi
Balanced Scorecard.

HPV Scorecard
The HPV Scorecard includes indicators on HPV program impact and outcomes as well
as several high -level process indicators. Indicators have been selected via
consultations with business owners across the Secretariat with input from the global
HPV sub -team.

Board -2023 -Mtg -02-Doc 02b -Annex C

1
Report to the Board
26 -27 June 202 3
Annex C: Gavi 5.0/5.1 dashboard and update on key metrics
This is a technical report providing definitions of and progress against Mission and
Strategy Goal indicators in the new Gavi 5.0 measurement framework. The technical
report is populated based on available data and updated bi -annually. The newly
available data for 2022 included in this report relates to Mission Goal M1, and Strategy
Goals S1.4, S3.1, and SG4.
Note on target trajectories:
In the below graphs, the dotted lines represent the projected annual trajectory that was
forecasted when we set 2025 tar gets with the PPC/Board in May 2021; our assumption
was that coverage would return to 2019 coverage levels in 2021, with the exception of
India which would take until 2022. This was noted in a footnote in the PPC paper on
the 5.0 Measurement Framework at t he time (PPC -2021 -Mtg -2-Doc 04):
To account for COVID -19 -related disruptions and recovery, it is assumed that
vaccine coverage returns to 2019 levels by 2021, with the exception of India,
which we assume returns to 2019 levels in 2022 and sub -national thre e doses
of pneumococcal conjugate vaccine (PCV3) scale up takes an additional year.

Gavi 5.0 Mission Indicators
M.1: Under -five mortality rate ? Updated April 2023

By increasing access to immunisation and
enabling equal access to new and underused
vaccines, Gavi support is contributing to the
reduction in under -five deaths from vaccine -
preventable diseases.
Gavi countries saw an under -five mortality rate
of 55.7 deaths per 1,000 live births in 2021 . At
the portfolio level we are on track t o reach the
10% reduction target by 2025 ? in 2021, Gavi
countries have achieved a 6% reduction from
baseline .

M.2: Number of future deaths averted with Gavi support ?
Updated Sept 2022

This indicator estimates the impact of Gavi -
supported vaccinations in terms of averting
future deaths from vaccine -preventable
diseases.
More than 1.2m future deaths were averted by
Gavi -supported vaccinations in 2021. The
cumulative number of deaths averted from 2000
through 2021 is more than 16.2m.
This indicator will be updated in Sept 2023.


59.2 57.5 55.7 Target: decrease by 10%
0
10
20
30
40
50
60
2019(Baseline) 2020 2021 2022 2023 2024 2025
1.2M
Target: 7 -8M
0M
2M
4M
6M
8M
2021 2022 2023 2024 2025

1


Board -2023 -Mtg -02 -Doc 03

Report to the Board
26 -27 June 202 3

Subject Country Programmes Delivery Presentation
Agenda item 03
No paper

1


Board -2023 -Mtg -02-Doc 04
Report to the Board
26 -27 June 202 3

Subject COO and Financial Update, including forecast
Agenda item 04
Category For Decision
Section A: Executive Summary
Context
This paper presents the updated Financial Forecasts for Gavi 5.1 (2021 -2025), COVAX
AMC (2020 -2023) including COVID -19 immunisation programme (2024 -2025) to the
Board for approval based on the recommendation of the Audit and Finance Committee
(AFC).
The Gavi 5. 1 forecast confirms sufficient financial flexibility given the uncertain context
with US $ 109 million available for future investments. The forecast reflects a decrease
of US $ 161 million in resources and a decrease in programmatic expenditures of
US$ 12 5 million (before new items for decision).
? Changes to forecast: The decrease in forecast expenditure is driven by the
proposed rephasing of cash programmes into the next strategic period partly offset
by increased vaccine costs . W hile overall cash support to countries (Core and
COVAX COVID -19 Delivery Support (CDS) ) is forecast to remain at record levels
for the rest of the strategic period, the Gavi 5.1 H ealth Systems Integration and
Strengthening (HS IS) forecast s are US$ 268 million lower (US$ 15 0 million Health
Systems Strengthening (HSS) , US$ 14 0 m illion Equity Acce lerator Fund offset by
a US$ 23 million increase driven by Campaign Operational Costs ), reflect ing
absorptive capacity in certain co untries for HSS and to extend the time line into
2026/ 20 27 for countries to implement their EAF p rogrammes . These funds are now
forecast to be disbursed in the next strategic period but will remain available to
countries to utilise in Gavi 5.1 if absorption exceeds current forecasts (in which case
the forecast could be revised upwards again in a future cycle) . Therefore, the
resulting cash programme forecast reflects the current best estimate of
disbursement phasing and does not represent the active deferral of any underlying
programmatic activities . Increased vaccine procurement costs (US$ 151 million or
+3%) are driven primarily by increased demand for m easles & m easles -rubella
vaccines in response to coverage declines and increased outbreak risk. To balance
the rephasing of cash programmes into th e next strategic period, US$ 179 million
of IFFIm (International Finance Facility for Immunisation) proceeds will also be
deferred.
? Items for decision: the Board is asked to approve US$ 29 million expenditure in
the Gavi 5.1 forecast for the launch of the Hexavalent vaccine programme, noting
that the impact on Gavi 6.0 is forecast between US$ 357 ? US$ 430 million , as well
as a US$ 10 million time -limited envelope for a Global Virtual Pooled Inventory
(GVPI) for Ebola Sudan and Marburg candidate vaccines. As a result of countries?
EAF applications being delayed due to the pandemic, the Board is also requested
to approve the extension of the timeline to disburse the remaining EAF funds from

gavi.org
COO UPDATE
BOARD MEETING
David Marlow
26 -27 June 2023, Geneva, Switzerland
Executive Summary
2
? Operational Excellence ambition and approach endorsed by the AFC; presented at Governance Committee and Board
Closed Sessions
? Operational Excellence agenda continuing at pace while acknowledging need to balance running the business while
streamlining operations and improving ways of working; multi -year journey
? Increased transparency and connectivity between PPC and AFC discussions; careful sequencing and sharing of
information based on committee mandates. Additional opportunities for connectivity across multiple committees
? Financial forecast process strengthened
? Launch of Programme Leadership Team (PLT); enhanced cross -functional collaboration and ownership for
programmatic drivers impacting financial forecast
? More detailed and timely reporting from countries and partners : greater transparency of cash utilisation and
cash balances in -country
? New draft Balanced Scorecard providing improved holistic and systematic view of performance with relevant deep dive
modules available; will continue to evolve based on feedback and use
? Review and simplification of key policies underway; Ethics policy; PSEAH framework; Programme Funding Policy
? Strategy Operationalisation evaluation ; recommendations on strategy operating model; inform OE work and Gavi 6.0
Key Messages
Board Meeting, 26 -27 June 2023

gavi.org
FINACIAL UPDATE, INCLUDING FINANCIAL FORECAST
BOARD MEETING
Assietou Diouf
26 -27 June 2023
Table of contents
COVAX AMC and COVID -19 forecast
F orecast risks and opportunities
Gavi Core 5.1 financial forecast 1
2
4
3
5
Gavi 6.0 forecast
Annex
Board Meeting, 26 -27 June 2023

1


Board -2023 -Mtg -02-Doc 05
Report to the Board
26 -27 June 202 3

Subject Approach for Gavi 6.0 strategy design and the road to
replenishment
Agenda item 05
Category For Information
Section A : Summary
Context
The Gavi 6.0 strategy will set out the Alliance?s vision, mission, strategic goals,
objectives , operating principles , and critical enablers for the 2026 -2030 period . Th e
strategy is being developed against a backdrop of poly -crises such as climate change
and growing fragility and conflict and a n increasingly constrained donor environment .
The process will encompass three phases from contextual trends and the vision for
Gavi 6.0 (until October 2023) ; to discussion of strategic options (October 2023 -
January 2024 ); to making trade -offs and finalising the new Gavi strategic ?one -pager?
framework (January 2024 - May 2024) . Building on early discussions at the Board
retreat in March 2023 , t his report presents an overview of the envisioned process to
design the new strategy, to be presented to the Board for approval in June 2024.
Aligned with the Gavi 6.0 strategy development process, t his report also outlines the
road to replenishment which would take account of the issues which are particularly
salient for donors in the context of numerous upcoming elections . These notably
includ e the changing landscape of global health architecture, fiscal challenges, and
the need to proactively orchestrate replenishments and develop a shared narrative
with other international organisations . The proposed process will be implemented in
phases from the Mid -Term Review (MTR) in Madrid in June 2023 to a listening phase,
followed by the December Board meeting with a discussion on the Gavi 6.0 strategy ,
an Investment Opportunity launch event in Q3 2024 based upon the Gavi 6.0 strategy 1
and a pledging conference in Q4 2024/Q1 2025 . The plan would be to set in motion a
proactive resource mobilisation process so that the design reflects an appreciation of
the funding landscape.
Questions this paper addresses
? What will be the process to design Gavi 6.0?
? What will be the approach to the replenishment for Gavi 6.0 ?
? How are the strategy design and replenishment linked ?

1 To be presented to the Board for approval in June 2024

1


Board -2023 -Mtg -02-Doc 06
Report to the Board
26 -27 June 2023


Subject Hexavalent Investment Case
Agenda item 06
Category For Decision
Section A : Executive Summary
Content
In November 2018, the Board approved i n-principle support for whole -cell Pertussis
Hexavalent vaccine (Hexavalent), a combination vaccine that includes six antigens
already covered by Gavi support via Pentavalent and standalone Inactivated Polio
Vaccine ( IPV ). This approval was subject to a vaccine being licensed, recommended
for use by WHO, WHO prequalified, and with market attributes met that support the
successful implementation of Hexavalent. This topic is now being brought back to the
Board, since the support conditions laid out in the 2018 decision are now evaluated
as having been met , based on current market information (see Appendix 2 to May
2023 Doc 06 ) ? and the programme was endorsed unanimously by the PPC during its
May 2023 convening .
Support for Hexavalent (4-dose series )1 is expected to provide considerable
programmatic ease and reduce ancillary costs , among other benefits . Furthermore,
the shift to this combination vaccine would support Gavi 5.1 and polio eradication
objective s. These benefits need to be weighed against estimated additional costs to
Gavi of US$ 29 -62 million in Gavi 5.1 and US$ 357 -430 million in Gavi 6.0 and
increased co -financing obligations of countries of US$ 0. 2-2 million in Gavi 5.1 and
US$ 34 -60 million in Gavi 6.0 compared to the currently supported
(3Pentavalent+2IPV ) schedule 2.
Conclusions
This governance cycle is a critical window of opportunity to ensure the availability of
Hexavalent to Gavi -supported countries. Declining or delaying support for Hexavalent
could lead to unrealised programmatic benefits and negative consequences for any
future Hexavalent product and other combination vaccine market s ? and potentially
jeopardise Gavi?s credibility with the manufacturer base.
Given that the favourable analysis of the value of Hexa valent demonstrates that it is
commensurate with it s financial implications , the Programme and Policy Committee
(PPC ) recommend s to the Board that Gavi open s a funding window starting Q3 2023 .


1 See Table 1 below for WHO -recommended schedules and Appendix 1 to May 2023 PPC Doc 06 for additional
details. 2 The lower figure in each range is the base scenario costs currently reflected in the financial forecast . The higher
figure in each range is based on the high demand s cenario. See Appendix 1 to May 2023 PPC Doc 06 for details.

Board -2023 -Mtg -02 -Doc 06 -Annex A
1
Report to the Board
26 -27 June 2023

Annex A: Implications and Anticipated Impact
1. Anticipated impacts of a potential Hexavalent support decision
1.1 Financial impact s
Financial impact on the Gavi Alliance
Table 1: Additional cost of Hexavalent to Gavi versus currently used (Pentavalent+IPV )

Gavi vaccine costs ( US $M) as per latest
financial forecast (v20.1 )
Gavi 5. 1 Gavi 6.0 Total
IPV $874 M $77 3M $1,647 M
Pentavalent $492 M $42 5M $917 M
Total $1 ,366M $1 ,198M $2 ,564M
Additional cost to Gavi if Hexavalent
supported (a,b)
$29 M-$6 3M $357M -$430M $387M -$492M
% Increase versus [Pentavalent + IPV] 2% -5% 30% -36% 15% -19%
(a): the range of additional cost reflect s the base and high demand scenarios and includes the saved
ancillary costs to Gavi
(b): the additional cost includes a one -time switch grant based on US$ 0.25/child in birth cohort in the
year of introduction or US$ 30,000 (whichever is higher)
? The main driver of the increase in cost to Gavi is Hexavalent?s price
premium 1.
? In a highly unlikely scenario where all Gavi 54 eligible countries gradually
switch to Hexavalent by 2030, the additional cost to Gavi is estimated to
reach US$ 1 15 million in Gavi 5.1 and US$ 7 00 million in Gavi 6.0.
o Th is scenario assumes an optimistic supply availability outlook and a
gradual linear uptake of Hexavalent demand 2.
o Hexavalent price used in this scenario is lower than the base demand
scenario because we expect that higher demand would lead to improved
economies of scale and a more competitive environment 3.
1 This cost of this programme includes two additional doses of IPV (as part of a combination vaccine) that are not
currently supported . There may also be additional service delivery costs that are not currently reflected in the
forecast. 2 The uptake of Hexavalent demand was assumed as a linear increase , constrained by supply availability. This
approach is different than the base/high demand forecasts used to estimate the financial implications in Table 1,
which are based on a bottom -up mod el that assesses the likelihood of a country switching to Hexavalent (see
Appendix 1 ? Table 2 ). 3 Using the known cost of Hexavalent (not assuming competition), the additional cost to Gavi is estimated to be
US $ 117 million in Gavi 5.1 and US $ 793 million in Gavi 6.0 .

1


Board -2023 -Mtg -02-Doc 07
Report to the Board
26 -27 June 202 3

Subject COVAX update and Gavi?s Role in a future COVID -19 Vaccine
programme
Agenda item 07
Category For Decision

Section A : Executive Summary
Context
2023 is a critical year for the COVAX Facility. With the lifting of the Public Health
Emergency of International Concern (PHEIC) designation for COVID -19 on
5 May 2023 and recognition that the pandemic is now at a different phase, we continue
to operate in the World Health Organization -designated ?base -case? scenario for
COVID - 19 1, and we anticipate the approach to COVID -19 vaccination will continue to
evolve. Guidance from the WHO Strategic Advisory Group of Experts on Immunization
(SAGE) was u pdated in March 2023 2 recommending a more streamlined approach for
continued COVID -19 vaccination in 2023 focusing on the high priority user group.
In June 2022, the Gavi Board approved Gavi's continued hosting of the COVAX
Facility through the end of 2023. For the remainder of 2023, Gavi will continue to
integrate relevant COVAX processes into Secretariat and Alliance partner core
processes to enable a smooth transition to the proposed 2024 -2025 COVID -19
vaccine programme, pending Board approval. This paper provides an outlook for
COVAX in 2023 and seeks Board approval for a future Gavi -supported COVID -19
programme in 2024 -2025.
Questions this paper addresses

? What progress has COVAX made supporting Advance Market Commitment (AMC)
participants reach their COVID -19 vaccination goals, and what are the objectives
of a Gavi -supported COVID -19 programme in 2024 -2025?
? What is the state of supply and demand, and what is the supply strategy for
transitioning from COVAX to a future COV ID -19 vaccine programme?
? How is COVAX adjusting in preparation for the shift from an emergency response
to a potential future COVID -19 vaccine programme that utilises existing Alliance
processes?
? What are the financial implications of a 2024 -2025 COVID -19 vaccine programme
for Gavi?

1 Strategic preparedness, readiness and response plan to end the global COVID -19 emergency in 2022, WHO 2 https:/ /www.wh o.int/publications/i/item/WHO -2019 -nCoV -Vaccines -SAGE -Roadmap

 

Board -2023 -Mtg -02-Doc 07 -Annex A 1
Report to the Board
26 -27 June 202 3
Annex A: COVAX Reporting Fram ework
Section A: Update on Gavi?s COVAX Facility and COVAX AMC Monitoring, Evaluation
and Learning (MEL) strategy

The table below provides some of the key highlights and updates on progress against the core
elements of Gavi?s COVAX Facility and COVAX AMC MEL Strategy since the December 2022
Gavi Board.

MEL strategy
component
Key activity Highlights / update (May 2023)
Cross -cutting COVAX Theory
of Change
COVAX Facility and AMC theory of change for
2023 drafted, mapping against the objectives and
goals as presented to the Gavi Board in December
2022.
Monitoring COVAX
Reporting
Framework
Reporting against COVAX Reporting Framework
made available for PPC and Board. The 2023
Reporting Framework is further streamlined and
accompanied by short qualitative updates for some
key 2023 objectives (see below).
Complementary
monitoring to
COVAX
Reporting
Framework
COVAX Facility, Gavi Secretariat teams and core
COVAX partners continue to monitor aspects of the
Facility and AMC to a much greater extent beyond
the metrics currently captured in the topline
Reporting Framework. Examples includ e:
? COVID19 Vaccination Insights Reports
generated by WHO covering a range of
disaggregated analyses on uptake, supply
received and external delivery financing;
? Monitoring of progress across subgrants
funded through COVID19 Delivery Support;
? Other operational metrics and analyses across
supply, allocation, deliveries and in -country
implementation gathered internally.
Core country
monitoring and
reporting on
COVID -19 /
COVAX
COVAX continues to utilize data reported via the
WHO -UNICEF electr onic Joint Reporting Form
COVID -19 module and WHO regional COVID -19
vaccination dashboards to gather core reporting
from COVAX participants. Gavi recently co -
convened a Global Meeting with WHO, UNICEF
and CoVDP to set forth a pathway for revisions to
the c ore minimum dataset and reporting on COVID -
19 vaccination going forward.
Recipients of COVID19 Delivery Support funds are
expected to report back on a six -monthly basis to
Gavi.
Evaluation Multi -stage
independent
Itad ( www.itad.com ) was selected as the
independent evaluator for the first stages

 

gavi.orgG a v i ' s R o l e i n a F u t u r e C O V I D - 1 9 V a c c i n e P r o g r a m m e
Annex B ? COVID - 19
Vaccine Investment
Assessment
Gavi Alliance Board
26 - 27 June 2023 Doc 07 - Annex B
Disease context and uncertainties
Latest vaccine policy and strategy
Health and economic impact assessment
Demand assessment
Delivery strategy
Financial implications
Risks and potential mitigation
Detailed C19 Vaccine Investment Assessment
Appendix
2 Available vaccinesTable of contents Doc 07 - Annex B

1


Board -2023 -Mtg -02-Doc 08
Report to the Board
26 -27 June 202 3

Subject Gavi?s Role in Pandemic Prevention, Preparedness and
Response
Agenda item 08
Category For Decision
Section A : Executive Summary
In December 2022, as part of the Gavi 5.1 discussions, the Gavi Board supported the
Alliance?s engagement in four key targeted additional Pandemic Prevention
Preparedness and Response (PPPR) areas building on its existing role, experience
and comparative advantage: 1) retain and enhance required capabilities for the next
pandemic; 2) financial innovation 3) resilient routine immunisation (RI) programmes;
and 4) diversification of regional manufacturing. The Alliance is institutionalising,
embedding, and coordinating activities in line with these areas to strengthen the
Secretariat?s an d Alliance?s preparedness and response to public health events
(PHE) 1 while simultaneously contributing to the evolving global PPPR ecosystem and
political discourse.
This paper provides an update on the Secretariat?s work with the Alliance and other
part ners, including the Coalition for Epidemic Preparedness Innovations (CEPI ) and
regional institutions, to advance global, regional, and local mechanisms for PPPR and
highlights progress in the four targeted PPPR areas. It also requests the Gavi Board
provide a time limited approval for Global Virtual Pooled In ventories (GVPIs) for Ebola
Sudan and Marburg candidate vaccines to be deployed for expanded access. The
GVPIs will serve a dual purpose of accelerated outbreak response and incentives to
manufacturers to accelerate vaccine development.
Questions this paper addresses
? How is the Alliance engaging with and influencing the dynamic PPPR ecosystem?
? How is the Secretariat working alongside the Alliance and other partners to
advance the four targeted additional PPPR areas?
? Does Gavi have a role to play to ensure timely access to pre -licensed vaccines for
expanded access and to complement partners? actions to help accelerate vaccine
access and bolster outbreak response?



1 Public health events include outbreaks, epidemics, and pandemics.

Board -2023 -Mtg -02-Doc 08 -Annex A 1
Report to t he Board
26 -27 June 202 3
Annex A: Gavi?s Day Zero Pandemic Financing Facility for Vaccines
Overview
As the global community advances discussions to define an ecosystem to enhance
equitable access to medical countermeasures (MCM) during health emergencies, the
issue of financing remains unresolved. It is also important to note that not all financing
has t he same requirements. It is particularly complicated in the context of vaccines,
which require heavy up -front, at -risk investments at the onset of a crisis.
The Secretariat is exploring options to solve this problem by leveraging Gavi?s
existing suite of innovative financing tools to create a Day Zero Pandemic
Financing Facility for Vaccines. This could potentially see US$ 2 billion rapidly
mobilised as additional surge and contingent financing at the onset of a global
pandemic . Building on Gavi?s 20 years of experience in innovative financing, our core
proposition is to leverage the systems already built to support COVAX AMC, to avoid
the need for ne w complex structures or bodies to provide this surge funding capacity.
Pre -agreed considerations, such as a WHO declaration of a Public Health Emergency
of International Concern as well as geographic scope of concern and Gavi Board
processes, are examples of what would be considered in an expedited process to
realise liquid resources. While the total cost of a global vaccine response would likely
require much more than US $ 2 billion, based on the COVAX experience a figure of
approximately US $ 2 billion is a n initial needs estimate for early deals and preparation
for equitable delivery. This funding could enable Gavi to enter into advance purchase
agreements on a competitive timeline while we define a more complete picture of
expected funding needs spanning v accine procurement and delivery - buying time to
mobilize resources for a comprehensive response.
The Day Zero facility would comprise multiple financing windows and contingent
arrangements that offer donors different ways to contribute ? and could limit th e impact
of commitments on national balance sheets until they are activated.
Our proposed approach includes:
? Contingent financing ? funding that is only unlocked once certain predefined events
occu r. An example of a tool being developed to provide rapid access to contingent
donor financing in this way is the IFFIm Contingent Financing Mechanism.
? Surge funding includes two types of tools:
o Standby funds that can be deployed immediately ( e.g. a future iteration of a
Pandemic Vaccine Pool).
o Frontloading tools that accelerate the availability of funds once new pledges or
grants are made. Funding through frontloading tools would typically take longer
to become available than contingent financing but be faster than a traditional
new grant agreement. Examples of these types of tools are the European
Investment Bank frontloading facility and the US Development Finance

Board -2023 -Mtg -02-Doc 08 -Annex B 1
Report to the B oard
26 -27 June 202 3
Annex B: Design considerations for an Advance Market Commitment to support
sustainable vaccine manufacturing capacity
The Secretariat is currently exploring different options for the following AMC design
considerations:
1. AMC objectives
2. Value chain focus
3. Incentive structure
4. Antigen specificity
5. Procurement pathway and manufacturer eligibility
6. Financing, governance and operationalisation
Given the number of interested stakeholders and range of mode l options , the
Secretariat is facilitating a transparent and evidence -based treatment of these design
options to facilitate constructive open debate. These analys es reflect substantial
learning from the PCV AMC and explore the implications of multiple design choices
on operationalisation and impact. Further analysis and expert validation are being
conducted over Q3/4 2023 before any recommendations are made.
1. AMC objectives
To strengthen regional manufacturing of vaccines the Gavi Board approved three
underpinning objectives in December 2022 . The AMC mechanism is expected to
adhere to these as ?boundary conditions?:
Gavi board -
approved
objectives
Description
Support healthy
global markets
Minimize market distortions and help to sustain low global
prices and resilient supply for priority vaccines
Drive efficient
market outcomes
Provide a signal to guide and align new manufacturers and
investors behind resilient, sustainable business propositions
Reduce barriers to
investment
Carefully structuring the level of incentive to help offset
initial costs of market entry whilst aligning support with other
providers of capital for greater overall impact
These have been t ranslated into two clear overarching AMC objectives , that both
meet Gavi?s objectives and match the requirements of external stakeholders voiced
during the Secretariat?s consultations ( in order of priority below ). Drafting theories
of change for these AMC objectives has already begun. These will form the
foundation of a holistic monitoring, evaluation and learning strategy to accompany
the AMC as well as the broader four -pillar regional manufacturing strategy. Gavi is
also embracing learnings generated from other AMCs as part of this design
process .

1


Board -2023 -Mtg -02-Doc 09
Report to the Board
26 -27 June 202 3

Subject Vaccine Investment Strategy 2024: longlist and evaluation
frameworks
Agenda item 09
Category For Decision
Section A : Executive Summary
Context
The Vaccine Investment Strategy (VIS) is Gavi?s prioriti sation process to evaluate
vaccines and immunisation products for inclusion into the portfolio. Every 5 years,
through this rigorous, consultative and transparent process, the Secretariat review s
evidence and carries out impact modelling to identify and assess new and /or under -
used vaccines of high public health relevance for Gavi -eligible countries . The VIS
facilitates strategic decision -making and provides predictability to countries,
manufacturers, and donors for their own planning and future decision -making. It is a
fundamental tool in fulfil ling Gavi?s aim of shorten ing the time between life -saving
vaccines being available in high -income countries to them being rolled out in lower
income countries.
Th is paper seek s Board approval on the first step in the VIS 2024 process: vaccine
candidate longlist and evaluation frameworks to assess them against . Th ere will be
two more governance decision points related to the VIS : a) Board Dec ember 2023
will consider a shortlist of vaccines ; and b) Board Jun e 2024 1 will make f inal decision s
on investment cases into new r outine / preventive vaccination programme s, s tockpiles,
or l earning agendas for implementation in Gavi 6.0, subject to a successful
replenishment cycle.
The VIS draws on the expertise of Alliance partners and other stakeholders to reflect
multidisciplinary perspectives . An independent VIS Steering Committee 2 has been
convened to provide technical and scientific guidance to the Secretariat in advance of
governance decis ion points , and country input was sought during this first phase
through a non -representative survey that received 111 responses from 36 Gavi
countries .3
As part of the VIS 2024 , the Secretariat proposes to evaluate the potential of providing
support to develop, strengthen and deliver vaccines at new touchpoints for specific
target populations (i.e. health workers and pregnant people), building upon lessons
learned related to the relaunch of HPV, introduction of malaria and delivery of
COVID - 19 vaccines, which required additional support to ensure sustainability and
1 VIS 2024 is in close alignment with the development of the Gavi 6.0 strategy to ensure that the outcomes of VIS
2024 respond to and inform the strategic priorities defined in Gavi 6.0, which will also be reviewed by the Board in
June 2024. 2 Steering Comm ittee members and summaries from meetings (Dec 2022, Apr 2023) in Appendix 1. 3 The survey took place in March 2023 and targeted government officials (Ministry of Health, EPI managers, and
other ministries) and in -country Gavi Alliance partners. Result su mmary in Appendix 2.

1


Board -2023 -Mtg -02 -Doc 10

Report to the Board
26 -27 June 202 3

Subject Committee Chair a nd IFFIm Board reports
Agenda item 10
To follow

1


Board -2023 -Mtg -02 -Doc 11

Report to the Board
26 -27 June 202 3

Subject Review of decisions
Agenda item 11
No paper

1


Board -2023 -Mtg -02 -Doc 12

Report to the Board
26 -27 June 202 3

Subject Closing remarks
Agenda item 12
No paper

1


Board-2023-Mtg- 02-Audit and Finance Committee Chair Report

Report to the Board
26-27 June 202 3

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 202 2.

? Since the last Board meeting, the AFC met three times (14 February, 11 May
and 8 June ) to consider Gavi recurring matters in accordance with the standard
workplan for Gavi 5.0 and the Office of the COVAX Facility .

? In addition, the Committee Chair held several technical sessions in relation to
financial ri sk management with IFFIm and the Secretariat Treasury team .

? The C hief Operating Officer briefed the Committee at each meeting on progress
with the work on Operational Excellence.

? 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 : Subject s reviewed
1. Financial Update
Management reporting ? The AFC was presented with the Balanced Scorecard, December 2022 and Q1
2023 Mana gement reporting. The AFC acknowledged the excellent work
performed by the Secretariat to bring transparency on data in response to
stakeholder expectations.
2022 Annual Financial Report (AFR)
? The AFC reviewed the draft AFR and the report of the external auditor (Deloitte)
for the year ended 31 December 2022 at its meetings in May and June.

? The accounts for the 2022 Fiscal Year continue to reflect the complexities
associated with COVAX activities as well as the impact of a significant increase
in interest rates . As a result, the c ommittee chair held several sessions with the
S ecretariat and the external auditors to ensure financials reflect the appropriate

1


Board -2023 -Mtg -02-Evaluation Advisory Committee Chair Report
Report to the Board
26 -27 June 2023

Subject Evaluation Advisory Committee Chair Report
Category For Information
Section A: Introduction
? This report provides the Board with an overview of the activities of, and
guidance provided by, the Evaluation Advisory Committee (EAC) since the
Committee Chair last reported to the Board in December 2022.
? At the in -person EAC meeting on 22 -23 March 2023, the EAC provided
guidance on: (i) the approach to assessing partners? role s across the Alliance
Strategy in evaluation s; (ii) the COVAX Facility and COVAX Advance Market
Commitment (AMC) Formative Review and Baseline Study; (iii) the proposed
scope, approach, and key questions of the next phase of the COVAX Facility
and COVAX AMC evaluation; (iv) progress of the commissio ned Gavi 5. 1
centralised evaluations; (v) the Zero -Dose learning agenda and related ongoing
evaluation; (vi) the operationali sation of the changes to the Gavi Evaluation
Policy; and (vii) EAC engagement in Gavi 5. 1 evaluations.
? Overarching issues and guidance
? As reported at previous Board meetings, the EAC continues to reflect on its
Remit, Voice and Practice in supporting a G avi evaluation portfolio of optimal
Independence, Credibility and Utility. The Multilateral Organisation
Performance Assess ment Network (MOPAN ) assessment, a potential further
independent assessment of the Evaluation function, and planning for Gavi 6.0
all offer opportunities to support this work.
? Recogni sing the importance of partnerships given the nature of Gavi as an
Allia nce, EAC members advised that Gavi Alliance partners should be
considered within the scope of the evaluations where their roles, responsibilities
and delivery contributes to the area of Gavi's work or Theory of Change (ToC)
being evaluated, and the focus f or evaluations should be on learning rather than
accountability of specific partners. The discussion focused on: (i) developing
and promoting an approach to enhanced engagement with partners on the
scope and questions for evaluations, to promote shared own ership of findings
and recommendations; and (ii) ensuring independent evaluators undertaking
evaluations are well briefed on the Gavi Alliance model and on the assumptions
related to the roles and responsibilities of partners within the ToC being
evaluated . The EAC further advised that the latter should be conducted as part
of the inception process - rather than as a condition of bidding - and validated
by relevant Alliance stakeholders.
? The EAC reviewed findings from an After Action Review on the
operati onali sation of the changes to the Gavi Evaluation Policy which was
revised in December 2021 to allow EAC members to join Evaluation Steering

1


Board -2023 -Mtg -02-Governance Committee Chair Report
Report to the Board
26 -27 June 2023

Subject Governance Committee Chair Report
Category For Information
Section A: Introduction
? This report provides the Board with an overview of the activities of the
Governance Committee ( GC ) since the Committee Chair last reported to the
Board in December 2022 .
? The GC met virtually on 9 February 2023, met in person on 29 March 2023 and
will meet again virtually on 22 June 2023 .
? In addition to some business such as Board and Committee nominations , the
recruitment of Unaffiliated Board Members and the governance risk matrix ,
Committee discussions focused on work in relation to (i) the CEO recruitment
process , appointment and transition ; (ii) the Board and Committee Evaluation;
(iii) updates on Operational Excellence and Human Resources; (iv) updates to
the Board Travel and Delegation of Authority policies ; and (v) guidelines for the
dissemination of Board and Committee materials and draft confidentiality
undertaki ng for Board and Committee Members .
? At its meeting on 22 June 2023 the Governance Committee will discuss the
nomination process for a Vice Chair to succeed Sarah Gou lding who comes to
the end of her second term on 31 De cember 2023 .
? The GC C hair report is attached in the form of a presentation as Annex A .
Annexes
Annex A : Governance Committee Chair report

1 Board-2023-Mtg-02-Investment Committee Chair Report
Report to the Board
26-27 June 2023
Subject Investment Committee Chair Report
Category For Information
Section A: Introduction
? This report provides the Board with an overview of the activities of the
Investment Committee since the Committee Chair last reported to the Board in
December 2022 .
? The total portfolio value is US$ 1.2 billion. The re is US$ 17 million of cash
out side of the long- term portfolio with Gavi?s Swiss custodian available for
immediate investment.
? The financial markets experienced market volatility across equity and fixed
income markets but still had positive gains year -to -date after brutal
performance last year. Since the end of 2022, US headline inflation steadily
declined from 6.5% to the current 4. 0% (end of May ). This decline ignited a
significant run-up by growth stocks . To show the scale of outperformance, the
tech- heavy Nasdaq 100 Index returned 21.4% vs S&P 500?s return of 9.2% as
of the end of April, and the trend continues. The inflation rate, while falling,
remains above central bank targets .
?T

he increase in interest rates sparked market instability with the failure or an
orderly winddown of several US banks. Gavi?s long- term portfolio suffered
minimal impact and the Investments team reported the impact to the Investment
Committee and the senior management team.
? The long- term portfolio had a year -to -date return of +3.9% versus the policy
benchmark return of +4.6% as of 30 April 2023. Gavi?s Equity and Diversifiers
assets contributed to the year -to -date portfolio underperformance. The Fixed
Income assets modestly outperformed its composite benchmark. For trailing 1
year, 3 years? and 5 years? annualised periods, the long- term portfolio
outperformed its policy index.
? The Equity composite underperformed with a return of +6.5% versus its
benchmark return of +8.3%. A long- short technology-focused fund and a
market -neutral strategy were the main contributors to the equity
underperformance. The former has been terminated for underperformance. A
growth equity fund with a focus on shareholder engagement and a US index
fund were significant outperformers relative to the composite benchmark.
? T

he Diversifiers composite underperformed with a return of - 0.7% versus its
benchmark return of +1.0%. A ?9.3% return from a systematic trend -following
strategy contributed significantly to the underperformance. This fund had a
substantial risk allocation to higher interest rates and the drop in global yields
during March?s banking turmoil hurt their performance. The manager of the fund

1 Board-2023-Mtg-02-IFFIm Chair Report
Report to the Gavi Board
26-27 June 2023
Subject IFFIm Chair Report
Category For Information
Overview
?This report provides the Board with an overview of the activities of IFFIm?s
support to date for Gavi?s 2021- 2025 strategic period and expected future
capacity .
? IFFIm remains central to donors? participation in Gavi programmes. We are
pleased that Canada has finalised its pledge to IFFIm becoming IFFIm? s 11
th
s

overeign donor.
? As part of continued efforts to maximise IFFIm's strategic value for Gavi, the
Gavi Secretariat , The World Bank (as IFFIm?s Treasury Manager), donors and
the IFFIm Board are coordinating to establish a Contingent Financing
M echanism to support Gavi?s Pandemic Preparedness and Response (PPR)
work .
? IFFIm has reviewed administrative aspects of its operations including a
transition of its listing to the Euro MTF exchange and a transition in external
legal counsel. Additionally, IFFIm plans to recruit a board member in the coming
months.
? The IFFIm Chair report is attached in the form of a presentation as Annex A,
which will be presented and discussed during the forthcoming Gavi Board
meeting.
Annex es
Annex A: IFFIm Chair Report

1


Board -2023 -Mtg -02-Programme and Policy Committee Chair Report

Report to the Board
26 -27 June 2023

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 2022 .
? On 16 -17 May 2023 , the PPC held an in -person meeting . 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 26 -
27 June 2023 meeting for consideration.
? The PPC Chair report is attached in the for m 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 : 16 -17 May 2023 recommendations to Gavi Alliance Board

gavi.org
CONSENT AGENDA
BOARD MEETING
26 -27 June 2023, Geneva, Switzerland
Decision 1: Consent Agenda: Board and Committee
appointments
The Gavi Alliance Governance Committee recommends to the Gavi Alliance Board that it:
a) Appoint Sai Prasad as Board Member representing the vaccine industry developing countries in the seat
currently held by Mahima Datla effective 1 July 2023 and until 30 June 2026
b) Reappoint Beth Arthy as Board Member representing the United Kingdom on the donor constituency
cluster anchored by the United Kingdom, effective 1 September 2023 and until 31 August 2024
c) Reappoint the following to the Market -Sensitive Decisions Committee and to the Programme and Policy
Committee effective immediately:
? Beth Arthy (Board Member) until 31 December 2023
d) Appoint the following to the Governance Committee effective 1 July 2023:
? Sai Prasad (Board Member) until 31 December 2023
e) Appoint the following to the Audit and Finance Committee effective 1 July 2023:
? Deena Shiff (Board Member) until 31 December 2023
f) Appoint the following to the Investment Committee effective 1 July 2023:
? Sai Prasad (Board Member) until 31 December 2023
? Teresa Ressel (Board Member) until 31 December 2023
2 Board Meeting, 26 -27 June 2023

gavi.org
CEO Board
Update
D R S E T H B E R K L E Y
2 CEO Board Update
? >20 heads of state and ministers , plus private sector
innovators, civil society, pharmaceutical industry
? New pledge from Republic of Korea
? European Investment Bank (EIB) support extended
? New partnerships with private sector, philanthropy and
development finance ? many through Gavi Matching Fund
? MTR report: Alliance on track to meet majority of key
commitments to donors
Mid - Term Review conference hosted by Spain

gavi.org
COUNTRY PROGRAMMES
DELIVERY PRESENTATION
BOARD MEETING
Thabani Maphosa, Ephrem Lemango ,
Kate O?Brien
26 -27 June 2023, Geneva, Switzerland
Planning &
Execution

Classified as Internal
HPV vaccination
Experience of Burkina
Faso
Minister Kargougou J.L.C Robert
Gavi Board Meeting
June 2023
Classified as Internal
Context of HPV vaccination
Security Context
? 200 Health
Facilities closed or
with limited
functionning
? IDPs
? 316 245 nine years
girls
Epidemiology of
Cervical cancer
(Globocan 2020)
? 1 132 new cases
? Incidence of CCU
20/100.000 women
? Mortality of 11/100
000
Challenges exists but we are resilient!

Classified as Internal
Vaccination contre le
papillomavirus
Exp?rience du
Burkina Faso
Kargougou J.L.C Robert, Ministre de la sant ?
Burkin a Faso
June 2023
Classified as Internal
Contexte de la vaccination contre le papillomavirus
Contexte s?curitaire
? 200 CSPS ferm?s ou
fonctionnant ?
minima
? Personnes
d?plac?es interne
? 316 245 filles de
neuf ans
Cancer du col de
l? uterus au BFA
(Globocan 2020)
? 1132 nouveau
cas/an
? Incidence :
20/100.000 femme
? Mortalit? :
11/100.000
Les d?fis existent, mais nous sommes r?silients !

gavi.org
COO UPDATE
BOARD MEETING
David Marlow
26 -27 June 2023, Geneva, Switzerland
Executive Summary
2
? Operational Excellence ambition and approach endorsed by the AFC; presented at Governance Committee and Board
Closed Sessions
? Operational Excellence agenda continuing at pace while acknowledging need to balance running the business while
streamlining operations and improving ways of working; multi -year journey
? Increased transparency and connectivity between PPC and AFC discussions; careful sequencing and sharing of
information based on committee mandates. Additional opportunities for connectivity across multiple committees
? Financial forecast process strengthened
? Launch of Programme Leadership Team (PLT); enhanced cross -functional collaboration and ownership for
programmatic drivers impacting financial forecast
? More detailed and timely reporting from countries and partners : greater transparency of cash utilisation and
cash balances in -country
? New draft Balanced Scorecard providing improved holistic and systematic view of performance with relevant deep dive
modules available; will continue to evolve based on feedback and use
? Review and simplification of key policies underway; Ethics policy; PSEAH framework; Programme Funding Policy
? Strategy Operationalisation evaluation ; recommendations on strategy operating model; inform OE work and Gavi 6.0
Key Messages
Board Meeting, 26 -27 June 2023

gavi.org
FINANCIAL UPDATE, INCLUDING FORECAST
BOARD MEETING
Assietou Diouf
26 -27 June 2023, Geneva, Switzerland
Table of contents
COVAX AMC and COVID -19 forecast
F orecast risks and opportunities
Gavi Core 5.1 financial forecast 1
2
4
3
5
Gavi 6.0 forecast
Annex
Board Meeting, 26 -27 June 2023

gavi.org
APPROACH FOR GAVI 6.0
STRATEGY DESIGN AND THE
ROAD TO REPLENISHMENT
BOARD MEETING
Marie -Ange Saraka -Yao, Johannes Ahrendts
26 -27 June 2023, Geneva, Switzerland
Key trends and contextual developments considered
in the development of Gavi 6.0 and the replenishment
? Backsliding of routine immunisation (RI) following the COVID -19 pandemic in Gavi -
supported countries and Middle -Income Countries though signs of recovery in 2022
? Increased pressures on health systems in lower -income countries stemming from drivers of
vulnerability : population growth, urbanisation , growing fragility & conflicts, migration
? Climate change further exacerbates the drivers of vulnerability posing an unprecedented
challenge to global health
? Reshaping of the global health architecture and of the international community in a context of
poly -crises
? Innovation in immunisation systems and technologies , new vaccine agenda
2 Board Meeting, 26 -27 June 2023

gavi.org
HEXAVALENT INVESTMENT
CASE
BOARD MEETING
Aur?lia Nguyen, Kate O?Brien
26 -27 June 2023, Geneva, Switzerland
Governance pathway and key decisions
Board approved:
? In -principle support for wP -Hexavalent , subject to a vaccine being licensed, recommended for use by WHO, WHO
prequalified, and with market attributes met that support the successful implementation
? Support for IPV -based on the rationale that polio eradication is a global public health good, and routine vaccination
with IPV plays a fundamental role in the polio eradication strategy
Gavi Alliance partners assessed Hexavalent support conditions , using price and supply information ? 4/5 conditions met,
price condition to be confirmed by MSDC
MSDC (February 2023) confirmed that the price aligns with Hexavalent?s expected benefits ? 5/5 support conditions are met
PPC (May 2023) recommended to the Board to open a funding window for Hexavalent in Q3 2023
Board (June 2023) to decide on opening a funding window for Hexavalent in Q3 2023
2018
2022
2023
2019
Gavi joined GPEI as an official core partner
Board approved : continuation of its 2019 IPV support decision -countries are exempt from Gavi eligibility and co -financing
policies until polio eradication and the withdrawal of bivalent oral polio vaccine (bOPV ) from routine immunisation
Board Meeting, 26 -27 June 2023 2

gavi.org
COVAX UPDATE AND GAVI?S ROLE IN A FUTURE COVID -19
VACCINE PROGRAMME
BOARD MEETING
Derrick Sim, Richard Mihigo
26 -2 7 June 2023, Geneva, Switzerland
Population
Focus
Progression from COVAX to Gavi -supported COVID -19 programme
Today: COVAX in transition
2024 -2025: Potential Gavi
supported COVID -19 Programme
Increasing focus on high
priority user groups, incl.
additional boosters
Continued support across all
user groups for primary + 1, esp.
for low coverage countries
Transition to support high
priority user groups
Additional doses/ newer products
via Pandemic Vaccine Pool (PVP)
for worst case scenario
Reactive strategy for worst
case scenario
ILLUSTRATIVE
2 Board Meeting, 26 -27 June 2023
2026 and beyond
To be evaluated through the
Vaccine Investment Strategy

gavi.org
GAVI?S ROLE IN PANDEMIC PREVENTION,
PREPAREDNESS AND RESPONSE
Board Meeting
Derrick Sim, David Kinder
26 -27 June 2023, Geneva, Switzerland
Gavi?s Role in PPPR
2
? Outbreak Response and Prevention
? Vaccine Stockpiles
? Market Shaping for Manufacturing
Diversification
? Financial Innovation
? Health System Strengthening
? COVAX
1. Retaining and enhancing capabilities for readiness and response
? Global Virtual Pooled Inventory accelerates access to vaccines for
emerging / rare diseases
? Health Care Worker programme protects capabilities for response
? 'Playbook' for Surge and Operational Capabilities
2. Resilient Health Care Systems and Routine Immunisation (RI)
programmes
? Digital Health Tools strengthen resilience of country health care systems,
RI, vaccine traceability
? Resilience and adaptability to Climate Emergency challenge
3. Diversification of Regional Manufacturing
? African Manufacturing ?4 Pillar? Strategy
4. Financial innovation
? Day Zero Financing Facility
Emerging Key Areas for an Alliance Plan for PPPR Vaccines are critical in outbreaks,
epidemics, pandemics
Alliance is the hub for vaccines and vaccines
delivery in global health architecture
Gavi has brought capabilities & contributed
to PPPR as part of its core activities:
Board Meeting, 26 -27 June 2023

gavi.org
VACCINE INVESTMENT
STRATEGY 2024
BOARD MEETING
Marta Tufet Bayona
26 -27 June 2023, Geneva, Switzerland
Vaccine Investment Strategy informs Gavi 6.0 (2026 ? 2030)
Evidence -based approach to identify immunisation investments for future strategic
cycle(s), while sending valuable advance signals to vaccine developers and suppliers
Transparent
methodology
Analytic review of
evidence & modelling
Consultations and
independent expert
advice
Every 5 years
Strategic decision -making
Predictability for long -term
planning by industry,
governments & donors
? Gavi strategy
? Resource mobilisation
? Vaccine programmes
? Global stockpiles
? Learning agendas
In response to public health threat or a research and development (R&D) milestone for a priority pathogen,
diseases of epidemic/pandemic potential can be evaluated in real time, outside five -year cycle, through VIS epidemics framework.
Informs:
Types of investment:
2 Board Meeting, 26 -27 June 2023