Health , Climate Change
and the Environmental Impact of
Immunization
National Mitigation and adaptation
approaches
Yifru Brehan (Prof)
Minister Of Health, Ethiopia
Background:
we were not too late to start vaccination
? Small pox vaccination campaign 1964 - 1977.
(WHO declared campaign 1966 ? 1980)
? EPI was declared in 1980.
(WHO declared in 1974)
? Polio eradication campaign since 1996 .
(WHO declared in 1988 )
? Polio free since 2014 . (WHO expected in 2000 ).

Gavi

SWEDEN?s role in
protecting vulnerable
populations in the face
of climate change
1 Ministry for Foreign Affairs , UN Policy Department
Climate change ? what can we expect ?
2 Ministry for Foreign Affairs , UN Policy Department
? Rise in temperatures , more extreme weather , droughts and heat
waves , changes in precipitation , stronger storms and hurricanes ,
rising sea levels

Health, Climate Change
and the Environmental
Impact of Immunization
Environmental
Sustainability of
Immunization ? UNICEF
perspective
Gavi Technical Briefing
June 13, 2017
ADVOCACY AND
ACCOUNTABILITY
? Evidence -based
advocacy
? support governments
in meeting to their
commitments
CLIMATE CHANGE
ADAPTATION
through resilient
development
CLIMATE CHANGE
MITIGATION
(= low carbon development )
.
?By 2020 all country offices should have incorporated climate change
in their programmes and operations? (Executive Directive on
addressing climate change for children )
UNICEF Executive Directive on Climate Change
GREENING UNICEF

I M M U N I Z AT I O N I N H U M A N I TA R I A N
R E S P O N S E a n d
PA R T N E R C O O R D I N AT I O N
GAVI Board - 13 June 2017, Geneva
SCALE OF HUMANITARIAN RESPONSE NEEDS

www.gavi.org
GAVI?S VACCINE
INVESTMENT STRATEGY
(VIS)
BOARD TECHNICAL BRIEFING
13 June 2017, Geneva
Reach every child
Agenda 2 1. Overview of the VIS and Gavi?s portfolio (15 mins) ? Gavi Secretariat
2. Landscaping of candidate investments (10 mins) ? Martin Friede, WHO
3. Rabies case study (10 mins) ? Bernadette Abela-Ridder, WHO
4. Strategic considerations for 2018 VIS (5 mins) ? Gavi Secretariat
5. Moderated discussion ( 45 mins)

CASE STUDY:
2013 VIS DECISION
ON RABIES LEARNING AGENDA Geneva, 13 June 2017
Bernadette ABELA-RIDDER
WHO Rabies Lead & Team Leader, Neglected Zoonotic Diseases
Department of the Control of Neglected Tropical Dise ases
Our Goal:
Zero by 30
Rabies is a neglected, vaccine-preventable disease An indicator for impact on inequity
?
100% fatal
?
~60,000 deaths per year
?
Weak data and under-reported
?
Mostly children
?
Vicious cycle of supply and demand
?
Vaccine is a key component of the global plan
and triggers national programmes Rabies per capita death rates per 100,000 persons.
2

Landscaping of Candidate
Investments Martin Friede PhD
Initiative for Vaccine Research
World Health Organization
2
|
The Vaccine Landscape
The Vaccine Landscape

Board -201 7-Mtg -1-Doc 00 a



G avi Alliance Board Meeting
14 -15 June 2017
Intercontinental Hotel, Geneva, Switzerland

Monday 12 and Tuesday 13 June: Pre -Board meetings
Wednesday 14 June: 0 9.00 -17.30 (Board meeting Day One)
Thursday 15 June: 09.00 -16.00 (Board meeting Day Two)
Qu orum: 14

Document list

No. Document
00a Document list
00b Agenda
01a Declarations of interest
01b Minutes from 7-8 December 2016
01c Unanimous consent decisions
01 d Action Sheet
01 e Workplan
02a Consent agenda: Board Leadership (To follow)
02b Consent agenda: Board/Committee member appointments (To follow)
02c Consent agenda: Changes to Committee Charters (To follow)
02d Consent agenda: Changes to Statutes and By -Laws (To follow)
02e Consent agenda: Gavi Policy: Fragility, emergencies and re fugees
02f Consent agenda: Review of Cold Chain Equipment Optimisation Platform
02g Consent agenda: Programme Funding Policy (To follow)
03 2016 -2020 Strategy: Implementation and progress
04 CEO?s report (To follow)
05 Financial update
06 Partners? E ngagement Framework
07 a Country Programmes: strategic issues
07b Case study: Alliance partners joining efforts towards improving equitable and
sustainable immunisation coverage in Pakistan
08 Chair?s reflections on the day ? No paper
09 Chair?s overvie w ? No paper
10 Committee Chair and IFFIm Board reports (To follow)

Board -201 7-Mtg -1-Doc 00b




G avi Alliance Board Meeting
14 -15 June 2017
Intercontinental Hotel, Geneva, Switzerland

Monday 12 and Tuesday 13 June : Pre -Board meetings
Wednesday 14 June : 0 9.00 -17.30 (Board meeting Day One)
Thursday 15 June : 0 9.00 -16.00 (Board meeting Day Two)
Qu orum: 14


Agenda REVISED


Pre -Board Meetings ? Monday, 12 June 2017
Item Subject Room Schedule

? IFFIm Donors? meeting Moscou 13. 00 -15.30
? Audit and Finance Committee meeting Gavi Offices, 101 14.00 -18.00
? AMC Stakeholders? meeting Berne 16.00 -18.00


Pre -Board Meetings ? Tuesday , 13 June 2017
Item Subject Room Schedule

? Technical Briefing Session s
o Vaccine investment strategy
Break
o Immunisation in humanitarian settings
Ballroom AE 09.00 -12.30
09.00 -10. 30

11.00 -12.30
? Governance Committ ee meeting Londres 11.00 -13.00
Lunch Ballroom BC/
Foyer D
12. 30 -13. 30
? Technical Briefing Sessions (contd.)
o Health, climate change and environmental
impact of immunisation
Berne 13. 00 -14.30
13. 00 -14.30
? Developing Countries Board members meeting Ballro om AE 14.00 -15. 30
? All Chairs meeting Bruxelles 14. 30 -15. 30
? IFFIm Board meeting Moscou 15.30 -19.00
? Board Meeting: Closed session for Board
members and Alternate Board members
Ballroom AE 16.00 -19.00
? Unaffiliated Board members meeting Woods 19.15 -20. 15
? Gavi Donors? meeting Berne 19. 30 -21. 30

Board -201 7-Mtg -1-Doc 01 a



Gavi Alliance Board Meeting
14 -15 June 201 7
Intercontinental Hotel, Geneva, Switzerland

Quorum: 14
Declarations of Interest

Declarations
Section 5.2 of the Conflict of Interest Policy states, ?Annually, each member of the Board
(including a lternate Board members and Committee delegates)...shall complete and submit a
conflict of interest form to be distributed by the Managing Director, Law and Governance.? The
following declarations were made by members of the Board on their most recent annu al
statements:
Board members:
Member Org anisational Interest s

Financial/Personal/Advisor Int /
Others
Ngozi Okonjo -Iweala , Chair None Gavi -appointed special adviser
Flavia Bustreo, Vice Chair WHO Gavi -appointed special adviser
Gunilla Carlsson None
Gen eva Center Security Policy
(Associate Fellow)
ADB (Special Advisor)
Annexin Pharmaceuticals AB
(Board)
NGS Group AB (Board)
Boxholms Sk rgar AB (Board)
Kolmarden Charity (Board Chair)
Tundra (Board)
Peggy Hamburg None
Joint Coordinating Group (Chair)
Coali tion for Epidemic Innovations
(CEPI) (Board)
Yifei Li None
Man Group (Country Chair)
Rockefeller Foundation (Board)
Jackson Institute for Global
Affairs, Yale University (Board)
Helen Rees None None
William H. Roedy None None
Richard Sezibera None Gavi -appointed special adviser
David Sidwell None
Chubb Limited (Board)
UBS (Board, Risk and
Governance Committees)
Stephen Zinser None Roxbury Asset Management
(CEO and Co -CIO)
Orin Levine Bill & Melinda Gates Foundation PATH ( Spouse )
Tim Evans The World Bank None

Board -2016 -Mtg -02 1
Minutes



Gavi Alliance Board Meeting
7-8 December 2016
Sofitel Abidjan Hotel Ivoire, Abidjan, C ?te d?Ivoire


1. Chair?s report

1.1 Finding a quorum of members present, the meeting commenced at 09.19 local
time on 7 December 201 6. Ngozi Okonjo -Iweala , Board Chair , chaired the
meeting .

1.2 The Chair welcomed new Board member s and Alternate Board member s, as well
as Rob Moodie, Chair of the Evaluation Advisory Committee . She shared regrets
from Ren? Karsenti, Chair of the IFFIm Board, who had been unable to attend due
to other commitments. She noted that departing members would be recognised
for their service at the dinner that evening.

1.3 The Board met in closed session on the evening of 6 December and the morning
of 7 December to discu ss a number of items including potential Gavi engagement
in Syria, the Board an d Committee self -evaluation and to review the CEO ?s
performance.

1.4 Standing declar ations of interest were tabled to the Board (Doc 01a in the Board
pack). The Chair noted that in the context of the items for decision on the agenda ,
there were a number of Board member s who would have conflicts of interest and
that these would be raised at the appropriate time and recorded in the applicable
parts of the minutes.

1.5 The Board noted its minutes from 22 -23 June 2016 (Doc 01b), which were
approved by no objection on 22 September 201 6. The Board also noted its
workplan (Doc 01c) and the Chair e ncouraged Board members to contribute to the
forward plan by raising issues which they may wish to add either with her directly
or with the Secretariat . She had solicited inputs to the agenda for this meeting but
had only received two responses. It is plan ned that further work will be done to
identify the best process for eliciting input of Board members.

1.6 The Chair informed Board members that the Secretariat continues to work on the
quality of the Board meeting materials and that the e xecutive summaries for the
papers requiring decisions continue to be condensed and are easier to read.
Considerable additional material related to the topics on the agenda can be
access ed on myGavi for those wishing to receive more comprehensive
informatio n.

1.7 Finally, the Chair informed Board members that the Executive Committee had only
met once since the last Board meeting, on 1 November 2016, to consider a
commercially sensitive decision regarding a rotavirus vaccine.

1



Board -2017 -Mtg -1-Doc 01c
Report to the Board
14 -15 June 201 7


Since the December 2016 Board meeting, one decision has been circulated to the
Board electronically for approval by unanimous consent in line with Article 2.7.3.1
of the By -Laws.

On 13 March 2017, Board members were invited to consider the following:

The Gavi Alliance Board:

(a) Approved that the transitioned countries who have already been approved
for an HPV National introduction (i.e. Bolivia, Guyana, Honduras and Sri
Lanka) can apply for support for multi -age cohort HPV vaccinations (9 -14
years of age) in year one of introduction of t he vaccine, including support
for 50% of vaccine costs for the additional cohorts as well as operational
costs of US$ 0.45 per girl targeted.

(b) Noted that the funding associated with the above approval for the period
2017 -2020 is expected to be approximatel y US$ 3 million and will be allotted
to individual programmes from the Programme Funding Envelope approved
by the Board for each year, in accordance with the Programme Funding
Policy.

On 22 March 2017, c onsent to the decision had been received from all vo ting
me mbers of the Board and it was therefore considerd a pproved by unanimous
consent, and Board members informed accordingly .

In line with the Gavi Conflict of Interest Policy, Dr Yolani Batres (Honduras)
recused herself from voting on the decision. Her Alternate Board member, Dr
Sergey Khachatryan (Armenia) voted on behalf of their constituency.
SUBJECT: UNANIMOUS CONSENT DE CISIONS
Agenda item: 01c
Category: For information

Board -2017 -Mtg -1-Doc 01 d 1




G avi Alliance Board

Action sheet as of 31 May 2017

Request Matter Responsible Action taken

22 -23 June
2016
? 4
CEO?s report :
? Request for a pre -Board technical
briefing session on CSO?s role in
contributing to coverage and
equity

Secretar iat
(Armstrong )

Combined with
June 2017
session on
immunisation in
humanitarian
settings

22 -23 June
2016
? 4
CEO?s report:
? Ensure that risk is a standing item
on the agenda for all Board
meetings going forward

Secretariat
(Armstrong)
Included as a
stan ding item
on Board
workplan

22 -23 June
2016
? 13
Partners? Engagement Framework
& Alliance Accountability
Framework:
? Comparison of PEF with old
business plan

Secretariat
(Gupta/De
Chaisemartin)

Will be
addressed as
part of the
prospective
evaluation of
Technical
Assistance (TA)


7-8
December
2016 ? 3
2016 -2020 Strategy:
Implementation and progress :
? Sustainability to be included as a
topic for discussion at the Board
Retreat in April 2017

Secretariat
(Armstrong)

Was discussed
at 2017 Board
Retreat

7-8
December
201 6 ? 4
CEO?s report:
? Board to do a deep dive on one or
two countries to better understand
how the Alliance works in -country

Secretariat &
Alliance

Deep dive on
Nigeria and
PNG at Oct
2017 PPC an d
Nov 2017
Board in the
context of the
develo pment of
country -specific
strategies (for
approval in
Spring 2018)

BOARD WORK PLAN
Graphical format

Board -2017 -Mtg -1-Doc 01 e
GAVI Alliance Board Agendas
FOR BOARD DECISION/INFORMATION/GUIDANCE
Board Chair or Vice Chair appointment (Consent Agenda)
Board/Cte member appointments (Consent Agenda)
Cte chair appointments (Consent Agenda)
Statutes and By-law changes (Consent Agenda)
Changes to Committee Charters (Consent Agenda)
Partners' Engagement Framework (incl. Secretariat and Partners Budget 2018-2019)
Country Engagement Framework
Vaccine Investment Strategy
[3 step process - (i) methodology; (ii) short list; (iii) final decision)]
Typhoid conjugate vaccine support window (TBC)
Tailored approaches for Nigeria and PNG
Engagement with countries post-transition
Update on India Strategy
Annual financial report
Chair rpt (Decl of Int, Mins, Acts, W kpl)
CEO report
2016-2020 Strategy: Implementation and progress
Committee chair reports
IFFIm report
Financial update and programme funding envelopes
Country Programmes: strategic issues
Risk update (incl. risk and assurance report)
Review of decisions and actions
Any other business
Report from Audit and Investigations
Resource mobilisation update
Discussion
Decision
Information/Decision
Information
Discussion
Information
Information
Information
Discussion
Discussion
Information
Information
Discussion
Information
N/A N/A
Discussion
Decision
Decision
Decision
Information
STANDING REPORTS AT EACH REGULAR MEETING
Decision
STANDING REPORTS ONCE PER YEAR
July-Aug 2017 Sept NoObj Oct 2017
Decision
Decision
Decision
Decision
Discussion
Discussion
Information
Discussion
June 2018 (TBD) April-May 2018
Decision
Information
Decision
Information
Guidance
28-29 Nov 2017 March 2018 Jan-Feb 2018
Decision
Decision
Decision

1



Board -2017 -Mtg -1-Doc 02a
Report to the Board
14-15 June 2017

Section A: Summary
? The term of the current Board Vice Chair, Dr Flavia Bustreo, ends on
30 June 2017.
? At its meeting on 5 December 2016, the Governance Committee approved
the terms of reference for the positio n of Board Vice Chair and established
a Board Vice Chair Nominations Subcommit tee (Nominations
Subcommittee) chaired by Dr Ngozi Okonjo -Iweala, Board Chair.
? This paper outlines the process undertaken by the Nominations
Subcommittee to identify and nominate a candidate to fill the position of
Board Vice Chair starting 1 July 2017 . A recommendation was subsequently
made to the Governance Committee which during its meeting on 13 June
2017 approved a recommendation to the Board as outlined in this report .
Section B: Vice Chair Nomination
Introduction
1.1 Current Board Vice Chair, Dr Flavia B ustreo, has served on the Gavi
Alliance Board in this capacity since 1 January 2015 and her term ends on
30 June 2017.
1.2 At its meeting on 5 December 2016 , the Governance Committee approved
the terms of reference for the Board Vice Chair ( Annex B ) and establ ished
a Board Vice Chair Nominations Subcommittee (Nominations
Subcommittee) (Annex C ) to consider and institute an appropriate process
for the nomination of a suitable candidate to fill the position of Board Vice
Chair starting 1 July 2017.
1.3 The Nomination s Subcommittee was composed of Board Chair, Dr Ngozi
Okonjo -Iweala, as Chair of the subcommittee and Reina Buijs and Danny
Graymore from the Governance Committee.
Process
2.1 The Nominations Subcommittee met by teleconference on 7 March 2017
where it noted its terms of reference and mandate and reviewed the terms
of reference for the position of Board Vice Chair.
SUBJECT : BOARD LEADERSHIP: VICE CHAIR APPOINTMENT
Agenda item: 02 a
Category: For Decision

1



Board -2017 -Mtg -1-Doc 02b
Report to the Board
14-15 June 2017

Section A: Summary
? At its meeting s on 4 April 2017 and 13 June 2017 , the Governance
Committee considered a number of nominations for Board and Committee
membership and subsequently agreed on a set of recommendations which
are being s ubmitted to the Board for approval at its meeting on 14 -15 June
2017.
Sec tion B: Board and Committee Nominations
Constituency processes for Board and Committee nominations
1.1 Nominations from donor country governments were submitted following
consultative processes within the relevant group s.
1.2 Nominations from the vaccine industry industrialised countries and the
vaccine industry developing countries were submitted following
consultative processes within the International Federation of
Pharmaceutical Manufacturers & Associations (IF PMA) and the
Developing Countries Vaccine Manufacturers Network (DCVMN)
respectively.
1.3 Nominations from the civil society organisations constituency were
submitted following a consultative process whereby the Gavi CSO
Steering Committee issued an open call for nominations for the Alternate
Board member seat. Four individuals were nominated. The Steering
Committee agreed on a short list of two candidates and Steering
Committee members eligible to vote were invited to vote for their preferred
candidate. In line with the CSO constitu ency charter , the incumbent
Alternate Board member is nominated to take up the Board member seat.
1.4 It should be noted that in line with the Board Committee Charters which
stipulate that ?all members shall be appointed once every two years?, all
appointment s to the Board?s Committees will be reviewed and refreshed
at 31 December 2017 as appropriate.
SUBJECT : BOARD AND COMMITTEE NOMINATIONS
Agenda item: 02b
Category: For Decision

1



Board -2017 -Mtg -1-Doc 02c
Report to the Board
14-15 June 2017

Section A: Summary
? This paper presents a number of recommendations to the Board which the
Governance Committee agreed on during its meeting on 13 June 2017. The
recommendations relate to actions arising in response to the
recommendations of the Board and Committee self -evalu ation presented to
the Board in December 2016 .
? Some additional actions will be further discussed by the Governance
Committee during the second half of 2017 and presented to the Board in
November 2017 to conclude the process.
Section B: Review of Committee Charters
Background
1.1 The Board and Committee self -evaluation in 2016 was undertaken with two
principal objectives:
(a) Evaluate alignment of governance system established in 2008 with the
2016 -2020 strategy and whether it remains fit for purpose or requires
en hancements that will support the current strategy.
(b) New Board Chair wanting to take stock and assess effectiveness and
efficiency of the current governance system.


SUBJECT : REVIEW OF COMMITTEE CHARTERS
Agenda item: 02c
Category: For Decision

1



Board -2017 -Mtg -1-Doc 02d
Report to the Board
14-15 2017

Section A: Summary
? Given the revisions to the Board Committee structure of the Gavi Alliance
more fully described in Doc 02c , this has necessitated some consequential
revisions to the Statutes and By -Laws.
? The Governance Committee considered these during its meeting on 13
June 2017 and agreed to make a recommendatio n to the Board to approve
the revisions to the Sta tutes and By -Laws as outlined in this report .
? It should be noted that the changes are subject to confirmation and
registration with the Swiss Supervisory Board for Foundations (Supervisory
Authority) and th e Registry of Commerce of the Canton of Geneva .
Section B: Review of Statutes and By -Laws
Background
1.1 Following the recommendations of the Board and Committee self -evaluation
presented to the Board in December 2016, a number of revisions to the
Committee st ructure of the Board of the Gavi Alliance are being
recommended to the Board at its meeting on 14 -15 June 2017.
1.2 This is more fully set out under Doc 02c and accompanying Annexes B
through F .
Board and Com mittee self -evaluation: Recommendation to retire the
Executive Committee
2.1 One of the consequences of the Board and Committee self -evaluation has
been the recommendation to retire the Executive Committee as at
31 August 2017.
2.2 If approved by the Board, this will require a number o f consequential
modifications to the Sta tutes and By -Laws.
2.3 Annex B sets out the specific changes to the Statutes and By -Laws
throughout that will be required in relation to the Executive Committee .
SUBJECT : Review of Statutes and By -Laws
Agenda item: 02d
Category: For Decision

Gavi, the Vaccine Alliance
Fragility, Emergencies,
Refugees Policy
Version 2.0

DOCUMENT ADMINISTRATION

VERSION
NUMBER APPROVAL PROCESS DATE
2 .0 Prepared by: Aur?lia Nguyen

Reviewed by: Programme and
Policy Committee 1.0 - 17 October 2012
2.0 - 12 May 2017
Approv ed by: Gavi Alliance Board 1.0 - 5 December 2012
Effective from: 1 January 2013
2.0 - 15 June 2017
Effective from: 1 July 2017
Next review: At the request of the Board
Annex A




2
Gavi , the Vaccine Alliance
Fragility, Emergencies, Refugees Policy
1.
Policy p urpose
1.1. This policy contains prioritisation criteria for identifying a sub -set of Gavi countries
affected by fragility as per international standards. It provides guidance on
flexibilities in applying certain Board -approved policies and processes to adapt to
the local context , in order to increase the effectiveness of support towards
equitable access to immunisa tion.
1.2. This policy also details flexibilities that can be extended in the case of an
emergency and for Gavi -supported countries hosting refugees .
2. Key principles
2.1. Gavi?s approach in these settings is guided by the following principles:
? Transparency : Gavi applies objective and transparent criteria to identify
countries facing fragility as defined in section 5, while assessing emergencies
and situations of refugees on a case- by-case basis, acknowledging that any
categorisation must be treated flexibly.
? Prioritisation: countries that face fragility are prioritised for Alliance-wide
engagement recognising that these countries need stronger and more
sustained dialogue, increased planning and implementation support and
regular review and monitoring.
? Flexibility : Gavi recognises that its standard policies and processes may need
adaptation to effectively and swiftly respond to special needs in these settings.
Such flexibilities are adapted to the local context and may sometimes involve
a temporary departure from the principles underpinning Gavi?s general
approach.
? Resilience : while recognising the need to adjust support and support
modalities to respond to an emergency, where feasible, Gavi seeks to maintain
a longer -term perspective and focus on building resilience of systems and,
ultimately, transition readiness, in line with its comparative advantage.
? Complementarit y: Gavi funding and activities are intended to complement ?
and not replace or duplicate ? the funding and activities of individual Alliance
partners an d other actors operating in these settings.
? Coordinatio n: the Alliance seeks to coordinate, consult and share information
with the nation al government, other in -country partners and international
partners including humanitarian actors.
? A higher risk appeti te: Gavi recognises and accepts that its engagement in
fragile settings, emergencies and situations involving refugees, exposes the
Alliance to higher levels of risk, including fiduciary risk, operational risk (e.g.
security of personnel), and programmatic risk (e.g. value for money and
sustainability). Operating in such environments may therefore come with
increased cost of risk management and mitigation and may also require a
higher risk appetite where it may not be possible to fully mitigate the risks
re quired to engage in these settings.
? Humanitarian principles : Gavi recognises the importance of the neutrality,
independence and impartiality of humanitarian actors operating in conflict
situations.
? Gender lens: cognizant that gender inequities can be exacerbated in fragile
and emergency settings, and that gender-sensitive approaches are expected
Annex A

Annex B : Overview of decision process for exceptions and flexibilities in Gavi policies and guidelines
- Flexibilities in categories B and C (orange shading) are subject to the Fragility, Emergencies, Refugees Policy
- All flexibilities granted will be documented by the Secretariat in a ? Flexibilities Tracker ?
- Twice per year an update on CEO -approved flexibilities will be included in the C ountry Programmes update to the PPC and Board
- This list is not exhaustive; other similar flexibilities as in categories B and C may be identified and will be documented and reported as per the policy
Exceptions/flexibilities
Relevant
Policy/Board
decision
Decision -making Authority 1
Countries
facing
fragility 2
Countries
with an
emergency
Country
hosting
refugees
A. Material Exceptions to the Board -approved Eligibility & Transition, and Co -Financing policies
Waiving of co-financing requirement (with
supplemental provision of vaccines if there is a
risk of supply shortages) , repeated as needed in
case of extended emergency
Co -financing
Policy PPC/ Board N/A 3 N/A N/A
B. Exceptions to Board -approved policies and/or with financial implications
Bridge grant in between two HSS grants HSIS Framework IRC /HLRP/ CEF mechanism recommendation
to CEO ? ?
Flexible use of Performance based funding
component of HSS grant HSIS Framework HLRP recommendation to CEO ? ?
Additional HSIS support beyond the country
allocation to support recovery/rebuilding of
systems post -emergency
HSIS Framework IRC /HLRP recommendation to CEO ?
Additional support for operational costs of
campaign delivery of routine vaccines in hard to
reach areas, or for refugees
HSIS Framework IRC /HLRP/CEF mechanism recommendation
to CEO ? ? ?
Additional vaccines to cover a broader age o r
antigen range in vaccination of refugees and for
unreached populations
Board decisions
on Gavi -funded
vaccine
programmes
IRC /HLRP/ Alliance coordination body
recommendation to CEO ? ? ?
1 Detailed decision -making process for flexibilities in categories C and D to be finalised and confirmed as part of the development of operationa l guidelines 2 Gavi classification 3 May be decided for any country regardless of classifications under the Fragility, Emergencies, Refugees Policy

Annex C :
Gavi Policy : Fragility , Emergencies , Refugees
Monitoring Framework
DRAFT

Implementation of the Gavi Policy on Fragility, Emergencies and Refugees will be monitored by the Secretariat

This framework is a first attempt to outline outcomes and outputs that the Alliance will monitor throughout the
implementation of the policy. This framework would not represent an additional reporting burden to countries
and Alliance partners as it leverages existing processes and data sources. Where relevant, A lliance Key
Performance Indicators (KPIs) are used. The monitoring would by and large be ann ual whilst the tracking of
flexibilities would be done on a quarterly basis.

In addition, the Secretariat would include regular (qualitative) updates on the implementation of this policy in the
Country Programmes Update to the PPC and Board.

An external evaluation of the policy is planned for 2019 as part of a broader evaluation of Gavi?s Country
Engagement Framework (CEF) in order to assess i ts effectiveness, efficiency, and results.

1



Re port to the Board

Annex D - Illustrative financial implications
1.1 The application of certain flexibilities could have financial implications, for
example additional HSS support in the case of an emergency, waiving of
co -financing requirements for refugees or additional technical support under
the Partners? Engagement Framework (PEF) as illustrated below. Overall,
the financial implications of the policy are expected to be limited.
1.2 Experience has shown that in most cases of fragility or emergencies,
countries have reduced capacity to absorb grants and need more time to
spend existing support rather than additional funding. To date, the only case
where an emergency resulted in an immediate need for additional Gavi
resources was the Ebola outbreak, when increased HSS support was
approved by the Board for the affected countries. Other responses to
emergencies or to fragility situations have to date been catered for through
reprogramming of existing grants. If in the future an emergency situation
arises where additional HSS sup port by Gavi would be needed to address
an urgent need, up to 50% of the HSS ceiling may be granted in additional
funding (within the Board -approve d envelope). The median HSS ceiling for
Gavi countries is US$ 14 million. If a country with this ceiling expe rienced a
major emergency requiring rapid rebuilding of destroyed health systems as
was the case in the Ebola -affected countries, a proposal for additional
support of up to US$ 7 million could be submitted for review by the IRC or
HLRP. Any amount above 50 % of the ceiling would require a Board
decision.
1.3 Three Gavi countries host more than 500,000 refugees, 13 countries host
between 100,000 -500,000 refugees, while the remainder (48) host fewer
than 100,000 refugees. By default, Gavi would promote and encour age
integration of refugees into regular programmes by the host government in
line with the Refugee Convention. If Gavi were to waive co -financing for a
medium -sized, preparatory -transition country with a refugee population of
500,000, this could amount to US$ 50,000 for a full schedule of Gavi -
supported vaccines for children.
1.4 Countries identified as facing fragility for the purpose of this policy would be
added to PEF Tier 2, enabling access to additional Target ed Country
Assistance if there was a need fo r such additional support. Based on current
projections of countries to be identified as facing fragility and of utilisation
rates of PEF TCA funding, it is foreseen that such additional costs could be
absorbed within the PEF budget.
1.5 Implementation of thi s policy will be mainstreamed in existing country
engagement processes and no additional costs for human resourcing in the
Secretariat is foreseen.

1



Board -2017 -Mtg -1-Doc 02e

Section A: Introduction
? In December 2016, the Board approved a set of principles to form the basis
for a Gavi Policy on Fragility, Emergencies and Refugees . It also approved
immediate operationalisation of these principles pending a formal policy
document that would replace the previous Fragility and Immunisation Policy.
? The PPC has now reviewed the revised policy enshrining the principles
approved by the Board in December 2016 . It noted the complexity of the
topic and welcomed the extensive consultations undertaken by the
Secr etariat to guide the finalisation of th is policy. It suggested that the
Secretariat provide some illustration of the potential financial implications .
Annex D includes several examples of how the policy might be applied and
the resulting financial implications (which are expected to be relatively
limited) . The civil society constituency also expressed their interest in
providing input into the operational guidelines being developed by the
Secretariat to implement the policy , especially on engagement with non -
state actors. Following their discussion, t he PPC recommended the policy
attached as Annex A for approval by the Board through the consent agenda .
Section B: Gavi Policy: Fragility, Emergencies, Refugees
1.1 The policy takes into account the followi ng key principles approved by the
Board (summarised below based on the December Board paper )1:
(a) The policy should distinguish between (1) fragility (2) emergencies and
(3) refugees. The criteria for classification of countries facing fragility
should be obj ective and transparent. For emergencies Gavi should
use WHO and UN classifications as reference points.
(b) The policy should allow sufficient flexibility to enable a swift and
effective response in each of these circumstances. Flexibilities applied
should be reported regularly to the PPC and Board.

1 These can found in sections 4.5, 5.3 and 6.4 of the Board document available at
http://www.gavi.org/about/ governance/gavi -board/minutes/2016/7 -dec/minutes/08a --- fragile -
settings, -emergencies -and -displaced -people/
SUBJECT : CONSENT AGENDA: GAVI POLICY: FRAGILITY,
EMERGENCIES AND REFUGEES
Agenda item: 02e
Category: For Decision
Report to the Board
14 -15 June 2017

1



Board -2017 -Mtg -1-Doc 02

Section A: Introduction
? In June 2015 the Gavi Board approved the creation of the cold chain
equipment optimisation platform ( CC EOP ) with an initial amount of
US$ 50 million to launch its implementation and fund the first applications.
The CCEOP was launched in 2016 and 24 countries submitted applications
between January 2016 and March 2017. This is ~20% higher than the
number of applications that had been projected in 2015 and likely reflects
pent -up demand from previous underinvestment in cold chain equipment
(CCE) . Recognising the high level of country demand, the Board agreed in
December 2016 to expand its investment in the CCE OP, while also
requesting that ?the total multi -year commitments of grants for the CCEOP
should not exceed US$ 250 million in the period up to the Board meeting in
June 2017 ?. The Board also requested that the Secretariat develop
strategies for the equitab le allocation of CCEOP funding .
? This report asks that the Board approve the proposed approach for the
equitable allocation of existing CCEOP resources to countries, as described
in Section 2.2 . This approach was recommended by the Programme and
Policy Com mittee (PPC). It also provides an update on the initial
implementation of the CCEOP and lessons learned to date .
Section B: Review of Cold Chain Equipment Opt imisation Platform
Purpose of the CCEOP
1.1 The CCEOP is a catalytic investment that helps countries t o modernise and
extend the cold chain with reliable and high -perform ing equipment at an
accelerated pace. As discussed in the June 2015 and December 2016
Reports to the Board , the CCEOP :
(a) Safeguards the potency of vaccine stocks , thereby mitigat ing risk s to
the ~US$ 1 billion investment in vaccines that the Alliance mak es each
year 1.

1 A refrigerator supported by the CCEOP can have a lifetime cost of between US$ 4,000 and
US$ 10,000 and it could be storing on the order of US$ 180,000 worth of vaccines over its lifetime.
SUBJECT : CONSENT AGENDA: REVIEW OF COLD CHAIN
EQUIPMENT OPTIMISATION PLA TFORM
Agenda item: 02f
Category: For Decision
Report to the Board
14 -15 June 2017

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Board -2017 -Mtg -1-Doc 02g

Section A: Introduction
? This report proposes changes to the Programme Funding Policy to further
simplify and streamline processes.
? The Audit and Finance Committee (?AFC?) recommends that the Board
approves these changes.
Section B: Programme Funding Policy revision
1. How programme funding is a pproved
1.1 The Gavi Board established the Programme Funding Policy in 2010, to
ensure the prudent management of Gavi resources and commitments. In
2012, the Board modified the Policy to include a Programme Funding
Envelope mechanism to streamline and accelera te funding decisions at
country level. This delegates to the Secretariat the authority to allot funding
? up to a particular total monetary limi t (?E nvelope?) ? to individual country
programmes, following the approval processes established by the Board. 1
1.2 The Envelope mechanism has yielded significant acceleration and
efficiency as country -specific funding decisions are now made on a
continuous basis, instead of awaiting meetings of the Executive Committee
or the Board.
1.3 Since 2012, the Board has progressiv ely increased the scope of the
Envelope mechanism as a result of the satisfact ory experience of its
functioning , efficiency and effectiveness . In December 2016, the Board
extended the scope further, expanding the mechanism to all 2 programme
funding allotme nts to individual country programmes. This means that the
mechanism now applies to all components of programme expenditure
included in the Financial Forecast, removing the need to establish a


1 The Board continues to decide on the overall programmes that Gavi will support, by approving
the Vaccine Introduction Strategy, eligibility policy and other specific policies such as the Measles -
Rubella strategy, Stockpiles strategy, etc. 2 Country -specific funding allotments encompass those for Vaccines, HSIS, and CCEOP. Funding
is allotted at the time of initial approval and upon subsequent extension of each country -specific
programme.
SUBJECT : PROGRAMME FUNDING POLICY REVISION
Agenda item: 02g
Category: For Decision
Report to the Board
14 -15 June 2017

Board -2017 -Mtg -1-Doc 03 1
Report to the Board
14 -15 June 2017

Section A: Introduction
? Th is update has been developed at the request of the Board to provide
regular and systematic, data driven, reporting on progress made against
implementing Gavi?s strategy. The first update was shared with the Board
in December of last year. This edition builds on the previous report and
includes updated dashboards with r esults from the first year of
implementing the 2016 -2020 Strategy . Coverage data for 2016 is still not
available and will be updated after WHO -UNICEF estimates are released in
July . Therefore, a number of indicators have not changed since the last
report. Discussions are underway among Alliance partners on how to
improve the generation, reporting and use of coverage data.
? The Alliance Accountability Framework, which informs this update, is a new,
ambitio us, approach to measure progress and increase accountability in the
Alliance. As we monitor progress of delivering the 2016 -2020 Strategy, w e
are learn ing more about the utility and relevance of indicators and the
availability of data . Going forward, we plan to review this and potentially
refine some indicators , based on lessons learned . At the recent Programme
and Policy Committee (PPC) meeting , members suggested that areas for
simplification and streamlining be explored, whilst maintaining rich and
detail ed reporting. Areas of learning are highlighted throughout the report
and feedback is sought on h ow this report could be made more useful for
the Board.
Section B: 2016 -2020 Strategy : Implementation and progress
Progress against Gavi?s mission aspiration
Discusses Mission Progress Indicators and Disease Dashboard Indicators


SUBJECT : 2016 -2020 S TRATEGY: IMPLEMENTATION AND
PROGRESS
Agenda item: 03
Category: For Information 2016?2020 INDICATORS MISSION PROGRESS
2015 2017201820192020
TARGETS
2016
Children immunised 300 million > 65 million 1
Future deaths av erted 5-6 million > 1.2 million 2
Under-fiv e mortality rate 58 per 1,00010% reduction in rate from 2015 baseline by 2020 Future disability -ad justed life years (DALYs) av erted 250 million > 56 million 4
Vaccines sustained after Gav i support ends 100% 100% 5
Projected on track, based on assumed continued improvement over last report (latest available data shown ) 2015 2017201820192020 2016 On track, based on data available year to date

1



Board -2017 -Mtg -1-Doc 04
Report to the Board
14 -15 June 2017


7 June 2017
Dear Board members ,
We are 18 months into the 2016 -20 20 strategy and our focus is on implementing,
learning and adjusting our approach to support countries to achieve our
ambitious coverage , equity and sustainability goals . The agenda at this meeting
reflects that with few er major decisions and more of a focus on reviewing
progress and lessons learned, and adapting where needed . We will be
reflecting on implementation of the Partners? Engagement Framework (PEF) ,
progress and challenges in country programmes including the lessons we can
draw from Pakistan?s recent experience , aligning on updates to our risk appetite
statement and discussing an extension to our support for inactivated polio
vaccine (IPV) given programmatic developments.
Following positive feedback at the last Board meeting, the Update on Gavi?s
2016 -2020 Strategy, Indicator s and KPIs is now a standing item on the Board
agenda. It provides a systematic overview of key areas of progress and
challenges as we implement our strategy (the end of year report will be more
complete as it will include updated coverage data , which the World Health
Organization ( WHO ) and UNICEF publish in July). The Board also discussed at
our last meeting the desir e for more strategic discussion of higher -le vel
and longer -term issues . I have sought to use this report to frame two issues
that I think are particularly timely: our initial thinking on how we might engage
differently with countries during and after transition (in follow -up to the April Board
Retreat) and how we balance risks and country ownership given our growing
understanding of weaknesses in some countries? systems . The report also
provides an update on key developments in the global landscape, reports back
on previous Board decisions which are not otherwise addressed in the Board
agenda , and provides an update on the Alliance?s performance and operations. I
will expand on some of these issues in my presentation at the meeting.
In response to Board requests, we have continued to make Board papers
more concise and strategic and have rolled out the BoardEff ect platform to
facilitate easier access to materials. We ar e organising technical briefings for
Board members on the day before the meeting to allow for more informal
presentation and discussion of issues that are relevant to the Board but not on
Report of the Chief Executive Officer

1



Board -2017 -Mtg -1-Doc 05

Section A: Introduction
? This report requests the Gavi Alliance Board ("Board") that it approve a fee
budget for vaccines and c old chain equipment procurement functions to be
performed by UNICEF in 2018 .
? It also informs the Board of a ctual expenditure and resources for 2016 and
the upda ted outlook for 2017 . The overall Financial Forecast for 2016 -20
that was reviewed by the Board in December 2016, will be updated and
presented to the Board in November 2017.
Section B: Budget for 2018 procurement fees; update on resources and
expe nditure
Budget request for 2018 procurement fees
1.1 Procurement activities are governed by a MoU between Gavi and UNICEF
(signed in 2016) covering the period 2016 -2020. UNICEF has provided an
early indication of procurement fees for 2018 and an overview of what the se
fees relate to (see Appendix 2). The Board is requested to now approve a
budget for UNICEF for 2018 procurement fees for vaccines and cold chain
equipment now , because 2018 procurement ac tivity will commence in Q4
2017, before the November 2017 Board meeting.
1.2 The current MoU sets out the procurement fees for 2016 and 2017 for both
vaccine and cold chain equipment. Fees for procurement of vaccines are
based on volume estimates and a retrospective fee adjustment mechanism
as set out in the MoU. UN ICEF is requesting a 2018 vaccine procurement
fee of US$ 19.0 million , which is US$ 0.6 million less than for 2017 . The
Secretariat considers this fee request reasonable.
1.3 For procurement of cold chain equipment , UNICEF is requesting approval
of a procureme nt fee of US$ 2.4 million in 2018 . An increase to this amount
may be requested in November 2017 based on updated demand estimates
at that time , informed by projected country applications and approvals in the
interim. UNICEF notes that these preliminary est imates may require
discussion of an upwards adjustment to as much as US $ 4.6 m illion .

SUBJECT : FINANCIAL UPDATE
Agenda item: 05
Category: For Decision
Report to the Board
14 -15 June 2017

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Board -2017 -Mtg -1-Doc 06

Section A: Overview
The purpose o f this report is to inform the Board o n the progress of implementation
of the Partners? Engagement Framework (PEF).

The PEF seeks to leverage the comparative strengths of Alliance partners to boost
immunisation outcomes in countries. US$ 132 1 million was provided to partner s
towards this purpose in 2016 . 84 % of th ese resources are allocated to WHO and
UNICEF. Additionally, the World Bank, Centr es for Disease Control and Prevention
(CDC) and 15 expanded partners including JSI, AMP, CHAI, Aspen Institute and
Civil Society Orga nisations (CSOs ) are engaged in providing technical assistance
and support to countries to improve coverage, equity and sustainability of
immunisation.

Introduced in pursuit of Gavi?s new strategic vision for 2016 -2020, PEF ushers in
a new way of plannin g, funding, operationalising and monitoring technical
assistance provided by partners. With its new country -centric approach and
emphasis on transparency and accountability, PEF is triggering Alliance -wide
changes in mindsets, behaviours, incentives, proce sses and structures.

There is improved communication between the Gavi Secretariat and partners,
better clarity and appreciation of each other?s roles and joint efforts to understand
challenges and devise solutions/strategic approaches. A strong country lens is
being applied to planning and oversight activities at regional and global level
recognising that country level outcomes are pivotal to success.

The new way of working together is permeating all critical Alliance processes and
forums including Joint Appraisals (JAs), the High Level Review Panel (HLRP),
Regional Working Groups (RWGs) and is now paving the way for the Country
Engagement Framework (CEF) .
Section B: Progress Update
There are three key mechanisms under PEF through which partners receive
funding: targeted coun try assistance, foundational support and special
investments in strategic focus areas.

1 US $ 22 million is provided to the UNICEF Supply Division as procurement fees for vaccines and
cold chain equipment
SUBJECT : PARTNERS? ENGAGEMENT FRAMEWORK
Agenda item: 06
Category: For Information
Report to the Board
14 -15 June 2017

1


Re port to the Board



Annex A: Accelerating the equitable uptake and coverage of vaccines: Update on Gavi supported Vaccine
Programmes
Anne x A: Accelerating the equitable uptake and coverage of vaccines : Update on
Gavi supported Vaccine Programmes
1. Introduction
Gavi anticipates approximately 270 1 new vaccine introductions between
2016 and 20 20, a greater number than in any previous strategic period, with
a particularly high number expected in 2018. Over 4 0% of the se
introductions will be for non -routine programmes (e.g. Supplementary
Immunisation Activ ities , catch -up campaigns) . Over this strategic period,
Gavi expects to support 152 programme types.



1 This tally assumes that introductions for routine immunisation and multi -cohort campaigns for HPV
are counted as one event for a given country. NB: based on an alternate approach, the total
number of introductions, as reported to the PPC in May 2017, is more than 300 events 2 The count of 15 includes HPV (RI and MAC), IPV, JE, MSD, Meningitis A, MR, Pneumococcal,
Rotavirus, Yellow Fever and Pentavalent (10) routine programs and HPV demo, JE campaign,
Measles SIA/follow up, Meningitis A mini -catch -up, MR campaign.

Annex E: Update on the progress achieved in the Strategic Focus Areas

Annex B: Increase effectiveness and efficiency of immunisation delivery as an
integrated part of strengthened health systems: Update on Health Systems
Strengthening efforts
The Secretariat is undertaking several streams of work related to the HSIS portfolio,
including the Country Engagement Framework (CEF , see Doc 03b to May 2017 PPC )
and CCEOP ( see Doc 02f ). The information below provides an update on HSS grant
financia l disbursements and new approvals, as well as recent analyses conducted on
HSS intermediate results. The HSS results reported in 2016, for 2015 implementation,
are noteworthy as they represent the first year of reporting through the grant
performance frame work, allowing the Alliance to better look across the HSS portfolio
at performance by grant category or region, view alignment between programmatic
and financial reporting, and better inform decision making and country specific
recommendations during the J A and HLRP.
1. HSS Portfolio
1.1 Total HSS approvals equal US $ 1.33 billion (2007 -2017), of which
US$ 1.06 billion have been disbursed (80%) by February 2017.
1.2 As of February 2017, 34 countries have an HSS or PBF approval for 2016 or
earlier that is pending disbursement ( For additional details on balancing risk
assurances with timely and predictable HSS disbursements, please see
Alliance update on Country Programmes ). Two countries, Kenya and Zambia,
have recently requested Gavi to disburse HSS funds directly to CSOs. To
accommodate these requests and manage fiduciary risk, the Secretariat is
developing appropriate mechanisms and tripartite agreements with each
government and the CSOs, and will monitor these type of demands and their
implications to revert to the PPC and Board as appropriate.
1.3 Since the last PPC update, the November IRC recommended four HSS grants
for approval (Burkina Faso, Cote d?Ivoire, Mauritania, and Somalia). The IRC
noted the continued alignment of HSS grants to National Health Plans and
improved engagement of the Ministry of Health and health partners in the
country dialogue, highlighting this as a positive result of the Joint Appraisal
process and strengthened relationships in country. The IRC provided
suggestions to further strengthen s ynergies between HSS and CCEOP
proposals and recommended identifying locally relevant and innovative
solutions for building capacity and sustainability of health systems, especially
for countries approaching transition.
2. Using grant performance results to i nform decision making
2.1 In 2016, the Gavi Secretariat focused on introducing and setting up grant
performance frameworks as well as on encouraging programmatic reporting
compliance with countries. Reporting compliance has been high, with 80% of

Annex C: Improve sustainability of national immunisation programmes: Update on Co -financing Performance

Annex C: Improve sustainability of national immunisation programmes: Update on
Co -financing Performance
1.1 In terms of co -financing performance, 2016 has been the best year since the
beginning of the previous strategic period. Of the 63 1 countries that were
required to fulfil their co -financing requirements by the end of the 2016 calendar
year, 58 fulfilled their co -financing requirements on time, which is the highest
share since 2011 (92%, see graph 1) despite country obligations having
increased five -fold. Only five countries defaulted on their 2016 obligations
(DRC, Ghana, Madagascar, South Sudan and Niger), and one will request an
extension of the waiver granted by the Board for its 2015 co -financing
requirements (Yemen). 2 Two of the countries in default (DRC and Madagascar)
already resolved their arrears.
Graph 1 ? Country co -financing performance

1.2 In 2016, countries financed or co -financed 184 vaccine programmes that were
introduced with Gavi support, which is an 11% increase from 2015 3. The total
amount co -financed on time also increased by 25% from US$ 88 million by the
end of 2015, to US$ 110 million by December 2016. In addition, 14 countries
fully self -financed approximately US$ 20 million in 21 vaccine programmes
which were originally introduce d with Gavi support. This means that 15% of all
1 The figure excludes Yemen which is requesting an extension of the co -financing waiver. 2 Originally also South Sudan was expected to continue the extension of the co -financing waiver but
the country committed to fulfill its obligations. 3 It includes the vaccine programmes in Yemen.

1


Report to the Board
Annex D : Update on specific countries
Appendi x D: Update on specific countries (DRC , India, Nigeria, Pakistan and
Syria)
1. Introduction
As requested by the PPC this Annex provides a detailed overview of in -
country operations, strategic issues and challenges encountered in four of
the most complex Gavi eligible countries, DRC, India, Nigeria and Pakistan.
It also provides a short update on the 2016 December Gavi Board approved
time -limited support to Syria . A portfolio overview of performance against
key issues of the PEF 10 countries is provided in the Country Programmes
update to the PPC and Annex E to the Country Programmes update
provide s country summary sheets for these 10 countries.
2. Democratic Republic of Congo (DRC)
2.1 Context

a) The political and security situation in DRC remains uncertain ahead of
elections expected to take place before the end of 2017 and this may
have an impact on the EPI programme.

b) The security situation in Kasai provinces has also worsened. More
than 400 people have been killed, including 2 UN staff in March 2017
and more than 200,000 have been displaced since August 2016.
c) Macroeconomic situation
? In December 2016 DRC's Central Bank announced a reduction in
the country's 2016 GDP growth from 4.3% to 2.5%, and down from
9.5% and 6.9% in 2014 and 2015 respectively, in part due a sharp
decline in global commodity prices.
? As a result, DRC's fiscal space remains constrai ned. The 2016
national budget has been revised and decreased by 22% in May
2016 (from ?7,86 billion to ?6,13 billion) and the 2017 budget
proposes a further 15% cut, with the health budget being reduced
from 9.3% to 6.8% of the total budget. This budget ha s not been
approved (an interim budget has been approved until April 2017).
2.2 Ebola Outbreak
a) As of 14 May 2017, 19 cases have been notified and 3 deaths have
been registered in the Bas Uele province. Of these 2 Zaire -type Ebola
cases have been confirmed by t he national laboratory INRB. A
response plan has been approved by local authorities. At this stage
this does not include plans for using a vaccine to respon d to the
outbreak and there has been no formal request from the DRC
government for rVSV -ZEBOV vaccin e (300,000 doses available) or for

Report to the Board
1
Annex E : Update on the progress achieved in the Strategic Focus Areas

Annex E: Update on the progress achieved in the Strategic Focus Areas
In 2015, six Strategic Focus Areas (SFAs) were identified where cross -cutting
strategies might be able to deliver transformational impact and lead to improved
coverage and more equitable immunisation systems (a new Gavi Engagement
Framework for implementing the 2016 -2020 Strategy, June 2015 Board ). These
included supply chain ; data; demand generation; leadership, mana gement and
coordination; political will; and sustainability. The below provides updates on the
progress achieved to date (note that the supply chain update is addressed in the
strategy progress update ).

1. Data
1.1 2016 was the first year of implementing the Data SFA , in which the Alliance
detailed its approach to supporting country data strengthening and Special
Investments at global / regional levels . The Data Strategy is articulated around
three priority areas: Immunisation D elivery, Coverage and Equity (DCE);
Vaccine Safety (Safety) and Vaccine Preventable Disease (VPD) Surveillance .
Building upon the early learning from 2016, 2017 PEF Special Investments in
data will focus on PEF priority countries, incorporate new ways to s upport
country planning and implementation of data strengthening activities, and drive
the ?use? of data. These investments will deliver a complementary series of
guidance documents, tools and methodologies across DCE, Safety and VPD
Surveillance as well a s key capacity building activities in the AFRO region.
Specific updates on Special Investments in the three priority areas are detailed
below.
1.2 In addition to direct investments through PEF, the Data SFA has also had key
achievements in other areas such as through ensuring Data related guidance
is included in Gavi guidelines on PEF, HSS and New Vaccine Support (N VS )
and JAs a s well as enhanced monitoring of country implementation of data
strengthening plans. Being a broad and crosscutting area, the Data Strategy
engages individuals from multiple teams within each partner and this has been
acknowledged as a challenge. To overcome this challenge and facilitate the
Alliance?s work in Data, 2016 also saw the initi al development of a Data SFA
Results framework, a new partner collaboration framework and in 2017 a
partner coordination group will be established to better facilitate planning and
coordination of Gavi support for country data strengthening. The Results
framework and the partner coordination group will be a step change for the Data
strategy and facilitate the identification of transformational approaches for
future investments in the three priority areas .
1.3 DCE update : Early achievements in this area include: coverage estimates for
first dose of rubella and first dose of IPV available for the first time; development
of an EPI module for DHIS2 (District Health Information Software ). This year,
investments in DCE will yield a methodology for triangulation of various data

Re port to the Board

Annex F: Country Summary Sheets
Anne x F: Country Summary Sheets
1.1 The summary sheets are intended to provide a high -level systematic
snapshot of a country?s performance across a number of key thematic areas
(e.g. coverage, supply chain, data quality) . The y provide additional context
and country -specific overviews and highlight main challenges to inform PPC
and Board discussions.
1.2 Each key thematic area is assessed through a ? tra ffic light?. For the traffic
light assessment, a standardised approach has been applied t o assess
countries? p erformance using agreed -upon quantitative and qual itative
criteria. For example, to measure a country?s performance related to equity ,
the country ?s DTP3 coverage differences in wealth, ma ternal education, and
geography are used as standardised proxies to understand the main drivers
of inequities within the country. This quantitative assessment has then been
complemented with a qualitative assessmen t by the country team, building
on broader assessments and work in this area ( e.g. assessing inequities
across marginali sed groups, urban slums, etc. ).
1.3 Wherever possible and to ensure consistency, the Secretariat has used
indicators and data sources that align with the Alliance?s strategic goal
indic ators and existing, agreed -upon performance measurements (e.g.
grant performance framework target achievement, financial reporting
compliance) . Data for these indicators have been retrieved from various
routine source s, including W HO/UNICEF estimates , DHS/MICs surveys,
EVMAs, and other standardised analyses conducted by Secretariat staff.
1.4 As most thematic areas consider performance across several indicators, to
obtain the ev entual traffic light assessment , each indicator has been given
equal weight , and been validated through the qualitative assessment (where
applicable) .
1.5 In addition to provid ing a traffic light assessment for each key thematic area ,
a trend arrow is included to understand if performance in that area is
improving, declining, or stagnating . Where possible, trends are measure d
through quantitative criteria and data ( e.g. coverage) , but some areas rely
on a more qualitative assessment . For example, in a situation where health
workforce shortages are particularly compelling, this could be marked as
red. However, in view of recent efforts towards developing a health
workforce strategy, the trend may show that we are optimistic that this
situation is on a more positive trajectory.
1.6 Going forward , the Secretariat is considering refinements to the
methodology used for the development of the cross portfolio overview and
country summary sheets (e.g. additional metrics to be considered) . Based
on PPC and Board feedback, the Secretariat is evaluating ho w to provide
country specific information and a cross portfolio overview for all remaining
PEF countries , as well as a higher level summary of progress in remaining
countries.

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Board -2017 -Mtg -1-Doc 07a

Report to the Board
14-15 June 2017

Section A: Summary
This update :
o Requests the Board to decide to continue support to Yemen despite the
country?s continuing defaulter status based on a recommendation by the
Programme and Policy Committee (PPC) (see under 1 in Section B) .
o Presents two programmatic challenges that were discussed by the PPC for
further guidance from the Board :
? balancing risk assurance with the need for timely and predictable HSIS
funding, and with ensuring country ownership and sustainability of
programmes (see under 2 in Section B) .
? sustaining progress in introducing pneumococcal and rotavirus
vaccines (see under 3 in Section B) .
o provides a high level cross -portfolio overview of PEF tier 1 countries?
performance (see under 4 in Section B) for the Boa rd?s information and
feedback.
A case study presenting Pakistan?s recent progress towards improving equitable
and sustainable immunisation coverage and describing how Alliance partners have
come together to support the country in reaching more children wit h vaccines is
provided in Doc 07b .
Detailed information on the Alliance?s in -country operations, activities,
achievements and challenges is provided in Annexes A through F. The PPC also
discussed the progress made on the implementation of the Country Enga gement
Framework ( Doc 03b to the May 2017 PPC) .
Section B: Alliance Update on Country Programmes
Improving sustainability of national immunisation programmes and
continued support to Yemen
1.1 As discussed in the Strategy Progress Update, 2016 was a record year in
terms of country co -financing for Gavi -supported programmes. However ,
Yemen is an exception to this trend, ha ving not been able to co -finance due
SUBJECT : COUNTRY PROGRAMMES : STRATEGIC ISSUES
Agenda item: 07a
Category: For Decision

1



Board -2017 -Mtg -1-Doc 07b

Section A: Summary
? This case study presents Pakistan?s progress and challenges towards
improving equitable and sustainable immunisation coverage.
? One out of ten under -immunised children within Gavi -eligible countries are
living in Pakistan . Gavi has committed more resources to Pakistan than any
other country , exceeding US$ 1.16 billion .
? Pakistan is an encouraging example of the Alliance partners coming
together and leveraging their inst itutional mandate to support national and
provincial leadership to gain momentum on immunisation in a very
challenging context.
? Through strategic and sustained engagement, with annual high -level joint
Alliance missions mounted by Gavi , Alliance partners have galvanised
po litical commitment and support ed evidence -based decision -making .
? The implementation of the National Immunisation Support Project (NISP)
has created a unique and innovative partnership for routine immunisation.
The national and provincial governments of Pak istan have invested more
than US$ 370 million in their immunisation programmes, with a partial
reimbursement based on results . To support this, resources have been
brought together by the Alliance that include US$ 84 million from Gavi,
US$ 50 million from the World Bank (as a loan with a potential
US $ 25 million buy -down by Bill & Melinda Gates Foundation ) and
US$ 10 million from USAID. The NISP Performance and Results
Framework is shared by all parties and is independently validated.
? These joint interventions and investments are beginning to deliver
significant results. Independent surveys in Punjab, the province that hosts
half of the country?s population, show a 22 % increase in DTP -3 coverage
over the past two years . Administrative d ata from other provinces also
suggest coverage is increasing, though less rapidly.
? Despite this progress, significant challenges remain and continued high -
level and strategic engagement by the Alliance is critical for Pakistan to
reach every child with li fe -saving vaccines in the years to come.
SUBJECT :

CASE STUDY : A LLIANCE PARTNERS JOINING EFFORTS
TOWARDS IMPROVING EQUITABLE AND SUSTAINABLE
IMMUNISATION COVER AGE IN PAKISTAN

Agenda item: 07b
Category: For Information
Report to the Board
14 -15 June 2017

1



Board -2016 -Mtg -1-Doc 08
Report to the Board
14 -15 June 201 7

















SUBJECT: CHAIR?S REFLECTION S ON THE DAY
Agenda item: 08
No paper

1



Board -2016 -Mtg -1-Doc 09
Report to the Board
14 -15 June 201 7

















SUBJECT: CHAIR?S OVERVIEW
Agenda item: 09
No paper

1



Board -2017 -Mtg -1- Audit and Finance Committee Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the Audit
and Finance Committee (AFC ) since the Board last met in December 201 6.
? The AFC met twice (9 February and 27 April) and will also be meeting on
12 June 2017 . Subjects re viewe d in February and April are noted below
under Section B and those matters to be reviewed on 12 June are noted
under Section C.
? The AFC Chair report is attached in the form of a presentation as Annex A
and the AFC recommendations to the Board are attached a s Annex B .

Section B: Subject matters reviewed
1) Audit and financial reporting
? Discussed with KPMG their 2016 Financial Statements audit strategy and
planning ;
? On track for on -time completion of financial statements; with no significant
issues identified to date;
? Received from Secretariat its annual review of Gavi?s accounting policy
documentation including proposed updates , none of which are significant .
The report also included an overview of upcoming US GAAP changes and
potential impacts on Gavi?s financi al reporting ;
? Received an update on the 2016 audit status ;
? Provided the Secretariat with suggested enhancements to Annual Financial
Report, to be incorporated into the 2016 report ;
? Received confirmation that the Gavi Campaign was dissolved in December
201 6.
2) Financial Update
? Reviewed a financial update covering 2016 actuals and an outlook for 2017 .
In addition, the Secretariat confirmed that to the best of its knowledge the
2016 -2020 forecast completed in December 2016 is still valid ;
SUBJECT : AUDIT AND FINANCE COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
14 -15 June 2017

1



Board -2017 -Mtg -1-Evaluation Advisory Committee Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the
Evaluation Advisory Committee ( EAC ) since the Board last met in
December 201 6.
? As a follow -on to the October 2016 EAC meeting, there was a n EAC
teleconference in February 2017 to revi ew the draft Terms of Reference
(ToR s) for the second phase of the Full Country Evaluations project. The
EAC approved the ToRs and requested the Secretariat to engage with the
current FCE Consortium on the development of a proposal for the second
phase of the FCE.
? The EAC met in Geneva on the 15 -16 March 2017 where the members:
a) were updated on ongoing Gavi evaluation activities including those
related to strengthening cross -organi sation work (such as evaluation
collaborations with the Global Fund) ;
b) were updated by the Gavi Secretariat communications team on how
the evaluation work at Gavi is communicated externa lly to its various
stakeholders;
c) assessed the technical and financial proposal for the second phase
of the FCE and deferred the decision , request ing the Secretariat to
follow up with the FCE consortium to request a revised proposal ,
taking into account comments from the EAC ;
d) discussed and approved the Request for Proposal s (RFP) for the
CCEOP evaluation suggesting to include evaluation questions
regarding the market shaping component as well as to further
explore the country selection process ;
e) were presented the preliminary insights of the baseline assessment
for the Evaluation of Targeted Country Assist ance (TCA) provided
through the Partne rs? Engagement Framework (PEF) , by the
indepen dent service provider (Deloitte) ;
f) discussed and provided guidance on the T oRs for the P eer review of
Gavi?s e valuation function which aims to inform the review of the Gavi
Evaluation Policy; the review of the EAC Charter; and improve the
evaluation function within the Gavi Secretariat (and within the
broader Alliance) ; and
g) discussed and provided guidance on the criteria for prio ritisation of
Evaluation Work considering the increasing demand for evaluations
and approved the annual evaluation workplan for 2017 .

SUBJECT : EVALUATION ADVISORY COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
14 -15 June 2017

1



Board -2017 -Mtg -1-Investment Committee Report

Section A: Introduction
? This report provides the Board with an overview of the macro economic
environment and the activities of the Investment Committee since the Board
last met in December 2016 . The Investment Committee met in February
and May 2017.
? The update includes year -to -date April 2017 performance figures for the
long -term portfolio as well as the ultra -low and short duration fixed income
strategies overseen by the Investments team. Gavi uses both active a nd
passive investment managers .
? Declining unemployment and higher co nsumer spending are key signs that
the global economy continues to pick up strength in the first half of 2017.
The April World Economic Outlook report published by the IMF reported a
3.1% global growth rate in calendar year 2016. Its global growth estimat es
for 2017 and 2018 are 3.5% and 3.6% , respectively.
? While political challenges are still a factor, the Macron victory in France
sealed the outcome of a series of key electoral challenges that could have
negatively impacted market momentum and global economic growth .
Markets have shifted their focus back to corporate earning s and key
economic statistics. The current outlook for economic growth is supportive
for global equities and much is debatably priced into current valuations.
Equity performance continues to vary by region. For example, in contrast t o
2016 , European equities this year are outpacing US equities , particularly in
USD terms.
? With growing confidence in the US economy, the US Federal Reserve has
signalled another near term rate increase, likely at its June meeting. If
enacted it would be the third in a 6 -month period , and only the fourth rate
increase since the 2008 financial crisis. In addition, the Fed may also start
to reduce its balance sheet by re -investing only a portion of maturing assets
(US Treasury and mortgage -backed sec uritie s). The European Central
Bank is expected to follow suit but it is unlikely it will take similar action
before 2018.
? Another defining feature of 2017 is the weakness of the US Dollar relative
to other major currencies. The euro has been particularly strong against the
US dollar in 2017.
SUBJECT : INVESTMENT COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
14 -15 June 2017

1



Board -2017 -Mtg -1-IFFIm
Report to the Gavi Board
14 -15 June


Section A: Overview
Executive Summary
1.1 This report provides the Board with an overview of the activities of the
International Finance Facility for Immunisation (IFFIm) since the Board last
met in December 2016.
1.2 IFFIm continues to be a valuable tool for Gavi having disbursed over
US$ 2.5 billion since it was implemented in 2006 and its financial position
remains strong.
1.3 Pledge agreements for Australia, France, and the Netherlands have been
finalised in 2017. These pledge agreements now bring the total of IFFIm
commitments to US$ 6.5 billion .
1.4 Significant progress has been made in developing potential additi onal roles
for IFFIm to support Gavi?s strategic goals.
1.5 A draft presentation has been shared with donors in advance of an IFFIm
Donor s? meeting to be held on 12 June in Geneva . The presentation will be
the basis of discussion with donors, the IFFIm Board, the Gavi Secretariat
and the World Bank as to which r ole (s) to prioritise.
1.6 The proposed roles are :
(a) Vaccine scale up to utilise IFF Im?s flexible funding capabilities to
support Gavi?s VIS.
(b) Financial commitments for market shaping to secure guarantees
to support vaccine procurement for market shaping.
(c) Contingent pledges for outbreak response to be on stand -by and
activated upon occurrence of a pre -determined event, such as a
disease outbreak to enable rapid deployment of funds.
(d) Col d Chain Equipment Optimisation Platform (CCEOP) support
to provide innovative financing support for CCEOP through themed
IFFIm bonds or helping unlock other sources of capital.
1.7 Socially responsible investing (SRI) continues to grow and SRI investors
are se eking investments that will not only that provide attractive returns, but
SUBJECT : IFFIm CHAIR REPORT
Category: For Information

1



Board -2017 -Mtg -1-Programme and Policy Committee Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the
Programme and Policy Committee ( PPC ) since the Board last met in
December 201 6.
? The PPC met in Geneva on 11 -12 May 2017. During the two -day PPC
meeting, the Committee discussed a number of important topics for the
Alli ance and agreed on recommendations which are being put forward to
the Board at its June meeting for consideration.
? The PPC Chair report is attached in the form of a presentation as Annex A
and the PPC recommendations to the Board are attached as Annex B.
Annexes
Annex A: PPC Chair report
Annex B: PPC recommendations to Gavi Alliance Board
SUBJECT : PROGRAMME AND POLICY COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
14 -15 June 2017
www.gavi.orgPROGRAMME AND POLICY
COMMITTEE CHAIR REPORT
Reach every childBOARD MEETING
Richard Sezibera
14 - 15 June 2017, Geneva, Switzerland
Annex A

Annex A ? Updated Risk Appetite Statement

Introduction

Every orga nisation needs to take risk to achieve their objectives and sometimes the greatest risk is
inaction . Effective risk management optimises potential outcomes by balancing risk versus reward and
the cost of mitigation versus the potential benefit this brings . Gavi?s Risk Appe tite Statement defines on
a broad level the amount of risk the Alliance is willing to take, accept , or tolerate to achieve its goals.
Risk appetite is defined at the mission, organisation and strategy level on a five -point scale between
low and high. A high risk appetite represents a willingness to be exposed to a high likelihood and / or
potential impact of a risk . Having a high appetit e for a risk does not mean actual occurrence of the risk
is desirable or the event should be tolerated once it actually occurs .

The purpose of this Board -approved statement is to align stakeholders across the Alliance and guide
decision -makers in taking the right amount of the right type of risks to deliver on Gavi?s mission . It aims
to encourage staff and stakeholders to be risk -aware and to feel comfortable to take agreed and
calculated risks whe re appropriate , to recognis e and plan for the possibility of failure, and to learn from
both positive and negative results.

Risk appetite at the mission and organisation level

The Vaccine Alliance embraces the need to take risk given its ambitious mission to rapidly improve
coverage and equity of immunisation and build sustainable systems in the world?s poorest countries ,
and given its operating model as an Alliance of many partners with a lean Secretariat without in -country
presence. The Alliance is in gen eral willing to accept risk s in pursuing its goals , w hile ensuring effective
processes and systems are in place to pro -actively identify, manage and monitor those risks guided by
the Board -approved risk appetite .

The Alliance has overall a low er appetite for organisational risks that could impede its ability to deliver
on the mission. It seeks to maintain a low level of risk related to the quality and robustness of Secretariat
processes, systems and management . Similarly, the appetite for risks associated with the processes,
systems and management of Alliance partners is moderately low, while recognising that the Gavi
Secretariat has less ability to directly influence this. The Alliance recognises that it is exp osed to higher
risks associated with weak management and controls at country level and has a moderately high
appetite for the risk that these weaknesses may hinder achievement of its goals , working actively to
reduce risk exposure over time . However, given its obligation to be an effective steward of donors?
resources , Gavi has a low appetite for risks related to fiduciary oversight and control while recognising
the risks inherent to its model of channelling support through country systems where these are
sufficiently robust . Gavi?s reputation is critical to its ability to deliver on the mission, and the Alliance
therefore has a low appetite for risks affecting its brand and confidence of its stakeholders .

1



Board -2017 -Mtg -1-Doc 11

Section A: Introduction
? Gavi?s Risk & Assurance R eport 1, approved by the Board in December
2016 , prioritised 15 top risks . It provided an initial view of Gavi?s inherent
exposure to each of those risks and primary mitigation strategies . T his
paper provides a high -level update on major changes in Gavi?s risk
profile since then . A new comprehensive Risk & Assurance Report will be
prepared for the November 2017 Board meeting .
? This paper also presents an updated Risk Appetite Statement (Annex A)
for approval by the Board . ?Risk appetite ? defines on a broad level the
amount of risk the Alliance is willing to accept to achieve its mission and
goals . The Audit and Finance Committee (AFC) has reviewed the updated
statement and recommended it for approval. Guidance from both the AFC
an d the Programme and Policy Committee (PPC) is summarised in this
paper and has been incorporated in the final version .
? This paper also provides an update on progress in strengthening risk
management across the Alliance .
Section B: Content
Changes in Gavi?s risk profile since Decemb er
1.1 Gavi?s last Risk & Assurance report prioritised 15 top risks (4 very high and
11 high risks) and 15 medium risks (Annex B) . Risks are dynamic in nature
(due to changing risk factors and progress in mitigation) and may emerge,
increase, decrease, or disappear. The Secretariat closely monitors these
risks for changes in exposure. No substantial new risks have emerg ed since
December 2016 . However , the following top and medium risks have be en
impacted by recent trends and events:
(a) HI GHER: Vaccine confidence (risk f 2) ? Th is risk has increased, with
growth in anti -vaccine campaigning most notably in the United States,
the European Union and India. Campaigners are explicitly seeking to
target other countries in Europe and elsewhere. While policymakers

1 http://www.gavi.org/about/governance/gavi -board/minutes/2016/7 -dec/minutes/11 --- risk -
management -update/ 2 Refers to numbering of risks in Risk & Assurance report (see Annex B).
SUBJECT : REVIEW OF R ISK APPETITE STATEMENT AND RISK
MANAGEMENT UPDATE
Agenda item: 11
Category: For Decision
Report to the Board
14 -15 June 2017

1



Board -2017 -Mtg -1-Doc 12

Section A: Introduction
? This report requests a decision by the Board to extend Gavi?s support for
IPV to the end of 2020 under arrangements agreed by the Board in
November 2013, and subject to sufficient polio -specific funding being made
available . The Programme and Policy Committee ( PPC ) su pported this
proposal at its meeting in May 2017 and requested that Gavi?s longer -term
role in supporting IPV (beyond 2020) be considered as part of the upcoming
Vaccine Investment Strategy (VIS) . This paper is the product of close
collaboration between th e Gavi Secretariat and GPEI.
Section B: Gavi?s Potential Engagment In IPV Post -2018
1.1 In November 2013 the Board decided to support the introduction of
inactivated poliovirus vaccine (IPV) in all 73 Gavi -supported countries as
pa rt of the polio eradication ?E ndgame ? strategy . The Board approved
support until the end of 2018 , which was the projected date of global
certification of polio eradication at the time of the Board decision . Subject to
polio -specific additional funding being available beyo nd 2018, support
would continue until the Endgame target for stopping vaccination of 2024 ,
or an appropriate exit strategy for Gavi had been identified . Three donors to
GPEI (BMGF, UK, Norway) provided US$ 405 million to fund IPV
introduction up to end -2018 1.
1.2 The Board approved a series of policy exceptions to allow for the
unprecedented introduction timeline and other aspects of IPV support that
were different to Gavi? s regular vaccine support . These included waivers to
the policies on country co -financing and country eligibility . The Board
decided that the se policy exceptions would be reviewed in 2018.
1.3 Applications from all 70 IPV -eligible countries were received and approved
for Gavi support within 12 months of the Board decision 2. However, there
have been two significant developments since the n:

1 This is less than the original funding of US$ 430 million due to exchange rate fluctuations (current
funding estimate converted at 28 Feb 2017 FX rate, from GBP (DFID), NOK (Norway) and US$
(BMGF)). 2 India was funded separately , with GPEI providing US$ 3 0.6 million through Gavi for one year of
catalytic vaccine support ending in 2016; Ukraine had introduced IPV in 2006, and Georgia opted
for a combination vaccine not supported by the Alliance.
SUBJECT : GAVI?S POTENTIAL ENGAG EMENT IN IPV POST 2018
Agenda item: 12
Category: For Decision
Report to the Board
14 -15 June 2017

Board -2017 -Mtg -1-Doc 13

Section A: Introduction
? The Managing Director Audit and Investigations is required to report to the
Board at least annually (reports are otherwise made to the Audit and
Finance Committee (?AFC?) on matters arising, typically five times per year,
and ad hoc as required) . This report update s the Board o n the results of the
Audit and Investigations (? A&I ?) activity (summarised in Annex A ) since the
last Board report of June 2016 and is a high level summary of matters
reported to the AFC .
? The Board approved the reconstitution of the audit function from a single
person Internal Audit activity in December 2014 (as part of Gavi?s
enhancement of its risk management activities incorporating the three lines
of defence model, a commonly used configuration of risk management ). A&I
comprises the third line of defen ce being independent of the operational
activities of the first two lines, and re ports to the Board, which is effected
through routine reporting to the A FC , and the Chief Executive Officer. Audit s
are conducted against annual plans approved by the AFC, dra wn from a
risk -based assessment of priority .
? The A&I function was established in February 2015 with a 13 person
authorised headcount. The B oa rd approved the function?s charter of
operation (?Audit and Investigations Terms of Reference? , ToR ), reflecting
th is reconstitution, in December 2015. The A&I function comprises four
main activities:
o Internal Audit which is an independent and objective assurance and
consulting activity to evaluate and improve the effectiveness of the
organisation's risk management, co ntrol, and governance processes .
o Programme Audit which conducts audits of programmes in -country to
assess whether Gavi support, including cash, vaccines and related
supplies, have been used as intended to provide value -for -money,
considering both financial and programmatic aspects.
o Investigations and Counter -Fraud which conducts an evidence -based
examination of possible misuse and other misconduct within Gavi, in
Gavi -supported programmes in -country, or which otherwise impact
upon the organisation. It condu cts preventive activities to minimise the
risk of such conduct occurring and/or impacting the organisation.
SUBJECT : REPORT FROM AUDIT AND INVESTIGATIONS
Agenda item: 13
Category: For Information
Report to the Board
14 -15 June 2017

1



Board -2017 -Mtg -1-Doc 14

Section A: Introduction
? This report provides the Gavi Board with an update on fundraising efforts in
the midst of significant geopolitical changes. It highlights (i) the status of
conversion and payment of the Berlin pledges, and (ii) the efforts being
deployed to broaden both sovereign and private s ector partners .
Section B: Status of fundraising efforts
Securing Berlin outcomes
1.1 Two years following the Berlin pledging conference, grants representing
86 % of the total cash value of pledges announced in Berlin have been
signed (see Figure 1) . All lon g-term pledges including new IFFIm grants
have now been secured. In total, 50 agreements have been signed , which
has involved complex negotiations with various multilateral, bilateral and
innovative finance sources and a variety of development agencies wit h
different requirements and procedures. The remaining pledges are annual
and will need to be signed year -by -year in line with countries ? annual budget
cycle s.
1.2 With elections in donor countries representing nearly two thirds of Gavi
support taking place i n late 2016 and 2017 , these results have required
deepened bi -partisan engagement, continuing advocacy and civil society
dialogue and early engagement with newly -elected governments. In the
midst of shifting global development priorities , competing needs ( e.g.
humanitarian crises and national security) and an increasingly divergent
worldview among donors, it has been particularly important to highlight
Gavi?s flexible, impactful and innovative model and reinforce the link
between immunisation, development and economic growth.



SUBJECT : RESOURCE MOBILISATION UPDATE
Agenda item: 14
Category: For Information
Report to the Board
14 -15 June 2017

1



Board -2016 -Mtg -1-Doc 15
Report to the Board
14 -15 June 201 7

















SUBJECT: REVIEW OF DECISIONS
Agenda item: 15
No paper

1



Board -2016 -Mtg -1-Doc 16
Report to the Board
14 -15 June 201 7

















SUBJECT: CLOSING REMARKS AND R EVIEW OF BOARD
WORKPLAN
Agenda item: 16
No paper

Board -2017 -Mtg -01 1
Minutes



Gavi Alliance Board Meeting
14 -15 June 2017
Intercontinental Hotel, Geneva, Switzerland


1. Chair?s report

1.1 Finding a quorum of members present, the meeting commenced at 09.0 9 local
time on 14 June 2017 . Ngozi Okonjo -Iweala , Board Chair , chaired the meeting .

1.2 The Chair welcomed new Board member s and Alternate Board member s, as well
as Rob Moodie, Chair of the Ev aluation Advisory Committee , and member s of the
IFFIm Board. She noted that departing members would be recognised for their
service at the dinner that evening.

1.3 The Board met in closed session on the evening of 13 June to discu ss a number
of items including Board Leadership, the Geneva Health Campus and a Gavi HR
update .

1.4 Standing declarations of interest were tabled to the Board (Doc 01a in the Board
pack). The Chair noted that in the context of the items for decision on the agenda ,
there were a nu mber of Board member s who would have conflicts of interest and
that these would be raised at the appropriate time and recorded in the applicable
parts of the minutes.

1.5 The Board noted its minutes from 7-8 December 2016 (Doc 01b), which were
approved by no objection on 24 February 2017 . The Board also noted its action
sheet (Doc 01d) and workplan (Doc 01 e) and the Chair encouraged Board
members to contribute to the forward plan by raising issues which they may wish
to add either with her directly or with the Secretariat .

1.6 The Chair noted that while there has been an improvement in the quality and
volume of the papers that are being shared with the Board , she feels that there is
still room to further reduce the volume and perhaps have more summary
documents and she encouraged the Secretariat to continue to work on this.

1.7 The Chair informed Board members that the Executive Committee had not met
since the la st Board meeting , and noted that the Board had approved a decision
by unanimous consent, as outlined in Doc 01c .

1.8 Finally, the Chair shared some thoughts with the Board in relation to the current
global environment and the potential impact on the global development agenda.
In such a context it will be necessary for the Alliance to reflect on the way we do
our work wit h countries, focus on the efficiencies we can get and keep our nose to
the grindstone. She thanked new donors from the Middle East and other areas
who have become recent supporters of Gavi .

www.gavi.org
UPDATE FROM THE
SECRETARIAT, INCLUDING
2016 -2020 STRATEGY,
INDICATORS AND KPIs
GAVI BOARD MEETING
Seth Berkley
14 June 2017, Geneva
Second update on the 2016 ? 2020 strategy
? Systematic, data -driven report on progress
? Based on new, ambitious framework
? Starting to bear fruit and strengthen our understanding
? Learning what works well and where we should revisit
Lessons on indicators discussed throughout
2 Board meeting
14 -15 June 2017

www.gavi.org
CEO Board update
Seth Berkley, MD
14 June 2017, Geneva
Key developments Previous Board decisions Strategic questions for discussion Update on the Alliance Board agenda
Sections
1. Key developments in the global landscape
2. Reporting back on previous Board decisions
3. Strategic questions for discussion
4. Alliance update
5. Board agenda
Key developments
Board meeting
14 -15 June 2017

Gavi

Gavi

Gavi

Gavi

1



Board -2017 -Mtg -1- Audit and Finance Committee Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the Audit
and Finance Committee (AFC ) since the Board last met in December 201 6.
? The AFC met twice (9 February and 27 April) and will also be meeting on
12 June 2017 . Subjects re viewe d in February and April are noted below
under Section B and those matters to be reviewed on 12 June are noted
under Section C.
? The AFC Chair report is attached in the form of a presentation as Annex A
and the AFC recommendations to the Board are attached a s Annex B .

Section B: Subject matters reviewed
1) Audit and financial reporting
? Discussed with KPMG their 2016 Financial Statements audit strategy and
planning ;
? On track for on -time completion of financial statements; with no significant
issues identified to date;
? Received from Secretariat its annual review of Gavi?s accounting policy
documentation including proposed updates , none of which are significant .
The report also included an overview of upcoming US GAAP changes and
potential impacts on Gavi?s financi al reporting ;
? Received an update on the 2016 audit status ;
? Provided the Secretariat with suggested enhancements to Annual Financial
Report, to be incorporated into the 2016 report ;
? Received confirmation that the Gavi Campaign was dissolved in December
201 6.
2) Financial Update
? Reviewed a financial update covering 2016 actuals and an outlook for 2017 .
In addition, the Secretariat confirmed that to the best of its knowledge the
2016 -2020 forecast completed in December 2016 is still valid ;
SUBJECT : AUDIT AND FINANCE COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
14 -15 June 2017

Gavi

IFFIm CHAIR REPORT
The International Finance Facility for Immunisation
Gavi Board Meeting
Ren? Karsenti, Chair IFFIm Board of Directors
14 -15 June , Geneva, Switzerland
1. Overview
2. Operational update
3. Strategic initiatives
4. Inspiring others
2

1



Board -2017 -Mtg -1-Programme and Policy Committee Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the
Programme and Policy Committee ( PPC ) since the Board last met in
December 201 6.
? The PPC met in Geneva on 11 -12 May 2017. During the two -day PPC
meeting, the Committee discussed a number of important topics for the
Alli ance and agreed on recommendations which are being put forward to
the Board at its June meeting for consideration.
? The PPC Chair report is attached in the form of a presentation as Annex A
and the PPC recommendations to the Board are attached as Annex B.
Annexes
Annex A: PPC Chair report
Annex B: PPC recommendations to Gavi Alliance Board
SUBJECT : PROGRAMME AND POLICY COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
14 -15 June 2017
www.gavi.orgPROGRAMME AND POLICY
COMMITTEE CHAIR REPORT
Reach every childBOARD MEETING
Richard Sezibera
14 - 15 June 2017, Geneva, Switzerland
Annex A

Gavi

Gavi

Gavi

Gavi