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

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

This country technical brief presents three use cases of Real Time Monitoring (RTM) approaches used in Rwanda for 1) COVID19 surveillance 2) Vaccination Delivery and Monitoring and 3) COVID19 case management. Good practices and lessons learned by Rwanda are also highlighted in the brief.