GAVI Alliance Board Meeting, 16 -17 June 2010 FINAL M INUTES


1




GAVI Alliance Board M eeting
16 -17 June 2010
Geneva , Switzerland

FINAL MINUTES 1

Finding a quorum of members present 2, the meeting commenced at 9.51 on 16 June
2010. Mary Robinson, Chair of the GAVI Alliance Board , chaired the meeting.

The Cha ir noted that on the ?Day of the African Child? there are achievements to
celebrate , and referred to that day?s media release accompanying the launch of the
GAVI Annual Progress Report . She welcomed the new board members and
alternates who were attending their first Board Meeting, and invited Rajeev
Venkayya, the Governance Committee?s nominee to serve as alternate for the Bill &
Melinda Gates Foundation, to participate at the Chair?s invitation until his formal
appointment was approved . The Chair recognis ed this would be the final meeting for
Gloria Steele and Julian Schweitzer and thanked them for their leadership and
service .

Next t he Chair welcomed Debbie Adams, the shortly to be appointed Head of
Governance and thanked Assistant Secretary Kevin Klock and the Secretariat
governance team for their stewardship. Finally , the Chair advised the Board that
Cyrus S. Poonawalla, Chairman & Managing Director of the Serum Institute of India
was unable to deliver his planned address due to a family bereavement bu t he was
invited to make a presentation at a future meeting.

The Board considered approval of outstanding minutes (Doc #1 in the board pack).

DECISION
The GAVI Alliance Board:
? Approved the minutes of its meetings on :
o 17 -18 November 2009
o 19 March 2010
o 20 April 2010

1 CEO Report
Julian Lob -Levyt, Chief Executive Officer, delivered a presentation on the state of the
GAVI Alliance (Doc #2). He contextualised GAVI?s achievements to date : in the last
10 years, GAVI has accelerated new vaccine introduction in o ver 70 of the poorest
countries, immunised 257 million children, improved vaccination safety, and
prevented 5.4 million future deaths.
1 Binding Resolutions approved by the GAVI Alliance Board are list ed in Attachment A. Decisions within the text
of the minutes are non -binding, ?plain English? actions agreed by the Board. 2 Board member participants are listed in Attachment B.

GAVI Alliance Board Meeting, 30 November - 1 December 2010 Doc 10 ? Risk Oversight

FOR INFORMATION

GAVI Secretariat , 16 November 2010 1
This document is being provided for information only. No requests are being made
of the Board.
To support the Board in its oversight role, Internal Audit has evaluated
management's consideration of risk in the preparation of the Business Plan and the
Bud get.
The main conclusions are:
? GAVI's current Risk Register, which has been provided to the Board,
provides a good overview of the key risks and mitigation activities ; Internal
Audit is not aware of any other important risks that should be brought to
the Board?s attention .
? For each of the three risks rated as ?high? (resource mobilisation, cash -
based programme risks, and country sustainability), management has
provided the Board with a good description of the nature of each risk and
how it proposes to (con tinue to) mitigate it through activities described in
the business plan.

Risk Oversight

Introduction / background

Risk management can be defined as follows, as set out in a recent authoritative
paper on the subject 1:

Enterprise risk management is a p rocess, effected by the entity?s board of
directors, management, and other personnel, applied in strategy setting and
across the enterprise, designed to identify potential events that may affect the
entity, and manage risk to be within the risk appetite, t o provide reasonable
assurance regarding the achievement of objectives.

The paper suggests four areas that can contribute to Board oversight with respect to
risk management. Specifically, the Board can undertake to:

? Understand GAVI?s risk philosophy and concur with its risk appetite
? Know the extent to which management has established effective
enterprise risk management within the organisation
? review GAVI?s portfolio of risk and consider it against its risk appetite
? be apprised of the most significant ri sks and whether management is
responding appropriately
1 'Effective Enterprise Risk Oversight ? The Role of the Board of Directors', Committee of Sponsoring
Organisations of the Treadway Commission ('COSO'), September 2009

GAVI Alliance Board Meeting 30 November - 1 December 2010 Doc #05 ? Evaluation Advisory Committee Chair Report

FOR INFORMATION

GAVI Secretariat, 16 November 2010 1

1
This document is being provided for information only. This paper provi des an
update on the activities from the Evaluation Advisory Committee including its views
on the quality and usefulness of the Second GAVI Evaluation .
No requests are being made of t he Board.


Report from Chair of Evaluation Advisory Committee to the
Board

1. Introduction

1.1 The GAVI Alliance Board approved the charter for an Evaluation Advisory
Committee in June 2009 and the Executive Committee appointed
members the following month . The Committee is comprised of Board
members (or their delegates ) and independent experts and requires a
majority of independent experts . The purpose of the Committee is to
assist the Board in fulfilling its responsibilities in respect to the oversight of
GAVI?s organisational and programmatic evaluation activities. The
Committee aims to support a ?learning culture? by maximising the utility
and quality of evaluations and helping develop a forward -looking
monitoring and evaluation system to assist in th e Board?s decision -making.

1.2 The Committee?s charter is in Annex 1 .

2. Update on activities

2.1 The Committee convened an in-person meeting in January 2010 , a
teleconference in June 2010 and an in -person meeting in June 2010.
Much of the committee work is d one through email exchange. The
next in -person meeting is scheduled for January 2011 .

2.2 A summary of the Committee?s activities to date follows:

? Second GAVI Evaluation. The GAVI Alliance commissioned the
Second GAVI Evaluation in late 2009 to a consort ium led by
Cambridge Economic Policy Associates. The final reports were
submitted by the evaluators in September . The Committee reviewed
the adjudication process to select the firm and concluded that it was
appropriate . The Committee reviewed the incept ion report , a
preliminary draft of the evaluation report and the final version of the
report . The Committee?s report on the quality and usefulness of the
report is in Annex 2 .

? Monitoring and Evaluation Framework . The Committee reviewed
the draft Monit oring and Evaluation Framework developed by the

GAV I Alliance Board Meeting, 30 November ? 1 December 2010 Doc # 5a ? Management
response to 2 nd GAVI evaluation

FOR INFORMATION

GAVI Secretariat, 16 November 2010

1
This document is being provided for information only. The Board received the
Second GAVI Evaluation in September. This paper provides the Secretariat?s
response to the evaluation, to inform the Board?s discussion of the Report of the
Evaluation Advisory C ommittee. The Secretariat welcomes the evaluation and
substantially agrees with its findings.
No requests are being made of the Board.


Management response to the Second GAVI Evaluation

In March 2009 the Board asked the Secretariat to commission a s econd evaluation
of GAVI covering the period 2006 -2010, and subsequently approved the evaluation?s
terms of reference. Cambridge Economic Policy Associates (CEPA) were selected
to conduct the evaluation through a competitive process and completed the
eval uation in September. The Secretariat provided the evaluation report to the
Board the same month . The Evaluation Advisory Committee has also reviewed the
evaluation and the report of the Chair of the Committee is prov ided to the Board
(document 4a).

The evaluation is a substantial , detailed and robust piece of work which has already
been of great assistance to the Secretariat. Overall, the evaluation affirms GAVI?s
value added and business model. It finds that the Alliance has accelerated the
introducti on of vaccines, attracted additional funding to immunisation, successfully
engaged in organisational and programmatic innovation, and has generated country
ownership ; and in so doing has prevented millions of future deaths .

The evaluation also identified a number of areas for improvement in the next
strategic planning period 2011 -2015. The Secretariat substantially agrees with the
findings of the evaluation , and indeed has been taking account of the emerging
evaluation findings in devel oping GAVI?s five y ear strategy, the busine ss plan which
will implement it, and in new policies . The Board will consider some of these new
policies in Kigali.

This paper provides a response to the evaluation?s main findings. Given the scope
and depth of the findings, ad ditional work to address issues raised will take place in
the coming year, and under the supervision of the new performance management
unit , a detailed plan will be developed .

For ease of reference, this paper follows the order of the evaluation?s execut ive
summar y ( see annex 1 for extracts from the executive summary ).

Cross -cutting issues and methodological limitations
The Secretariat agrees that with the evaluation?s finding that there has been a lack of
comprehensive analysis of data collected to in form monitoring and evaluation of
programmes. The Secretariat has developed a monitoring and evaluation plan

GAVI Alliance Board Meeting , 30 November - 1 December 2010 Doc #11 ? Report of PPC Chair
FOR INFORMATION

GAVI Secretariat, 16 No vember 2010 1

The Programme and Policy Committee (PPC) of the GAVI Alliance Board has held
one meeting since the June 2010 board meeting . This paper provides a brief
summary of issues discussed.
The Board will be requested to approve the PPC?s recommendations with re gard to
co -financing, performance based funding, and the health systems funding platform.

Report of the Programme and Policy Committee Chair
June ? December 2010

Introduction

1. The Programme & Policy Committee (PPC) serves as the principal advisory bod y to the
board on all GAVI programme areas and leads the development of new policies. It is
staffed by high -level technical experts from partner organisations and constituencies,
with knowledge in areas such as epidemiology, public health, research, health systems
and financing.

2. The Committee is chaired by Gustavo Gonzalez -Canali, the Board member representing
the France/EC/Luxembourg/Germany donor constituency. The Committee has held one
face -to-face meeting since June 2010 .

3. The policies recommended by the PPC for Board approval and key discussion elements
are summarised below . 1

Issues discussed

Co -financing

4. In March 2010 the PPC appointed a time -limited task team to review GAVI?s co -financing
policy. The task team concluded that the current co -financing policy has been
successful in several respects, with good compliance and positive reactions from
countries, there are areas where it needs to be adapted to changed circumstances. As
such, the PPC recommend s that the Board approve the three countr y groups and
associated co -financing levels (Low income group , intermediate group, Graduating
group) to be implemented starting in 2012 . In addition, the PPC noted the following
action items:

4.1 Ensure strong linkages between the supply strategy revision an d the implementation of
the co -financing policy and subsequent review in 2014.

4.2 Ensure clear advocacy and communication efforts with a focus on graduating countries.

1 Full minutes of the meeting have been distributed and are currently under review by the
committee.

GAVI Alliance Board Meeting, 30 November ? 1 December 2010 Doc #1 1a?HSS Decision and
Updates

FOR DECISION

GAVI Secretariat, 16 November 2010 1

At the meeting in June 2010 , the Board made three decision s of relevance to the nature
of the GAVI Alliance ?s co ntinuing role in health systems . The Board endorsed:

1. The inclusion of Strategic Goal 2 ? Contribute to strengthening the capacity of
integrat ed health systems to deliver immunisation? as part of the approval of the
GAVI Alliance Strategy 2011 -2015 ;
2. ?That the maximum share of funding for cash based program me s in a given
proposal round will be 15 -25%; and
3. ?A new HSS resource allocation method wh ereby the maximum potential amount
of funding would be based on an eligible country?s total population and weighted
against a graded gross national income (GNI) scale? . This resource allocation
formula would apply to any Health System s Funding Platform gra nt going forward .

The Board also decided , by a majority vote , to ?retain the no tional U S$ 179 million not yet
expended from the original HSS window subject to availability of funds and in line with
maintaining the appropriate balance between vaccine an d cash programmes? but stated
that the Board ?shall revisit this decision at its November 2010 meeting based on further
advice from the PPC as to what extent the maximum share of funding includes HSFP
funding?.

In Board discussions through 2009 and 20 10 there has been an implicit agreement that
all future GAVI support for health sys tems strengthening (HSS) would be provided as
part of the Health Systems Funding Platform and , wherever possible , existing grants
would be reconfigured to foll ow Platform pr inciples . In that context the June Board
minutes also noted that some countries are GAVI eligible but are not eligible for funding
from the expanded IFFIm funds (i.e. they are low er middle income countries , not low
income countries) but did not at that ti me make a decision .

The PPC at its October 2010 meeting addr essed the ques tion of whether, in the future,
GAVI health system support should be offered only to low income countries and revisited
the decision in relation to the notional allocation of US$ 179 million as requested by the
Board .

The PPC recommends the following decision to be taken by the GAVI Alliance Board

? That HSS support is currently being offered to low income countries (LIC s). Low -
income countries will be funded from the Expanded IFFIm .
? The notional US $ 179 million from the original HSS window be returned to the
balance of expected demand .

In relation to the first decision point , the PPC was in strong agreement that country
eligibility
should aim to be consistent across all GAV I programmes. It stressed that the
recommendation to restrict HSS support at this time to low income countries resulted
from the current financial environment.

GAVI Alliance Board Meeting, 30 November ? 1 December 2010 Doc #1 1b ?HSS Decision and Updates
ANNEXES 1 -3

FOR DECISION

GAVI Secretariat, 16 November 2010 1

ANNEX 1 HSS CURRENT FUNDIN G AND RESOURCE ALLOCATION 2010 -2015
The tables show the status of current HSS support and the resource allocation for HSS for:
- Low Income Countries (LIC) - As per the World Bank List (July 2010); countries with a GNI/capita
les s than $995 ;
- Low Middle Income Countries (LMIC) - As per the World Bank List (July 2010); countries with a
GNI/capita above $995 & below $1500 .
Two scenarios are presented:
1. With Cap -This scenario uses a notional cap for HSS (US$ 474 million). This al lows for the resource
allocation formula agreed at the June 2010 Board to be modelled. The scenario also takes into account
the current implementation rate of HSS programmes.
2. Without Cap - In this scenario no cap has been applied. This is an 'ideal wo rld' scenario (i.e there
are no funding restrictions). The scenario also takes into account the current implementation rate of
HSS programmes.
Resource Allocation Methodology

The new resource allocation method is calculated using the maximum potential amo unt of
funding is based on a country?s population and weighted against a graded gross national
income (GNI) scale 1. A floor of US$ 3 million is also applied as otherwise some very small
countries would be entitled to an unreasonably small amount of fundin g (in accordance with
the June 2010 Board Decision).

The resource allocation formula was developed by HLSP and is applied as follows:

Step 1
Allocation = Per Capita Allocation x Newborn Cohort (X)
(where per capita allocation = $5 per newborn if per capita income $365 and $2.5 if > $365)

Step 2 Replaces newborn cohort with overall population

Initial Allocation = Per Capita Allocation x Total Population
(where per capita allocation = $5 per newborn if per capita income $365 and $2.5 if > $3 65)
Allocation is then reduced pro rata
Final Allocation = (Initial Allocation x Total newborn cohort)/Total population) (Y)

Step 3 : Incorporates graduated equity factor

50% of Initial Allocation (population based) = Y/2 (A)
50% of Initial Alloc ation (equity based) = Total Population x Equity Index
(where equity index = (1/per capita income) (B)
1 Note ? some of the data for population and per capita income may not be consistent ? this may require further attention.
Data is taken from World Bank Development indicators (but there are gaps which were filled from a number of sources)

GAVI Alliance Board Meeting, 30 November ? 1 December 2010 Doc #11c ?Performance
Based Financing - IRIS

FOR DECISION

GAVI Secretariat, 16 November 2010

1


This paper describes the design of the proposed new performance based funding
window ? Incentives for Routine Im muni sation Strengthening (IRIS) . IRIS is
designed as a follow on program me to GAVI?s Immunisation Services Support
window. IRIS aims to incr ease accountability for results and value for money , while
minimising to the extent possible the reporting and management burden imposed on
countries. The objectives of IRIS are to:

? Improve routine immunisation coverage, as measured by DTP3
? Increase equi ty in immunisation coverage

The key design featur es of this programme are as follows:

? In their proposals to GAVI for IRIS support, c ountries will present detailed plans
for how performance incentives will be cascaded to lower levels of the system in
orde r to accelerate improvements in coverage and equity.
? Countries can receive an annual fixed payment, as well as performance
payments for achieving gains in DTP3 coverage.
? Countries will be responsible for managing activities conducted with IRIS funds.

Based on a simulation involving 13 of the 14 countries that qualify for IRIS support 1
(i.e., with DPT 3 coverage less than 70 percent) , it is estimated that IRIS will co st
approximately US $ 68 million over the 2012 -2015 period and support the
immunisation of 5.4 to 7.6 million additional children . Under this simulation, n ine of
the 13 countries would surpass 70% DTP3 coverage and thus qualify for GAVI
support for new and underused vaccines .

With regard to IRIS, the PPC recommends the following decision be taken by the
GAVI Board :

?Taking into account the potential risks associated with IRIS, the Board decides to:
1. Move forward with implementation of IRIS by opening a new window of support for
countries with DTP3 coverage of less than 70%;
2. Close th e existing ISS window, subject however to fulfilling any existing
commitments to eligible countries for ISS support;
3. Use WHO/UNICEF estimates as the data source to measure country progress
against the coverage milestones;
4. Conduct additional explorato ry work to provide the appropriate support to India
and Nigeria.?


1 For the costing estimate, India was not included as f unding for India has been accounted for through
the funding cap.

GAVI Alliance Board Meeting, 30 November ? 1 Decem ber 2010 Doc #11 d ? Co -financing Policy Revision

FOR DECISION

GAVI Secretariat, 12 November 2010 1


GAVI?s Co -financing Policy: Proposed Revision

1. Background

1.1. As part of the decision to adopt a co -financing policy in 2008, t he Board
requested that GAVI?s co -financing policy be reviewed following 2 years of
implementation to a sses s early experience. While the current co -financing
policy has been successful in several r espects, with strong compliance and
positive reactions from countries, there are ar eas where it needs adaptation .
For example, t he existing four country co -fina ncing groups 1 are no longer well
aligned with country income categories . Most importantly, the current co -
1 Fragile, poorest, intermediate, least poor ( see Annex 2)
Having reviewed and discussed the recommendations from the task team reviewing
GAVI?s co -financing policy, the Programme and Policy Committee recommends the
following decision be taken b y the GAVI Board:

?The Board approves the revision of the co -financing policy as follows. Beginni ng
January 1, 2012:

? Country groups to be divided into Low income group (GNI per capita at or below
World Bank low income threshold); Intermediate group (GNI per capita between
the low income group and the GAVI eligibility threshold); and, Graduating group
(GNI per capita above GAVI eligibility threshold). Each country will be reviewed
annually to enable transition s from one group to another based on GNI per
capita.
? Low income group co -financing, to be set at a minimum of 20 cents (US$) per
dose for all vaccines, and with no mandatory annual increases.
? Intermediate group co -financing, to be set at the higher of 20 cents per dose
(US$) or the amount paid for th e specific vaccine in the previous year . This
amount to increase annually by 15% per dose.
? Graduating group co -financing :
o For vaccines adopted prior to entering the Graduating group to be set at
an amount calculated on the basis of a linear increase over a four year
period from the amount paid in the first year in the graduating group to
the projected weighted average price of the vaccine the year after GAVI
support ends.
o For vaccines adopted after entering the Graduating group to be set in
2012 at 20 perc ent of the projected average price of the vaccine in 2016,
and shall increase linearly until it reaches 100% of the projected average
price of the vaccine the year after GAVI support ends.
? Countries moving between these groups will be given a one year grac e period to
plan for the associated changes in co -financing levels.

GAVI Alliance Board Meeting, 30 November ? 1 December 2010 Doc # 11e ? AVI Progress Report

FOR INFORMATION

GAVI Secretariat, 16 November 2010 1

This paper provides an update on the Accelerated Vaccine Introduction
initiative (AVI). It is for information only. A more detailed progress report
was presented to the Programme and Policy Committee in September) and
can be provided to Board members upon request.

Accelerated Vaccine Introduction (AVI) Progress Report

Background
1. The aim of GAVI?s Accelerated Introduction Initiative ( AVI) is to drive the
sustainable introduction of rotavirus vaccine and pneumococcal conjugate
vaccine in GAVI -eligible countries. Initial targets for th e initiative, set in 2008,
were to launch rotavirus vaccines in 44 countries and pneumococcal
conjugate vaccines in 42 countries by 2015. The targets are now revised to
align with the GAVI Alliance strategy 2011- 2105.

2. The AVI is coordinated by an interagency team (?AVI management team?)
consist ing of representatives of WHO, UNICEF, AVI Technical Assistance
Consortium (AVI TAC
1

) and the GAVI Secretariat. It is led by the GAVI
Secretariat and the Bill & Melinda Gates Fou ndation participate as an
observer. The management team has established a number of dedicated
sub -teams for key work areas including: strategic vaccine supply, large
countries, cold chain and logistics, and ad- hoc pneumococcal vaccine
introduction.
3. The A VI management team provides detailed reports to the Programme and
Policy Committee in addition a half day briefing session is scheduled prior to
each PPC meeting and AVI is standing item on the PPC agenda.

Progress since June
4. Following the Executive Com mittee approval of paused applications in August
2010, there are now 19 countries approved for pneumo introduction and one
country approved for rota introduction. Introduction is being planned for
pneumo in 13 countries over the next 12 months, and, in tot al, in 19 countries
over the next 24 months. For rota, introduction is being planned for 1 country
over the next 12 months.
5. The AVI management team and sub- team members ha ve been involved in
the development of the GAVI Strategy and Business Plan , including
1 A consortium of PATH, Johns Hopkins University (JHU), US Centers for Disease Control and Prevention (CDC)
and others

GAVI Alliance Board Meeting, 30 November ? 1 Decem ber 2010 Doc #11f ? Country Programme
Updat e

FOR INFORMATION

GAVI Secretariat , 16 November 20 10

1

Country programme update 2009

This paper provides a country programme update based on performance for 2009
and highlights programmatic achievements and challenges.

The Board is requested to note:

1) Programmatic achievements and challenges .
2) Prioriti es for 2011.


Country programme update 2009

Executive Summary

This paper provides a country programme update based on performance for 2009 1
and highlights programmatic achievements and challenges. (Some 2010 data is
included in this report to address is sues raised by the Programme and P olicy
Committee in October 2010 ).

Countries have made progress in new vaccine introduction in 2009 :

? 19 countries introduced pentavalent, 2 countries introduced pneumococcus
and 2 countries introduced rotavirus.
? GAVI eli gible countries reached an average DTP3 (WHO/UNICEF estimates)
coverage of 73% in 2009 compared to a global average of 82%.
? 16 countries qualified for ISS rewards based on DTP3 performance in 2009,
compared to 32 countries in 2006.
? Overall 38 countries reported on progress of HSS funded activities in 2009. 24
countries were recommended for continuing support by the IRC while 6
countries provided insufficient information; 8 countries were not due to receive
any further funding.

In 2009 the number of cou ntries required to co -finance increased from 32 to 49.
44 count ries had paid by the end of 2009 . The remaining 5 countries completed full
payment by October 2010.






1 It is not possible to bring the Country Progr am Update to the board earlier than the November/ December Board meeting each year because the annual Country P rogress Reports are received from mid -May to August, based on the financial planning cycles of countries. In addition the WHO UNICEF DTP3 coverage estimates used to assess country performance are provided by August each year . The reports are subsequently analysed by the Independent Revi ew Monitoring Committee. It would be difficult to prepare a rigo rous consolidated by July each year.

GAVI Alliance Board Meeting, 30 November ? 1 Dece mber 2010 Doc #02 ? Report of the Gov Cte Chair

FOR DECISION

GAVI Secretariat, 24 November 2010 1
The Governance Committee has met twice since the June 2010 Board Meeting in
Geneva and will convene the evening prior to the Kigali board meeting. This
report summarises the Committee?s activities and recommendations since the
Geneva Board Meeting on 16 -17 June 2010.

The Governance Committee recommends to the Board that it:
? Appoint nominees to their respective positions on the Board and
committees
? Amend the By -Laws to allow for no -objection voting on minutes (a separate
paper outlines this proposal).

Re port of the Governance Committee

CEO Succession

Consultant Retention

1.1 The Board requested that the Governance Committee undertake a
performance review of its search consultant prior to engaging it for the CEO
recruitment. The Committee determined th at the c onsultant was competent,
knowledgeable and that its familiarity and ability to begin work right away
were persuasive factors for awarding the assignment to it. However, the
Committee asked the Secretary to launch a procurement process to diversify
the Committee?s consultancy resources , focusing particularly on ensur ing full
geographic coverage in all future recruitments .

CEO Succession Committee Composition

1.2 The Board appointed four Board M embers (Dagfinn H?ybr?ten , Mary
Robinson, Jaime Sepulv eda, and George W. Wellde, Jr.) to constitute a core
group to perform each step of the process . Seven additional persons (Amie
Batson , Armin Fidler , Paul Fife , Gustavo Gonzalez -Canali , Alan Hinman , Jean
St?phenne , Richard Sezibera) were appointed by the Go vernance Committee
to constitute a reference group that is to be consulted whenever possible.
This satisfies the Board?s desire that the CEO Succession Committee be
representative but also agile and manageable.

Recruitment Update

1. 3 The entire CEO Suc cession Committee met on 15 September to finalise the
terms of reference for the CEO and the work responsibilities of the external
search consultant. Since then, the position has been advertised and
members from each GAVI -affiliated board have suggested p ossible
candidates. The Committee will begin its review of candidate profiles shortly.
The timeline established by the CEO Succession Committee takes the
recruitment process into 2011 and it is anticipated that first interviews will be
held early in the new year.

GAVI Alliance Board Meeting, 30 November ? 1 Dece mber 2010 Doc #02 b ? By -Law Amendment: Minutes

FOR DECISION

GAVI Secretariat , 16 November 2010 1

The Secretariat proposes a new practice for formal approval of meeting minut es to
ensure that reports are officially approved prior to their disclosure on the website.
However, implementing this practice in compliance with the By -Laws can be
inefficient given its constraints and the amount of reports .

The Governance Committee recommends to the Board that it :
? Amend the By -Laws as follows:
o New By -Laws Section 2.7.3.3:
The Board may approve the minutes of its meetings on a no -objection
basis. On such bas is, and subject to further procedures set by the
Board, a motion to approve the minutes shall be deemed approved if
the following conditions are met: (i) draft minutes are circulated to the
Board at least once for review and comment, (ii) a period of no le ss
than 5 calendar days is given for Board Members to provide
comments to the initial draft minutes (?Review Period?), (iii) Notice of a
request to approve the minutes is made after the conclusion of the
Review Period in writing and sent by mail to the las t recorded address
of each Board Member, or by email, (iv) a period of no less than 10
calendar days is given for Board Members to signal an objection in
writing or by email (?Objection Period?), and (v) no objections to the
motion are received by the Chai r, CEO, or Secretary by the conclusion
of the Objection Period.

By -Law Amendment: Approving Meeting Minutes

Introduction

1.1. A small change in the By -Laws will streamline the approvals process, allowing
the Board and the committees to approve the minutes i n good time and allow
GAVI to disclose them in their fully approved form shortly after each meeting.

Old processes

2.1 The old GAVI Alliance approved its ?reports? informally just after each
meeting. The Secretariat drafted the report and circulated it via email to all
board members for comment. Next the Secretariat provided a new version
incorporating edits and explaining those instances where edits were excluded.
It was noted that this was the final version and would be posted to the
website. Offici al approval was not required as the old GAVI Alliance was
unincorporated.

2.2 The GAVI Fund followed a similar pattern except that the Secretary tabled the
minutes for approval at the subsequent meeting. As a private charity in the
United States, it wa s good practice to request its board (or the requisite
committee) to formally pass a resolution that could be recorded in the
following meeting?s record. Since that board only met twice per year, its

GAVI Alliance Board, 30 November ? 1 Decem ber 2010 Doc #04 ? CEO report

FOR INFORMATION

GAVI Secretariat, 24 November 2010 1


CEO r eport to the Board

November 2010
1. Introduction

1.1 I am pleased to provide this report to the Board as interim CEO of the GAVI
Alliance. The fact that the search is well underway for a new CEO, and that Mary will
soon stand down as chair of the Board, means that the Alliance will experience a
transition to new leadership. We are also experiencing a significant transition and
challenges in GAVI?s funding, which has implications for our existing policies and
practices. If we do not have sufficient funds we will not be able to deliver on our
mission, and to build on the achievements and the considerable promise of the first ten
years. In the new more challenging environment for r esources we are seeking funding
more strategically , creatively and widely than ever before and at the same time
developing mechanisms to prioritise further how we allocate funds. Financial
management systems that allow robust and credible financial forecasting and active
risk management play central role s in this.
1.2 It is also the case that much about GAVI remains stable. The Second GAVI
E valuation identifies some clear areas which need attention, but it also reaffirms the
Alliance ?s added value and the effectiveness of our business model ? aggregating
demand, supply and donor funds, country selection of vaccines from a menu, country
applications independently reviewed, and country ownership of programmes through
those applications and through co -fina ncing . We have long term plans in place: the
Board in June approved the strategy for 2011- 2015, and the business plan and budget
which we have been developing with partners to implement the strategy is on the
agenda in Kigali. We also have plans for the shorter term: since the Executive
Committee?s decision in November to launch a new application round, we have a clear
timetable for 2011 and plans underpinning that timetable which I set out below.
1.3 It was very apparent at the Partners? Forum in Hanoi last year, at Board and
resource mobilisation meetings in The Hague and New York , and in my conversations
with many of you, how much support there is for our mission and for our business
model. There is work to do, and decisions to be made at the Board in Kigali for
example on the business plan, health systems strengthening and co-financing , but
these decisions are in the context of agreement on the overall framework . This should
give us all confidence that the Alli ance is in a strong position to meet the challenges it
faces , if we can raise the necessary funds .

GAVI Alliance Board Meeting, 30 November ? 1 December 2010 Doc #9b ? Financial Forecast Update

FOR INFORMATION

GAVI Secretariat, 16 November 2010 1

This document update s the Board on the updated GAVI financial forecast for
2010 -2015. It indicates that in order to fully respond to anticipated country
demand through 2015, additional resources of US $ 3.7 billion would be needed,
beyond the amount of re sources currently assured .

This funding challenge, which stood at US$ 4.3 billion in March 2010 , has
declined to US $ 3.7 billion mainly because of additional contributions committed
since then. Of the US $ 3.7 billion needed through 2015, US$ 1. 7 billio n is needed
through 2013 .

GAVI Financial Forecast Update
Novemb er 2010

1 Executive Summary

1.1 In order to fully respond to anticipated country demand, GAVI would be called
upon to disburse an estimated US$ 7.7 billion between 2010 and 2015 , for
existing and future programmes . Already -assured resources amount to US$ 4
billion , leaving a funding challenge that currently stands at US$ 3.7 billion
through 2015, of which US$ 1.7 billion is needed through 2013.

1.2 Many donors have yet to confirm the am ounts of their contributions to GAVI
for future years and the US$ 3.7 billion funding challenge will decline as their
contribution commitments are confirmed. If direct contributions for 2011 -2015
were maintained at the 2007 -2009 overall average of US$350 million per year,
then a further US$ 1.2 billion would be added to the r esources already
assured. If all of t ho se resources were directed to existing programmes,
continuity of funding for all existing programmes would be ensured through
2015. This would leave a further US$ 2.5 billion to be raised in order to fully
respond to expected demand from future programmes through 2015, while
still maintaining the cash reserve at US$ 1 billion .

1.3 The financial forecast reflects the latest estimates of coun try vacc ine needs
and readiness per the strategic demand forecast ; however the financial
implications of this create no material change to the overall projected vaccine
programme expenditure as estimated in the March 2010 forecast .

1.4 At US$ 3.7 billion, the fundin g challenge is US $ 0.6 billion less than it was in
March. This reduction results mainly from US $ 0. 4 billion of additional
contributions for 2010 -2015 received or confirmed since March 2010.

1.5 The other significant changes to the forecast since March are t he inclusion of
expected proceeds in 2011 -2015 from the latest pledges to IFFIm by
Australia, Norway and the United Kingdom (US $ 0. 5 billion) , and inclusion of
the projected expenditure (US $ 0. 5 billion) through the joint platform for health
systems streng thening , following the June Board decision on HSS resource
allocation. This HSS expenditure estimate supersedes the tentative estimate
of US $ 0. 2 billion per the March forecast and removal of the provision for this

GAVI Alli ance Board Meeting, 30 November ? 1 Decem ber 2 01 0 Doc #06a ? Resource Mobilisation Update

FOR INFORMATION

GAVI Secretariat, 26 November 2010 1
This document updates the GAVI Alliance Board on the implementation of GAVI?s
resource mobilisation strategy, including a review of:
? The step -change needed in funding levels for the 2012 -2013 period in order to
meet the overall funding requirements for 201 1-2015 ? Section 1
? An o utline of the new pledging and replenishment approach ? Section 2
? Outcomes of recent activities including the October 6, 2010 ?Saving Children?s
Lives: A Call for Action and Resources? meeting where the replenishment
process was laun ched ? Section 3
? Plans for a June 2011 pledging conference at which donors will be invited to
make multi -year pledges for the 201 1-2015 period ? Section 4
? Scope of activities that are planned beyond the pledging conference . These
includ e broadening the don or base, increasing and extending contributions,
delivering innovative finance, and securing increased private sector resources
? Section 6
This document is for information.

Resource Mobilisation Update
1. Resource needs 2011 -2015
1.1. A unique opportunity to d eliver on MDG4 and maternal and child
health : For the first time in history, we have the opportunity to deliver
new life -saving vaccines against the world?s biggest childhood killers
while, at the same time, further expand global immunisation coverage.
Ove r the next five years, support from the GAVI Alliance will help
immunise 243 million children in 72 countries, including 230 million with
pentavalent vaccines; 90 million with pneumococcal vaccines; and 53
million with rotavirus vaccines, while simultaneou sly strengthening
routine immunisation at large. Compared to the 256 million children
immunise d over GAVI?s first decade, a forceful acceleration of pace
between 2011 and 2015 will significantly advance the Millennium
Development Goals (MDGs) and MDG4, in particular.
1.2. Overall funding challenge 2011 -2015 : Estimates of country demand
indicate that between 2011 and 2015, the GAVI Alliance expects to
disburse a total of US$ 6. 8 billion to countries to meet their
immunisation plans . Of this amount, US$ 3. 1 billi on is already assured.
Therefore, GAVI?s overall 2011 -2015 funding challenge ? beyond
already assured resources -- is US$ 3.7 billion . Of this amount, US$
1.2 billion could be expected if donors maintain their contributions at
the overall average level for 2007 -2009. A further US$ 2.5 billion (an

GAVI Alliance Board Meeting, 30 November ? 1 Decem ber 2010 Do c #07 ? Repo rt of the Executive Cte Chair

FOR INFORMATION

GAVI Secretariat, 16 November 2010 1
The Executive Committee has met three times since the Geneva board meeting.
This report summarises the Committee?s activit ies and recommendations since the
Geneva board meeting on 16 -17 June 2010 .

Report of the Executive Committee Chair

Financial Updat e and Resource Mobilisation

1.1 At each meeting, the Executive Committee reviews GAVI?s resource needs
through 2015, the steps taken toward replenishment, and external
developments that may affect the donor environment. The Committee is
comfortable that projected inflows are certain but the timing of those inflows
may be less dependable if a donor extends the time horizon of its pledge
payments. Accounting for this, t he Committee requested the Secretariat
share its scenario planning , including pledges ma de and projected.

GAVI Alliance Business Plan 2011 -2015

2.1 In July, the Committee reviewed business planning development and
timelines. In September, it examined several components that required
guidance including the length of budget cycles ; Secretari at and partner
staffing capacity; specificity o f targets , timelines , and deadlines in the plan ;
and ways to ensure partners can engage when they have comparative
advantages while accounting for conflicts as they arise.

2.2 After the Programme & Policy Com mittee and Audit & Finance Committee
reviewed the programmatic and budgetary aspects of the plan , the Executive
Committee considered its recommendation . It did so, along with a couple
small changes to the strategy , subject to the following :

(a) Upon approval by the Board, the Interim CEO and the Executive
Committee Chair will review the twenty -two requested staff positions to
determine which positions are critical and must be filled without delay and
which positions can wait until after the permanent CEO is a ppointed.

(b) The Executive Committee noted that the Programme & Policy Committee
was concerned that further work was needed to improve on the proposed
programme objectives/activities in Strategic Goal 2 and had set up a time -
bound task team to review them . Consequently, changes could result.

2.3 Further , the Executive Committee requested certain governance risks be
monitored and that the Governance Committee develop ethics guidelines to
address the aforementioned multilateral partner conflicts.

Programme Approvals and Financing

3.1 In July, the Executive Committee approved the programmes recommended by
the New Proposals Independent Review Committee (IRC) in October 2009.
Total endorsement of multi -year budget s equalled US $ 1,502,885,499 and

GAVI Allia nce Board Meeting, 30 November - 1 December 2010 Doc #07 a ?GAVI Alliance Business Plan
2011 -2015
FOR DECISION

GAVI Secretariat 16 November 2010 1















GAVI Alliance Business Plan 2011 -2015
1. Background

1.1 In June 2010 the GAVI Alliance Board approved a S trategy for the GAVI
Alliance for 2011 -2015. The Board requested that the Secretariat lead the
development of an integrated Business Plan to support the S trategy. GAVI
Alliance Board members nominated individuals from their constituencies to
join technical sub -groups for each strategic goal. These sub groups were
tasked with developing programme objectives, deliverables and activities.
The deliberations of the technical sub -groups were facilitated by a single
consultant to maximise coherence across the strategic groups and cross -
cutting issues. Sub -group input was completed in July and consolidated by
the Secretariat in August. In mid -Sept ember the Business Plan, including a
detailed budget, was submitted for review to an External Advisory Group.
The Programme and Policy , Audit and Finance and Executive Committees
provided guidance October -November and at its recent meeting on 4
November, the Executive Committee recommended the Business Plan and
budget for approval by the B oard noting that the PPC had set -up a time -
bound task team to review the programme objectives/activities in Strategic
Goal 2 and that this could result in some changes to the Business Plan .

In November 2009, the GAVI Alliance Board began the development of a strategy
for the period 2011 -2015. Following approval of the strategy in June 2010, the
Board requested that the Secretariat lead the development of an integrated
Business Plan to deliver on the strategy . The Business Plan was developed in
consultation with a broad range of stakeholders and partners, and has been
reviewed and endorsed the Programme and Policy Committee, Audit and Finance
Committee and the Exec utive Committee of the Board. As a result of the
consultation process for developing the business plan, minor revisions have b een
proposed to the Strategy. These have also been reviewed and endorsed by the
Executive Committee.

The PPC, AFC and EC have also reviewed the proposed approach for mana ging
performance and risk. In short, t he plan will be reviewed quarterly and revised on
an annual rolling basis which will give the opportunity to ?course correct? for the
year ahead ? and to submit a budget for an additi onal year (e.g. such that a two -
ye ar budget is always in place).

Based on the recommendation from the Executive Committee, the Board is
requested to:

? Approve the changes to the S trategy
? Approve the Business Plan and associated two -year budget (2011 -
2012)

GAVI Alliance Board Meeting 30 November - 1 December 2010 Doc #07b ? GAVI Alliance Business Plan
Annex 1, Part 1


GAVI Secretariat 16 November 2010 1

Annex 1 Part I Overview - GAVI Alliance Strategy and
Business Plan 2011 -2015


E xecutive Summary

The GAVI Alliance Strategy 2011- 2015, approved by the GAVI Alliance Board in
June 2010 defines the Alliance?s mission, operati ng principles, strategic goals,
objectives and progress indicators (see Appendix 1 and 2 ).

This GAVI Alliance Business Plan 2011- 2015 describes the actions to be undertaken
to achieve the Strategy. It also lays out the context and challenges for the coming
years. The overview should be read in conjunction with the GAVI Alliance
Business Plan Part II ? strategic goals and cross -cutting issues.

Background

The GAVI Alliance Strategy 2007- 2010 had clear goals around accelerating the
uptake of new and underused vaccines, contributi ng to health systems
strengthening , improving the sustainability of immunisation and capitalising on its
unique partnership model (see Appendix 3) . Progress in these goals has contributed
to achieving the Alliance?s mission to save children?s lives and pr otect people?s
health through access to life- saving interventions. The Strategy was accompanied
by a corresponding ?work plan? which set out the activities of respective partners
organised by outputs. Activities and corresponding budgets were developed o n an
annual basis in 2007 and 2008 and on a bi -annual basis for 2009- 2010.

The results of the Alliance?s efforts are set out in detail in various publications and
documents
1 and documented in the recent second evaluation of GAVI. As a result of
its effor ts, GAVI has immunised over 25 0 million children, increased vaccination
coverage in low -income countries from 66 to 79%
2

(between 2000 and 2009) and
helped avert over 5.4 million future deaths.
There have been areas of continuity in GAVI?s context and internal operations and
areas of change since the last planning cycle in 2007. GAVI remains a public -
private partnership which brings together donors, countries, industry and others, and
which aims to promote immunisation as a highly cost -effective means o f protecting
health and saving lives with 23 million unimmunised children globally the majority of
them in GAVI -eligible countries . GAVI?s mission is unchanged.



1 Phase 1 and 2 evaluation (http://www.gavialliance.org/performance/evaluation/index.php), Progress Reports
(http://www.gavialliance.org/media_centre/publications/progress_reports.php)
2 World Health Organization. WHO/UNICEF estimates of national immunization coverage. 2010 Feb 24 [cited 2010 Feb].
Available fro m:
http://www.who.int/immunization_monitoring/routine/immunization_coverage/en/index4.html United Nations,
Department of Economic and Social Affairs, Population Division. World
Population Prospects: the 2008 Revision [CD -ROM edition]. 2009 May.

GAVI Alliance Board Meeting, 30 November - 1 December 2010 Doc #07 c ? GAVI Alliance
Business Plan 2011 -2015
Annex 2- Strategic Goals and
Cross -cutting issues

GAVI Secretariat 16 November 2010 1

Annex 2 Business Plan Part II
Strategic Goals and C ross Cutting -Issues

Summary

Strategic goal 1: Accelerating the uptake of new and underused vaccines

Accelerating the uptake of new and underused vaccines (?the vaccine goal?) is
GAVI?s core business, and has been since it was founded. For this reason, it also
represents the majority of GAVI?s business plan budget.

The first ten years of GAVI?s work focused mostly on yellow fever, HepB and Hib
containing vaccines. In the second decade, GAVI aims to maintain momentum on
these antigens while accelerating introduction of routine meningitis, pneumococcal
and rotavirus vaccines and supporting campaigns against yellow fever and
meningitis. The Alliance will also begin acti vities to prepare for new and underused
vaccines, including HPV, Japanese Encephalitis, Typhoid, and Rubella. If the
Alliance is fully resourced to meet demand, up to 100 new vaccine introductions
across GAVI -eligible countries would occur between 2011 an d 2015. The majority of
these introductions are pneumococcal and rotavirus vaccines - 70 countries in the
strategy period ? 40 of which introduce between 2011 and 2012.

Countries take the decisions to introduce vaccines, and are responsible for
managing the introduction of the vaccine. The GAVI secretariat and the members of
the Alliance ? primarily the multilateral partners and the AVI technical assistance
consortium ? can draw upon their comparative advantages and resources to help
countries:

? Improv e decision -making on vaccines , by strengthening decision making
bodies, providing impact information about specific vaccine introduction,
development of policy standards and reporting systems and producing key
scientific data. and to monitor of the results ;

? Strengthen vaccine introduction, by supporting, primarily through technical
assistance and training, cold chain capacity, supply plan management,
programme administration, monitoring and reporting, waste disposal,
surveillance systems and advocacy and s ocial mobilisation.

The programme objectives and deliverables under the vaccine goal identify the key
activities which will support this, which agency is responsible, and what budget is
available.

Funding for partner agencies is requested in those area s where the Alliance
activities necessitate additional effort as a consequence of supporting activities
funded by GAVI:

? WHO: develops global policy on immunisation recommendations, standards,
global reporting on disease burden and immunisation programmes. Provides

GAVI Alliance Board Meeting, 30 November - 1 December 2010 Doc 07d ?GAVI Alliance Business P lan 2011 -2015
Annex 3
Annex 3 - GAVI Alliance Strategy 2011 -2015



As a public -private partnership including civil society, the GAVI Alliance pla ys a catalytic role providing funding to countries and demonstrates ?added -
value? by:
1. Advocating for immunisation in the context of a broader set of cost -effective public health interventions
2. Contributing to achieving the Millennium Development Goals (MDG s)
3. Supporting national priorities, integrated delivery, budget processes and decision -making
4. Focusing on innovation, efficiency, equity, performance and results
5. Maximising cooperation and accountability among partners through the Secretariat
6. [Ensuring g ender equity in all areas of engagement]

Mission Indicators:
I. Under five mortality rate II. Number of future deaths averted III. Number of children fully immunised
SG1 Ac celerate the uptake and
use of underused and new
vaccines
SG2 Co ntribute to strengthening
the capacity of integrated health
systems to deliver immunisation

SG3 Increase the predictability of
global financing and improve the
sustainability of national financing
for immunisation


To save children?s lives and protect people?s health by
increasing access to immunisa tion in poor countries
I. Country introductions of underused and new vaccines - Number of GAVI supp orted countries introducing underused and new vaccines
II. Coverage of underused and new vaccines ? Coverage of underused and new vaccines in GAVI supported countries

1. Increase evidence based decision -
making by countries
2. Strengthen country introduction to
help meet demand


I. Drop -out rate ? Drop out between DTP1 and DTP3 coverage
II. DTP3 coverage ? % of surviving infants receiving 3 doses of DTP - containing vaccine
III. Equity in immunisation coverage ? % of GAVI supported countries where DTP3 coverage in the lowest wealth quin tile is +/ - 20% points of the coverage in the highest wealth quintile

I. Resource mobilisation ? Resources mobilised as a % of resources needed to finance forecasted coun try demand for vaccine support
II. Country investments in vaccines per child ? Average government expenditure on vaccines per surviving infant
III. Fulfilment of co -financing commitments - % of countries that meet their co -financing commitments in a timely manne r
1. Contribute to the resolving of the
major constr aints to delivering
immunisation
2. Increase equity in access to
services , including gender equity
3. Strengthen civil society engagement
in the health sector

1. Increase and sustain allocation of national resources to immunisation
2. Increase donor commitments and private contributions to GAVI
3. Mobilise resources via innovative financing mechanisms


Mission
Operating
Principles

Cross -cutting

Strategic Goals

Goal -level
Indicators
Strategic
Objectives



SG4 Shape vaccine markets
[for poor countries]

I. Reduction in vaccine price - Change in weighted average price per dose for pentavalent and rotavirus vaccines II. Suppliers in t he market ? Number of manufacturers with a pre -qualified vaccine, and active supply, in the market



1. Make vaccines more affordable 2. Ensure sufficient supply 3. Create market security and stability 4. Catalyse introduc tion of appropriate vaccines [1. Ensure adequate supply to meet demand ] [2. Minimise costs of vaccine s to GAVI and countries ]
Monitoring and Evaluation
Advocacy , Co mmunication and Public Policy

Annex 4 Risk Matrix - GAVI Alliance Board Meeting, 30 November - 1 December 2010
Level of risk High
Medium
Low
Risk category Main risk Likelihood
of riskPotential for
negative
impact
Specific risk
Risk mitigation strategy/activity in the business plan Strategic
goalProgramme
objective/
Residual
risk (post
mitigation
actions)
Predictability of donor
commitments
Re-designed replenishment mechanism, increased emphasis on
multi-year agreements and pledges
SG3 321
Size and diversity of the
funding base
Increased efforts to expand the funding base, specifically targeting
key members of the G20, innovative finance mechanisms and,
new private and corporate partnerships
SG3 322
Donor relations/
perceptions
Enhanced donor relations and improved donor communications.
Formalised and more active donor support network (e.g., Friends
of GAVI)
SG3, ACPP 321, 322, AC111
Economic and
financial market
risks
Low Medium Credit ratings, currency
fluctuation, interest
rates etc.
Long-range financial planning and forecasting. Robust financial
management strategies and policies
Financial
admin
Internal financial
management
Low
Medium-term
liquidity risks (2-3
years) Low
MediumCash flow Rigorous internal financial management policies and controls (inc.
cash flow reserve policies, regular internal audits) Financial
admin Internal financial
management
Low
Cash-based
Programme risks
High High Health system
strengthening grants,
CSO grants, IRIS
Programme
Dedicated infrastructure for the management of cash-based grants
(incl. TAP, FMAs etc.). Joint partnership with the World Bank,
Global Fund and WHO in the Health Systems Funding Platform
(incl. joint assessments and annual reviews, and a surveillance
platform).
SG2 211, 212 High
Applications, reviews
and disbursement
process risksDedicated country communications capacity, evidence based
decision making, direct support with GAVI applications (vaccines
and HSS). Independent Review Committee technical reviews and
recommendations around country applications. Alignment of GAVI
funding with country planning and budgeting cycles. SG1, SG2 111, 112, 113, 121,
211, 212
Forecasting and
planning
Specialised demand and supply forecasting across all vaccines
(current and future)
SG1, SG4 111, 112, 121, 122,
123, 411
Country capability and
infrastructure
Specialised in-country training and capability building.
Implementation of proven country systems, structures and
processes for vaccine introduction (incl. vaccine policies and
regulations) SG1 111, 112, 121, 122,
123
Programme
performance
Routine assessments and reviews (e.g., APRs, EVMs, pre and
post-Programme evaluations), routine Programme monitoring
SG1, ME 112, 121, ME111
High
Medium
Funding risk
Country introduction
risks
High
Low
High
Medium
Financial risk
Operating risks

GAVI Alliance Board Meeting, 30 November - 1 December 2010 Doc #07 f ? GAVI Alliance
Business Plan 2011 -2015
Annex 5 - Chair?s Summary
1


Annex 5 SG2 Time Limited Task Team : CHAIR?S SUMMARY


As requested by the PPC the Task Team (TT) has review ed the proposed
objectives/ deliverables/ activities in strategic goal 2 (?Contribute to strengthening
the capacity of integrated health systems to d eliver immunisation?) of the 2011 -
2015 B usines s P lan to ensure they are appropriate for delivery on strategic goal
2. The Task Team has , within the tight timeframe , strategically discussed GAVI?s
role and proposed activities relating to health systems str engthening in the
Business Plan , as well as suggested some adjustments to activities, objectives
and deliverables.

Spec ific deliverables :
? Submission of revisions as necessary to the objectives, deliverables,
activities and budget of strategic goal 2 (se e attachment) ;
? Input to the board paper on the business plan with respect to the SG2
section (this paper to be submitted as an annex ).

1. Overall p olicy -related issues

While some priority areas in the Business Plan are well addressed ( e.g. financial
managemen t) the TT confirmed the PPC ?s and the External Advisory Group?s
concern that SG2 , as previously configured , did not provide the necessary
confidence that GAVI will be successful in reaching its SG2 goals and related
strategic objectives .

a. There are valid reasons for this : all of the Strategic Objectives (2.1; 2.2; 2.3)
are w ork in progress - this includes IRIS, the CSO component and the HSFP .
Additionally, the HSFP is being implemented with other multilateral partners
(the Global Fund, the World Bank, and facilitated by WHO) . So, this part of
the GAVI Business Plan needs to be aligned with a broader plan of work,
which aims to make global financing for health systems more streamlined and
more outcome focused. This speaks to the need for a flexible approach to
SG2 in 2011 that allow s partners and countries to move ahead . Involvement
of the Board (or a mandated body) to review progress and adjust as
necessary will be needed .

b. The Task Team agrees that country eligibility thresholds for the cash -based
grants need to be revisited so that they get better aligned with country needs .
There needs to be more complementarity between HSS/HSFP ( ?general
service delivery support ? in which resources are directed to the underlying
operational components of health system s) and IRIS/ISS (in which resources
are spent on incentives aiming to directly support the improvement of
immunization coverage as part of integrated services). Specifically, the
current eligibility and filters for both HSS (40 LIC countries) and for IRIS (14
countries with DTP3 coverage below 70%) might need to be broadened.

GAVI Alliance Board Meeting, 30 November -1 December 2010 Doc #07g ? GAVI Alliance Business Plan
Budget

FOR DECISION

GAVI Secretariat, 16 November 2010 1

At its meeting in June, the GAVI Alliance Board adopted a new strateg y for 2011 -
2015, and asked the S ecretariat to produce a Business Plan. The annual GAVI
Alliance Business Plan Budget finances the operations of the Secretariat and
programmatic activit ie s conducted by the GAVI Alliance multilateral partners . It
also includes the cost of AVI technical assistance consortium 1

, procurement
costs and investment case costs. As such, it combines the previous work plan
and administrative budget. The only cost s not included are those for vaccines
and cash grants provided to countries .
The Board is asked to approve:
? Business Plan B udget of US$ 126 million for 2011, of which US$100.4
million is for Programme Implementation, and US$25 million is for Mission
Suppor t. Together these make up the programmatic activities supported
by the GAVI Alliance other than for vaccine s and cash grants , and the
budget for the Secretariat.
? Capital Expenditure budget of US$ 1.8 million for 2011.
? Provision al Business Plan Budget of U S$ 126 million for 2012, with a
proviso that a detailed budget be presented to the Executive Committee in
early 2011 for guidance and further recommendation to the Board.

Following review by the PPC and AFC and upon taking account of their
guidance, the Executive Committee has recommended that the Board approve
this Budget.

GAVI 2011 Business Plan Budget

1. Executive Summary

1.1 For 2011, the GAVI budget structure is chang ing in response to thinking from
the strategy development process . In the past, budget approval was sought
for two separate budgets: for a Secretar iat Administrative plan and for a two-
year Work Plan . For 2011, an all -inclusive ?Business Plan? Budget is being
presented.

1.2 The business plan places emphasis on strategic priorities w hich ensure
delivery on the GAVI strategy. These include:
a) Continuing to accelerate the uptake of underused and new vaccines ;
b) Mobilising the resources to meet demand for new vaccines ;
c) Reducing vaccine input costs [while ensuring secur e supply] ;
d) Ensuring ad equate country financing and delivery of introduced vaccines;
e) Continuing to improve aid effectiveness .
1 AVI TAC = AVI Technical Assistance Consortium

GAVI Alliance Board Meeting, 30 November
? 1 December 2010 Doc #09a ? Audit and Tax Engagement Ltrs

FOR DECISION

GAVI Secretariat, 16 November 2010 The Board is responsible for appointing GAVI?s independent auditor. At its meeting
on 29 November 2010 , the Audit and Finance Committee will review the
engagement letters for KPMG?s reappointment and consider recommending to the
Board that it:
? Appoint KPMG SA/AG as independent auditor of the GAVI Alliance for 2010
? Appoint KPMG LLP to provide US tax services for the GAVI Alliance for
20 10
? Approve the 2010 audit and tax engagement letters with KPMG SA/AG and
KPMG LLP .

Audit and Tax Engagement Letters

Audit Engagement

1.1 T he majority of GAVI?s overall audit work will be performed on the GAVI
Alliance in Switzerland. To perform the work, KPMG SA/AG (Geneva) has
tabled the enclosed audit engagement letter for the Board?s consideration.

1.2 KPMG ?s proposed fee is US$ 1 93,000 and represents an increase of 8%
versus last year?s audit, fully attributable to the devaluation of the US Dollar.
On a local currency basis, KPMG in Switzerland is keeping its costs flat. The
Secretariat considers this fee reasonable and will suggest that the Audit and
Finance Committee recommend this engagement to the Board.

Tax Engagement

2.1 Although the GAVI Alliance is exempt from taxation, it is still required to file tax returns in the United States and Switzerland . A tax engagement letter has
been provided by KPMG in Washington United States for tax services.

2.2 KPMG has proposed a fee of US$ 8,000 for 2010 and this represents no
increase versus last year. The Secretariat considers this fee reasonable and
will suggest that the Audit and Finance Committee recommend th is
engagement to the Board.

2.3 The Board approved in November 2009 an engagement with KPMG SA/AG to provide Swiss tax consulting services. The engagement was for a fixed price
of $8,000 for the fiscal years 2009 and 2010.

GAVI Alliance Board Meeting, 30 November ? 1 December 2010 FINAL MINUTES

1




GAVI Alliance Board Meeting
30 November ? 1 December 2010
Kigali, Rwanda


FINAL MINUTES

1 Welcome , Executive Session, and Approval of Outstanding
Minutes
Finding a quorum of members present 1, the meeting commenced at 8.30 on 30
November 2010. Mary Robinson, Chair of the GAVI Alliance Board, chaired the
meeting. The meeting began in executive session to discuss the appointment of a
new Chair. Dagfinn H?ybr?ten , Unaffiliated Board Member, did not attend this
session. The Board then moved into general session at 9.51.

The Chair noted that it was a wonderful opportunity to have the meeting in Rwanda
during the Mother and Child Health Week in Rwanda. She noted the success of the
launch event which took place on 29 November 2010 at the R oweser Health Clinic in
the Northern Province of Rwanda to launch the nationwide campaign focusing on
helping communities to make more informed health decisions.

The Chair highlighted recent GAVI news, including IFFIm?s entry into the Australian
bond market with the successful launch of a Kangaroo bond , and the recent drop in
price of the pentavalent vaccine. She welcomed the new Board members and
alternates who were attend ing their first Board meeting, and invited Leone Gianturco,
the Governance Committee?s nominee as the Italy/Spain constituency alternate, to
sit at the Board table as the constituency?s representative until his formal
appointment . The Chair recognised thi s would be the final meeting for Anders Molin
and thanked him for his time and dedication.

The Board considered approval of outstanding minutes (Doc #1 in the board pack).

Resolution One
The GAVI Alliance Board resolved to:

? Approve the minutes of its meeting on 16 -17 June 2010 .



1 Board member partici pants are listed in Attachment A .