Gavi statement on the global health architecture

Brussels, 25 June 2025 – Noting the tremendous progress in human capital and survival as a result of 25 years of international investment in health since the Millenium Development Goals, and the subsequent Sustainable Development Goals;

In view of the reduction by half of the number of children dying before the age of 5, 70% fewer child deaths from vaccine preventable disease, and life expectancy at birth having increased on average by 8 years in the Global South;

Acknowledging that while delivering this impact, these investments have at the same time created multiple agencies, initiatives and projects with increasingly overlapping mandates, inefficiencies and complexities for partner countries in the Global South;

Recognising the priority of alignment of scarce ODA expenditure with the development priorities and strategies of recipient countries, as demonstrated recently through the Lusaka Agenda;

Gavi commits to adopting – at the Global Summit: Health & Prosperity through Immunisation co-hosted by the European Union, the Gates Foundation and Gavi on June 25, 2025 – i) an ambitious internal reform programme through the Gavi Leap initiative; ii) a commitment to deep meaningful engagement with other global health agencies to exploit synergy; and iii) proactive engagement in reform of the global health architecture, recognizing that the principles that drive the Gavi Leap could well act as a catalyst for reform of the global health architecture.

These commitments are predicated on the sincere belief in the urgent need to reform ourselves and of the architecture in which we operate.

PRINCIPLES FOR REFORM OF THE GLOBAL HEALTH ARCHITECTURE:

• Country centricity: give countries more agency, simplify processes, and promote equitable approaches with country and community needs at the heart.
• Country sovereignty: support countries to fully transition out of donor support.
• Limited mandates: agencies and institutions operating in line with their comparative advantages preventing duplication and fragmentation
• Finite lifespans: agencies and institutions commit to define a date to put themselves out of business and focus on global public goods.

COMMITMENTS:

Gavi’s internal reforms – driven through the LEAP programme

The Gavi Leap is a radical transformation programme which embraces new ways of working to prepare Gavi to deliver the ambitious goals of its next five-year strategy. Acting fast to respond to the challenges identified through the Lusaka agenda, it places countries at the centre, simplifies operational procedures and funding. Amongst the many wide-ranging changes being insitutionalised, Gavi commits to:

1. Radical restructuring of the Secretariat to work frugally and with flexibility required during this period of unprecedented change; reduction in the costs of the Secretariat (by at least 30%) by 2026 with significantly enhanced checks and balances and transparency; explore bringing our operations closer to our partner countries.
2. Placing countries first by increasing countries’ decision-making discretion over their financial resources; and making it easier for countries and communities to work with Gavi including through the merger of 8 different country funding envelopes into one strategic support window aligned to national priorities by end 2026.
3. Holding itself and partners accountable for results through a new partnerships and performance assessment framework
4. Use new multi-billion partnerships with Multilateral Development Banks and innovative financing mechanisms, including with the private sector, to make Gavi’s investments to integrate immunisation into country health systems go further – at least doubling the number of projects to boost countries’ own health system financing between 2026–2030.
5. By the end of 2026, and in consultation with the Board, establish a roadmap to progressively transition Gavi’s country-level operational functions to national, regional, or other partners. This transition should be supported by strong incentives for countries to strengthen their leadership, ownership, and financial responsibility for immunization programs – enabling Gavi to focus on its global roles, such as market shaping, ensuring a sustainable and affordable vaccine supply, and providing specialized guidance and technical assistance where needed.
6. Drive additional savings through expanding shared services at the Global Health Campus.

Merger at the last mile – including closer collaboration with the Global Fund, GPEI, GFF and others

Alongside internal reforms, the Gavi Leap also commits the Alliance to deliver far greater alignment with close partners, especially where it will matter most – aligning service delivery in countries, at the last mile, for those who need it the most. To help deliver that ambition, Gavi commits to: 

7. Advocating for and practically facilitating last mile operations – including but not limited to grant cycle alignment, an integrated model for health systems investments, with full transparency and synchronized analytics – with all partners investing in countries on the ground, covering around $1.5bn from Gavi in the next strategic period.
8. Integrate malaria programming, through joint Gavi and Global Fund support behind national plans, in at least 80% of countries where the malaria vaccine has been introduced by the end of 2027, with an ambition to reach more countries.
9. Explore radical options with respect to Gavi and the Global Fund, as well as Gavi and GPEI and other partners.
10. Develop a global action plan to improve the coverage of polio vaccines and integrate planning during and outside of campaigns in the 31 countries common to both Gavi and GPEI, with a first update by October 2025.
11. Support the development and approval of joint approaches at Board level for malaria with Global Fund, polio with GPEI (and other key partners and areas as synergies are identified) at the latest by end of 2027.

The Global Health Leap – Gavi’s ideas to catalyze reform of the global health architecture

The four principles of the Gavi Leap could serve as a blueprint for a wider global health leap to improve the health and lives of those most in need during this period of unprecedented change. Gavi is willing to help catalyse this change by committing to:

12. Advocating radical reform options and proactively engaging in processes.
13. Playing a role in establishing a coalition of the willing, and advocating for an eminent independent commission/panel to improve coherence and integration in global health, ensuring a “merger of last mile delivery”.
14. Advocate for relevant international organizations and global initiatives to review their co-financing and transition policies to drive integration and alignment within the broader architecture in line with the principle of country sovereignty. 

MEDIA CONTACTS

media@gavi.org

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