Board -2024 -Mtg -03-Doc 12 1
Report to the Board
4-5 December 2024

Subject Road to Replenishment
Agenda item 12
Category For Information

Executive Summary
On 20 June 2024, Gavi launched its Investment Opportunity (IO) for the 2026 -2030
period (Gavi 6.0), as well as the groundbreaking African Vaccine Manufacturing
Accelerator (AVMA), convening seven Heads of State, 25 Ministers, and over 200
senior representatives from key Gavi stakeholders. France, Spain, and the United
States (US) provided a strong start to Gavi’s public replenishment campaig n by
announcing a total of US$ 2.4 billion in pledges. AVMA resonated strongly at a
political and practical level, demonstrating Gavi’s strengths of partnership,
innovation, and sustainability. Notwithstanding the political and financial success of
the lau nch event, the global geopolitical situation has grown more challenging with
continued budgetary pressures and elections in many countries, ongoing conflicts,
as well as other replenishment processes within the global health and development
space. The Secr etariat continues to adjust via a dynamic and agile approach,
adapting our replenishment campaign to respond to such challenges. Under the
strategic vision provided by the IO, specific and targeted market strategies have
been developed. These have helped t o maximise donor engagement, empower
advocates from civil society, and mobilise Gavi’s influential champions from both
donor and implementing countries. Following the launch event in Paris, the
European Commission (EC) made a high -visibility pledge to Gavi during the United
Nations General Assembly (UNGA) and stated that Europe will do its fair share. To
fund its 6.0 activities costing at least US$ 11.9 billion, Gavi is working to finalise the
level of assured resources to US$ 2.9 billion and to bring in ne w pledges for at least
US$ 9 billion (of which US$ 2.8 billion has been secured to date) both in direct
contributions and through innovative financing sources. Focused replenishment
activities will continue into 2025 to continue to build the momentum towar ds a final
Replenishment Summit.
Th e priorities for the Secretariat in the coming months are to:
• Finali se discussions with donors on funds for 5.0/5.1, confirm assured
resources for 6.0 and obtain new pledges for 6.0, including early pledges
• Double -down on an agile and flexible public replenishment campaign,
building on key global events notably at the World Economic Forum annual
meeting in Davos which will include Gavi’s 25 th anniversary leading to Gavi’s
Replenishment Summit in the first half of 2025

Board -2024 -Mtg -03-Doc 13 1
Report to the Board
4-5 December 2024

Subject Update on Collaboration with Other Organi sations
Agenda item 13
Category For Information

Executive Summary
The purpose of this paper is to provide an update on Gavi’s collaboration and recent
engagement with other global and regional health institutions. This includes: i) an
update on Gavi’s engagement with the Lusaka Agenda with a focus on Gavi’s
collaboration with GPEI ; ii) an update on Gavi’s enhanced collaboration across four
workstreams (malaria, health systems strengthening (HSS), country engagement,
enabling functions and operations) with a fifth under development (tuberculosis) with
the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the
Global Financing Facility (GFF); iii) the formation and readout from the first meeting
of the ‘Joint Committee Working Group’; and iv) a summary of engagement with the
African Union (AU) and Africa Centres for Disease Control and Prevention (Africa
CDC), including the finalisation of the Africa CDC Grant A greement and the launch
of its programme of work. This paper builds on recent discussions including the
October 2024 meeting of the Programme and Policy Committee ( PPC ), and the
previous June 2024 governance cycle. Other related topics at the December 2024
Board meeting include CEO Update, including Strategy, Programmes and
Partnerships; Health Systems Strategy; and Gavi 6.0 Operationalisation (evolution
of the partnership approach , 6.0 measurement framework ).

Action Requested of the Board
This report is for discussion only.
Next steps/timeline
Gavi will continue to collaborate with the Global Fund and the GFF to drive progress
across the four priority workstreams with close sponsorship from the Gavi CEO,
Global Fund Executive Director and GFF Director and regular updates to the Joint
Committee Working Group, Board and Committees as relevant. Gavi will also
continue to collaborate with Africa CDC on implementation of the Grant Agreement
as well as African Vaccine Manufacturing Accelerator (AVMA) and the mpox
response, and these collaborations will inform the evolution of Gavi’s operating and
partnership model in Gavi 6.0.

Clas s if ied as Inter nal
gavi.org
REPORT FROM AUDIT & INVESTIGATIONS
BOARD MEETING
Lucy Elliott
4 -5 December 2024, Bali, Indonesia
How has A&I fulfilled its ToR in 2024?
Overseen, reviewed and monitored by the Audit and Finance Committee
2 Board Meeting, 4 -5 December 2024
• Recommendations for improvement in governance,
risk management and control in the Secretariat and
Gavi implementing countries
• Reinforced country accountability
• Audit quality
• US$ 46.9 million identified since 2009
• US$ 43.8 million repaid as at the last report to the AFC
• Objective is 100% recovery
• Fraud risk assessment methodology piloted
• Advice to management on Gavi’s policies around ethics etc
• Appropriate treatment of reports
• Accountability
A&I’s Terms of Reference will need updating in 2025
AFC -approved work plan of country -
and secretariat -focused audits
Identification of misuse
Preventive counter -fraud work
Confidential whistle -blower reporting
Investigative activity

gavi.org
ELIGIBILITY, TRANSITION, AND CO - FINANCING,
INCLUDING CATALYTIC PHASE
BOARD MEETING
Benjamin Loevinsohn
Adriana Jimenez Cuen
4 -5 December 2024, Bali, Indonesia
ELTRACO Shifts and Catalytic Phase
A Coherent Continuum of Support for Countries
2
Board Meeting, 4 -5 December 2024 2
ISF countries
exposed to
price for some
vaccines Shift A
Additional programmatic
support for countries at risk
Shift E
SIDS
12 years of AT plus a one -time
downward co -financing
adjustment to 80%
Accompanied by an ELTRACO
Learning Agenda
Small Island Developing States
face specific and unique
challenges
Multi -year waivers or partial
co -financing for fragile
countries Shift F
A need for greater flexibility to
provide support in fragile
contexts
Co -financing in PT capped at 80%,
plus a 35% co -financing cap for new
vaccine introductions (NVIs) Shift C
Some countries in PT and AT face high & rapidly increasing
rates of co -financing and struggle to introduce new vaccines
ISF
Countries contribution
towards vaccine procurement
100%
80%
35%
AT
Low -income
threshold
PT
Gavi’s Eligibility
threshold
0%
Former Gavi Never Gavi
Catalytic Phase
End of Gavi support
LMIC
threshold
or IDA -eligible
Programmatic challenges pose a
risk to successful transition for
some countries
8 years of support for NVIs
in AT plus a 35% co -
financing cap for NVIs Shift D
NVIs
Limited price
sensitivity may lead
to unfavourable
demand
dynamics with
market shaping
consequences
• Eligibility threshold updated to US$ 2,300
• One -time downward adjustment of co -
financing to 80% for countries regaining
eligibility Shift B
Despite macro -economic difficulties & rising costs
of expanding vaccine portfolios, Gavi’s eligibility
threshold has remained constant in real terms
challenging countries’ ability to pay
Board Meeting, 4 -5 December 2024

Board -2024 -Mtg -03-Doc 0 6c 1
Report to the Board
4-5 December 2024

Subject Gavi 6.0 Measurement Framework
Agenda item 06c
Category For Guidance

Executive Summary
The purpose of this paper is to request that the Board provides guidance on:
i) potential key shifts to Gavi’s approach to measurement, evaluation and learning
(MEL) in Gavi 6.0, to be developed through the Gavi 6.0 Learning System Strategy ;
ii) the proposed design features of the 6.0 Measurement Framework, and iii) priority
topics for evaluations in Gavi 6.0.
The potential key shifts for MEL in 6.0 include coordinated MEL across the Gavi
results chain, strengthened MEL at country level, and use of adaptive learning
approaches. The design of the 6.0 Measurement Framework includes anchoring on
the Gavi 6.0 theory of change (TOC) and a proposed focus on indicators mapped
directly to the 6.0 strategic objectives. It will be supported by comprehensive
monitoring through a delivery cascade. Potential priority evaluation topics will be
further developed through on -goin g consultations including with the Evaluation
Advisory Committee (EAC).
The PPC agreed with the potential key shifts in Gavi’s MEL approach for Gavi 6.0
and the design features of the Gavi 6.0 measurement framework, including a more
focused measurement framework that leverages existing country data sources
without imposing new reporting requirements , with a n emphasis on supporting
countries to meet their measurement needs for effectively managing their
immunisation programme s in line with the Lusaka agenda . The PPC also provided
guidance on potential evaluation topics for the next strategy period.

Action Requested of the Board
The Gavi Alliance Board is requested to provide guidance on:
a) Key shifts to Gavi measurement, evaluation and learning for Gavi 6.0;
b) Design features of the Gavi 6.0 Measurement Framework; and
c) P otential evaluation topics for Gavi’s 2026 -2030 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) COVID-19 surveillance 2) Vaccination Delivery and Monitoring and 3) COVID-19 case management. Good practices and lessons learned by Rwanda are also highlighted in the brief.