Fragility is on the rise. So is Gavi’s commitment to tackling it

The scale of fragility and humanitarian need is spiralling, driven by conflict, the accelerating effects of climate change and political upheaval.

Yet at the same time, we are seeing an unprecedented withdrawal of funding for a humanitarian system that is perilously close to collapse.

At Gavi, the Vaccine Alliance we have taken a conscious decision in that context: far from downsizing, we are increasing our support to populations in fragile and humanitarian settings.

We have taken this decision even though, as an Alliance, Gavi faces a shortfall of US$ 3 billion for our forthcoming five-year strategy period, Gavi 6.0.

Through our new Fragility & Humanitarian (F&H) Approach, over the next five years we will invest almost US$ 3 billion – nearly 35% of our resources going to countries – to those countries classified as fragile, even though by number of children born these account for only 26% of Gavi’s portfolio.

Gavi immunisation support for fragile and humanitarian populations will include:

• Cash support for health system strengthening and immunisation campaigns, which is being held stable for fragile and humanitarian contexts at a time when cash grants for other groups of countries Gavi supports are seeing reductions of between 20% and 40%.
• Vaccine support through our newly designed Country Vaccine Budget (CVB), which has been weighted towards fragile countries where the need to lift immunisation rates is greatest, pending approval by our Board later this week. If approved, vaccine investments per child in fragile and humanitarian contexts will be almost twice as high than in all other groups of countries.
• New surge financing, including a new Gavi Resilience Mechanism (GRM), which has been established to address unforeseen needs in fragile and humanitarian contexts that are not covered by country plans. This new US$ 380 million flagship investment for our Gavi 6.0 strategy responds to the less predictable nature of fragile and humanitarian contexts – for example health emergencies impacting immunisation or newly arising humanitarian crises.
• Co-financing waivers for countries facing humanitarian crises.
• Working with partners and humanitarians with a new structured approach to reach populations and communities who fall outside the ambit of national immunisation strategies.
• Fragility support for lower middle-income countries that would otherwise not be eligible for full Gavi support.

Despite some recalibration downwards versus our initial Gavi 6.0 plans due to our US$ 3 billion funding shortfall, fragile and humanitarian contexts is the only area of investment across Gavi’s activities that will receive additional funding compared to our current period – an increase of more than 15%.

This makes sense in the context of Gavi’s mission to ensure that no child is denied the life-saving benefits of immunisation because of where they were born.

And in the context of broader unprecedented cuts to aid spending, directing more resources to the most vulnerable is the most ethical course of action.

The past five months have meant some tough conversations within the Secretariat, as we have reduced Gavi’s operating costs and streamlined our organisation.

We will start 2026 with a Secretariat that is almost 40% smaller than it was three years ago. This has not been an easy process, but when every penny we save in costs results in more vulnerable children reached with vaccines then it will have been more than been worth it. And on a personal level, our choice as an Alliance to protect the F&H Approach makes me even more proud to serve as Gavi’s CEO.

As a child growing up in Pakistan, then as a trainee and practicing physician, and later as a government minister, I have seen the effects of fragility and crisis from every perspective. From the communities devastated by floods in 2022 to the children struck down by vaccine preventable diseases.

I know what a lifeline Gavi’s support is to children and families enduring unimaginable hardship. Our new F&H approach will ensure we reach more of the most vulnerable families with Gavi’s support over the next five years than ever before.