Board -201 7-Mtg -3-Doc 00 a



G avi Alliance Board Meeting
29 -30 November 2017
Crowne Plaza Hotel, Vientiane , Lao PDR

Monday 27 and Tuesday 28 November : Pre -Board meetings & Field Visits
Wednesday 29 November : 0 9.00 -18.00 (Board meeting Day One)
Thursday 30 November : 09.00 -17.30 (Board meeting Day Two)
Quorum: 14

Document list

No. Document
00a Document list
00b Agenda
01a Declarations of interest
01b Minutes from 14 -15 June 201 7
01c Minutes from 7 July 2017
01d No -Objection Consent Decisions
01 e Action Sheet
01 f Work plan
02 a Consent agenda: Board/Committee member appointments (To follow)
02 b Consent agenda: Committee chair appointments
02c Consent agenda: Changes to Gavi By -Laws (To follow)
02d Consent agenda: Changes to Committee Charters (To follow)
02e Consen t agenda: Application Review P rocess
02f Consent agenda: Continuation of support to South Sudan
03 Country Presentation - Lao PDR ? No paper
04 a 2016 -2020 Strategy: Implementation and progress
04b CEO?s report (To follow)
05 Financial update , includi ng Forecast
06 Risk & Assurance Report
07 Partners? Engagement Framework and Secretariat and Partners Budget 2018 -2019
08 Typhoid conjugate vaccine support window
09 Chair?s reflections on the day ? No paper
10 Chair?s overview ? No paper
11 Comm ittee Chair and IFFIm Board reports (To follow)

Board -2017 -Mtg -3-Doc 00b




G avi Alliance Board Meeting
29 -30 Nov ember 2017
Crowne Plaza Hotel, Vientiane , Lao PDR

Monday 27 and Tuesday 28 Nov ember : Pre -Board meetings & Field Visits
Wednesday 29 Nov ember : 09.00 -18. 00 (Board meeting Day One)
Thursday 30 Nov ember : 0 9.00 -17.30 (Board meeting Day Two)
Quorum: 14


Agenda


Pre -Board Meetings ? Monday, 27 Nov ember 201 7
Item Subject Room Schedule

? Governance Committee meeting Hor Pha Keo 14.00-17.00
? Audit and Finance Committee meeting Simuang 16 .00-18.00
? Special Advis ers meeting Mekong 14.00-18.00
? Gavi -World Bank collaboration for sustainable
transitions: The case of Lao PDR
Xeingkhuan 17.00 -18.30
? Gavi Donors? meeting Xeingkhuan 19.30 -21.30


Field Visits & Pre -Board Meetings ? Tuesday , 28 Nov ember 201 7
Item Subjec t Room Schedule

? Field Visits 07 .00 -13.00
Lunch Mosaic 12.00 -14.00
? Developing Countries Board members meeting Lane Xang 1 -2 13.30 -14.45
? All Chairs Group meeting Simuang 13.30 -14.45
? Board Meeting: Closed session for Board members and
Altern ate Board members
Lane Xang 1 -2 15.00-18 .00

Welcome Event hosted by Lao PDR Lane Xang 3 19.00

Board -201 7-Mtg -3-Doc 01 a



Gavi Alliance Board Meeting
29 -30 November 201 7
Crowne Plaza Hotel, Vientiane, Lao PDR

Quorum: 14
Declarations of Interest

Declarations
Section 5.2 of the Conflict of Interest Policy states, ?Annually, each member of the Board
(including al ternate 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 annua l
statements:
Board members:
Member Org anisational Interest s

Financial/Personal/Advisor Int /
Others
Ngozi Okonjo -Iweala , Chair None Gavi -appointed special adviser
Gunilla Carlsson , Vice
Chair None
Geneva Center Security Policy
(Associate Fellow)
Africa n Development Band
(Special Advisor)
NGS Group AB (Board)
Boxholms Sk rgar AB (Board)
Kolmarden Charity (Board Chair)
Tundra (Board)
Gavi -appointed special adviser
Peggy Hamburg None
Joint Coordinating Group (Chair)
Coalition for Epidemic Innovations
(CEPI) (Board)
Yifei Li None
Man Gr oup (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 (Boar d)
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 -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 .

Board -2017 -Mtg -02 1
Minutes




Gavi Alliance Board Meeting
7 July 2017
Teleconference


1. Welcome and confirmation of participation

1.1 Finding a quorum of members present, the meeting commenced at 14.08 Geneva
time on 7 July 2017 . Ms Gunilla Carlsson, Board Vice Chair, chaired the meeting
for Agenda Item 2, and Dr Ngozi Okonjo -Iweala , Board Chair , chaired the meeting
when she joined for Agenda Item 3 .

------

2. Proposed Reappointment of Board Chair

2.1 Ms Carlsson invited Dr Flavia Bustreo, former Board Vice Chair and Chair of the
Governance Committee , to introduce this item as she had been tasked by the
Board to lead the reappointment process.

2.2 Dr Bustreo recalled the process which had been put in place at the request of the
Board, noting that the Board, in closed session in Geneva in June 2017 , had
tasked the Governance Committee to consider and make a recommendation to
them by no later than early July 2017 (Doc 02) .

2. 3 Board members unanimously agreed with the recommendation being presented
to them for approval .

2.4 A Board member asked that over and above the comprehensive rational given for
the Board Chair?s reappointment in Doc 02 that it should be acknowledged that
she is a credi t to wom en leader ship globally and especially Africa .

2.4 Ms Carlsson thanked Dr Bustreo on behalf of the Board for her work in leading this
thorough process.

2.5 Dr Ngozi Okonjo -Iweala joined the call and on being informed of the Board?s
decision thank ed them for the confidence they had reposed in her through their
decision to reappoint her as Board Chair.

Decision One

The Gavi Alliance Board:

a) Reappointed Dr Ngozi Okonjo -Iweala as an Unaffiliated Board Member through to
31 December 2020; and

1



Board -2017 -Mtg -3-Doc 01d
Report to the Board
29 -30 November 201 7



Since the June 2017 Board meeting, three decision s have been circulated to the
Board electronically for approval by no -objection consent in line with Article s
2.7.3. 2 and 2.7.3.4 of the By -Laws.


1) On 13 August 2017, Board members were invited to consider approval of the
2016 Annual Financial Report .

No objections were received prior to the end of 23 August 2017 and the following
decision was therefore entered into the record :

?In accordance with article 2.7.3 .2 of the By -Laws, on a no -objection basis the Gavi
Alliance Board:

? Approved the Gavi Alliance 2016 Annual Financial Report?


2) On 21 September 2017, Board members were invited to consider approval of
the appointment of members of the Mark et -Sensitive Decisions
Committee.

No objections were received prior to the end of 3 October 2017 and the following
decision was therefore entered into the record:

?In accordance with article 2.7. 3.4 of the By -Laws, on a no -objection basis, the
Gavi Alliance Board:

Appointed the following to the Market -Sensitive Decisions Committee effective
immediately:

? Ngozi Okonjo -Iweala (Board Chair) until 31 December 2019.
? Gunilla Carlsson (Board Member) until 31 December 2018.
? Shanelle Hall (Board Member) until 31 December 2019.
? Tim Evans (Board Member) until 31 December 2019.
? Violaine Mitchell (Alternate Board Member) until 31 December 2019.
? Felix Kabange (Alternate Board Member) until 31 December 2018.
? Daniel Graymore (Board Member) until 31 December 2019.
? Jean -Francois Pactet (Board Member) until 31 December 2018.
SUBJECT: NO -OBJECTION CONSENT DECISIONS
Agenda item: 01d
Category: For information

Board -2017 -Mtg -3-Doc 01e 1




G avi Alliance Board

Action sheet as of 15 November 2017

Request Matter Responsible Action taken

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


Secretaria t
(De Chaisemartin)


See Agenda Item
7, November
2017 Board
meeting

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

See Agenda Item
15 , N ovember
2017 Board
meeting


7-8
December
2016 ? 5
Financial forecast and programme
funding envelopes :
? Board to help devise an overarching
Alliance -wide framework for
decision -making from a trade -off
perspective


Secretariat
(Greene, Khatib -
Othman &
Nguy en )


See Annex F to
Agenda Item 4,
October 2017
PPC meeting and
CEO report to
November 2017
Board meeting

7-8
December
201 6 ? 11
Risk management update :
? Risk mitigation strategies to be put in
place and analysis and definition of
individual risks to be refined

Secretariat ( Van
der Blij)

See Agenda Item
6, November
2017 Board
meeting

14 -15
June 2017
? 2
Consent Agenda:
? Governance Committee to consider
statutory provision limiting
representation on Board Committees




? Clarifications requested on Fragi lity,
emergencies and refugees policy

Secretariat
(Armstrong)





Secretariat
(Kallenberg)

Amendment to
By -laws expected
to be on Consent
Agenda for
November 2017
Board meeting

See Agenda Item
13 , November
2017 Board
meeting

BOARD WORK PLAN
Graphical format

Board -2017 -Mt g-3-Doc 01 f
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)
IRC appointments (Consent Agenda)
Appointment of Independent Auditor (Consent Agenda)
Changes to Committee Charters (Consent Agenda)
Partners' Engagement Framework
Vaccine Investment Strategy
[3 step process - (i) methodology; (ii) short list; (iii) final decision)]
IPV
Nigeria strategy
Post-transition engagement (Angola, Congo, Timor-Leste)
India strategy review
Supply Chain strategy review
Review of Gavi support to Syria
Gavi Strategy 2021-2025
Annual financial report
Chair rpt (Decl of Int, Mins, Acts, W kpl)
CEO's report and 2016-2020 Strategy: Implementation and progress
Committee chair reports
IFFIm report
Financial update (including Forecast)
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 (Including MTR)
Decision
N/A
Information
Information
Information
Discussion
Discussion
Information
Information
Discussion
Information
N/A
Information
Decision
Decision
Discussion
Discussion
Information
Information
Decision
Discussion
STANDING REPORTS AT EACH REGULAR MEETING
Guidance
Guidance
Decision
Decision
Decision
Discussion
Discussion
Discussion
Decision
Decision
Discussion
Decision
Discussion
Decision
Guidance
Discussion
Decision
Decision
Decision
28-29 Nov 2018
STANDING REPORTS ONCE PER YEAR
14-15 Mar 2018 Jan-Feb 2018 July-Aug 2018 Sept NoObj Oct 2018 6-7 June 2018 April-May 2018

1



Board -2017 -Mtg -3-Doc 02a
Report to the Board
29-30 November 2017

Section A: Summary
At its meeting on 27 November 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 submitted to the Board for
approval at its meeting on 29 -30 November 2017.
Section B: Board/Committee Member Appointments
Constituency processes for Board and Committee nominations
1.1 Nominations from all constituencies were submitted following consultative
processes within the relevant groups, as confirmed to the Secretary to the
Board.
Gende r Implications
2.1 Board -approved guidelines on the Gavi Board gender balance state that a
ratio of 60/40 male/female Board Members and Alternate Board members
should be established and maintained. This is extended to include Board
Committees as required by Article 4.2 of the By -laws.
2.2 For the purposes of this calculation, the Board Members and Alternate
Board Members are assessed as separate groups. The Board currently has
14 men (50%) and 14 women (50%). 1 1 alternates are men ( 61%) and
seven are women (39%).
2.3 The gender balance is deemed to be within the acceptable range if there is
no more than 60% of any one gender. These same principles are also
applied to the Board Committees. In order to arrive at an aggregate position
across the Board and its Committees, it is the sum of the total number of
individuals calculated as a percentage between males and females as set
out in the table in 2.4 below.
2.4 Based on the nominations received and pending Board approval, as of
1 January 2018 , the gen der balance 1 of the Board and Boar d Committees
would be as outlined in Table 1 below :
1 Shading indicates compliance with gender policy
SUBJECT : BOARD /COMMITTEE MEMBER APPOINTMENTS
Agenda item: 02 a
Category: For Decision

1



Board -2017 -Mtg -3-Doc 02b
Report to the Board
29 -30 November 201 7


Section A: Introduction
? At its meeting on 5 October 2017, the Governance Committee considered
the appointment of Chairs to the Audit and Finance Committee (AFC),
Investment Committee (IC) and Programme and Policy Committee (PPC)
and subsequently agreed on recommendations which are being s ubmitted
to the Board for approval at it s meeting on 29 -30 November 2017.
Section B: Facts and Data
Board Committee Leadership
1.1 The incumbent Chairs of the AFC (David Sidwell), the IC (Stephen Zinser)
and the PPC (Richard Sezibera) are coming to the end of their terms on
31 December 2017. All three have confirmed their willingness to remain as
Chairs of their respective committees and their reappointments are
therefore being proposed.
1.2 The additional terms proposed are concomitant with their Board terms and
take into account the bi ennial refresh of the Board Committees.

1.3 It has been proposed that going forward it would be useful for the
Governance Committee to put in place a process for appointing and
reappointing Committee Chairs to ensure appropriate timelines and open
and tra nsparent processes for appointments to such key positions.
Section C: Actions requested of the Board
The Gavi Alliance Governance Committee recommends to the Gavi Alliance
Board :
a) That it reappoint the following as Chair of the Audit and Finance Committee :
? David Sidwell until 31 December 201 9
b) That it reappoint the following as Chair of the Investment Committee:
? Stephen Zinser until 31 December 201 9
SUBJECT: CONSENT AGENDA: COMM ITTEE CHAIR APPOINTM ENTS
Agenda item: 02b
Category: For information

1



Board -2017 -Mtg -3-Doc 02c
Report to the Board
29 -30 November 2017

Section A: Summary
This report sets out a recommendation to amend the Gavi By -laws in line with a
discussion of the Governance Committee on 5 October 2017 and 27 November
2017 at the request of the Board.
Section B: Changes to Gavi By -Laws
Proposed amendment to Gavi By -laws
1.1 At its meeting on 5 October 2017 the Gove rnance Committee discussed, at
the request of the Board, and in the context of the retirement of the
Executive Committee and the establishment of the Market -Sensitive
Decisions Committee (MSDC), the ?maximum three seat? principle currently
prescribed in th e Gavi By -laws for organisation/constituency representation
on Board Committees.
1.2 The Governance Committee agreed that the MSDC should be exempt from
this provision and the By -laws amended accordingly.
1.3 At its meeting on 27 November 2017 the Governance Committee
considered the proposed rewording of the By -laws and agreed on a
recommendation which is now being submitted to the Board for its approval.
Section C: Actions requested of the Board
The Gavi Alliance Governance Committee recommends to the Gavi Al liance Board
that it amend Article 4.2 of the By -laws to read as follows:
Each Board Committee shall be composed of three or more Board
Members/Alternates. Each of the Board Committees shall have a presiding Chair
who shall be one of the Board Members and shall be appointed once every two
years by the Board unless otherwise provided in the Statutes, By -laws or Charter
of the relevant Committee. If a Representative Board Member is appointed Chair
pursuant to this Section 4.2, that individual will not express his/her applicable
Eligible Organisation or Eligible Constituency viewpoint in deliberations nor
participate in voting at any Committee meeting. The Alternate Board Member for
that individual shall be entitled to participate in the Committee meetings to e xpress
SUBJECT : CHANGES TO GAVI BY -LAWS
Agenda item: 02 c
Category: For Decision

1



Board -2017 -Mtg -3-Doc 02d
Report to the Board
29 -30 November 2017

Section A: Summary
? This paper presents recommendations to the Board which the Governance
Committee agreed on during its meeting s on 5 October 2017 and
27 November 2 017.
? The recommendation s propose revisions to the Audit and Finance
Committee , Investment Committee and Evaluation Advisory Committee
Charters to align with the Governance Committee and Programme and
Policy Committee Charters approved by the Board in June 2017.
Section B: Changes to Committee Charters
Audit and Finance Committee and Investment Committee Charters
1.1 The Audit and Finance Committee (AFC) and Investment Committee (IC)
Charters were updated and approved by the Board in December 2016. The
revisions reflected the evolved and enhanced role of the Committees in
terms of their responsibilities and al igned the Charters to internationally
accepted standards and best practices.
1.2 At their meetings in July 2017 and August 2017 respectively, the AFC and
IC considered and agreed to further amendments to their Charters, which
were primarily of an editorial nat ure, to align with standard terms and
provisions which were developed during the first half of 2017 in the context
of the recommendations of the 2016 Board and Committee self -evaluation.
1.3 The updated and revised Charters were presented to the Governance
Com mittee at its meeting on 5 October 2017 and are now b eing presented
to the Board for approval (see Annexes A and B).
Evaluation Advisory Committee Charter
2.1 The Evaluation Advisory Committee (EAC) was not part of th e 2016 Board
and Committee self -evaluation exercise as it is not a Board Committee.
2.2 During its meeting in October 2017, the EAC was presented with the
findings of a peer review of Gavi?s evaluation function, which had been
initiated in April 2017. The rationale for this exercise was to inform the
SUBJECT : CHANGES TO COMMITTEE CHARTERS
Agenda item: 02 d
Category: For Decision

1



Board -2017 -Mtg -3-Doc 02e

Section A: Introduction
? Building on the flexibilities granted by the Board in December 2016, the
Secretariat has tested various revie w mechanisms over the past year with
the aim of im proving country dialogue, introducing mor e flexible timelines,
and ensuring that relevant expertise is leveraged at the time of review.
? Based on the lessons learn t from the various review mechanisms tested ,
the Prog ramme and Policy Committee ( PPC ) recommended that a
differentiated approach to application review be adopted going forward with
most reviews taking place at the global level (through the I ndependent
Review Committee mechanism) but maintaining the flexibility to conduct in -
country as well as ad hoc reviews , where required.
Section B: Gavi review mechanisms
The Board flexibilities approved in December 2016 for a period of 12
mo nths , included:
? Review of new Gavi support on a country -by -country basis and outside
of the existing IRC schedule;
? Enabling IRC members and other impartial technical experts with
local/regional expertise to serve in the capacity as independent
reviewers ;
? Leveraging engagement of country stakeholders to provide input during
the review process and immediately address issues raised by
reviewers;
? For those countries with relatively smaller Gavi investments, utilise
existing review mechanisms such as the HLRP (o r the subset of IRC
members of the HLRP) to provide funding recommendations on new as
well as existing Gavi support.
SUBJECT : CONSENT AGENDA: APPLICATION REVIEW PROCESS
Agenda item: 02e
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 02f

1. Continued support to South Sudan
1.1 Despite an overall positive trend in co -financing of Gavi programmes ( see
Strategy Progress Update ), South Sudan in recent years has struggled to
co -finance Gavi -supported vaccines due to ongoing conflict and the
decreasing global oi l price. In 2016, the PPC and the Board already found
that the exceptional circumstances in the country justified the continuation
of Gavi support despite the country?s defaulter status on its 2015 co -
financing obligations ( see Doc 07a to the 2016 December Gavi Alliance
Board ).
1.2 Despite the challenges, during the last Health Summit ,1 the government has
committed to increase its budget for health as soon as the economy
improve s. Furthermore, thanks to the active advocacy from the Gavi
Secretariat, among others, a vaccine specific budget line was added to the
2017 -2018 national budget to cover co -financing obligations. Gavi is
following up with the country in order to ensure a more sustainable approach
to co -financing going forward.
1.3 Nevertheless, sin ce the overall situation in the country has worsened over
the past months due to a further proliferation of the conflict and is not
expected to change in the immediate to short term future, South Sudan has
not been able to fulfil its 2016 co -financing obli gations and has requested
the continuation of Gavi support despite its default status (letter sent to Gavi
on 28 April 2017). With South Sudan's current vaccine stocks, it is not
expected to experience a shortage of doses due to 2016 arrears.
1.4 In view of the above, the Gavi Alliance Programme and Policy Committee
recommend s to the Gavi Alliance Board that it:
Find that exceptional circumstances in South Sudan justify the continuation
of Gavi support irrespective of its default status on its 2016 co -financing
obligations.

1 The Ministry of Health convened the Third Health Summit in March 2017 with the theme
?Harnessing strong partnerships for a resilient health system towards attainment of Universal
Health Coverage? to encourage partners to work together with the Ministry an d others in building
?a well -functioning resilient health system looking towards the larger goal of achiev ing Universal
Health Cove rage.?
https://www.humanitarianresponse.info/system/files/documents/files/health_cluster_bulletin_mar_
2017.pdf
SUBJECT : CONSENT AGENDA: CONTINUATION OF SUPPORT TO
SOUTH SUDAN
Agenda item: 02f
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 03
Report to the Board
29 -30 November 201 7

















SUBJECT: COUNTRY PRESENTATION ? LAO PDR
Agenda item: 03
No paper

1



Board -2017 -Mtg -3-Doc 04a

Section A: Summary
? This report provides a regular, data driven, update on progress made
against implementing Gavi?s strategy. This update focuses in particular
on progress on coverage and equity , drawing from the 2016
WHO /UNICEF Estimates of Immunisation Coverage (WUENIC) pu blished
in July 2017.
? The Alliance is on track for its overall target of immunising 300 million
children and averting 5 -6 million deaths in the 2016 -20 20 Strategy
Period. In the first year of its strategy, Gavi -supported countries
immunised 63.9 million children with three doses of DTP -containing
vaccine ,1 the highest number ever . Countries also significantly
expanded the breadth of protection by continuing to introduce and scale
up new vaccines. However, WUENIC data showed the % of children
reached with t hree doses of DTP -containing vaccine (DTP3) and first
dose of measles (MCV1) is unchanged , despite the increased number of
children immunised, as the number of children born each year is also
increasing. There are challenges with WUENIC data and it may not be
sensitive enough to pick up changes in coverage.
? Gavi?s support to strengthen health systems via Health System
Strengthening (HSS) grants and Partners ? Engagement Framework ( PEF )
targeted country assistance (TCA) will be critical to accelerate progress on
coverage and equity. The Alliance ha s beg un track ing the progress of
its support much more systematically and holistically through grant
performance frameworks, financial reporti ng, TCA milestones, and PEF
functions. While these have only been recently implemented and data
reporting and quality is still being improved, they are now being routinely
used to review grant progress, learn and adjust grants both at country level
(e.g., through Joint Appraisals) and at global level (by the Secretariat and
High -Level Review Panel (HLRP) ). The Cold Chain Equipment
Optimisation Platform (CCEOP) also continues to be scaled up and a
significant share of the equipment requested by countries is to extend the
cold chain to previously unequipped facilities. The Alliance is also scaling
up its approach to leadership, management and coordination.

1 Referred to as DTP3 in the rest of the paper.
SUBJECT : 2016 -2020 STRATEGY: IMPLEMENTATION AND
PROGRESS
Agenda item: 04a
Category: For Information
Report to the Board
29 -30 November 2017

1 Board -2017 -Mtg -3-Doc 04b
Report to the Gavi Board
27 -28 November 2017

Report of the Chief Executive Officer

22 November 2017

Dear Board members,
It is indeed an honour to have been reappointed by the Board as CEO of the
Alliance. I am excited by what our innovative model has achieved to date and
humbled by the challenges we still face to ensure that every child receives all the
vaccines they need. I am also delighted that we will continue to benefit from Dr.
Ngozi ?s leadership as we tackle these challenges, following her reappointment as
Chair by the Board.
My highest priority is to deliver on reaching every child ? both by continuing to roll
out new vaccines to deal with intra -country equity and improving coverage and
equity (C&E) ? and on ensuring the success of ou r sustainability model. Success
is critical both for the Alliance and the broader community. By extending routine
immunisation to reach the underserved, we are building a foundation for
universal health coverage (UHC) as I discuss further below. And by pio neering a
systematic approach to transitioning countries out of development assistance,
Gavi ?s sustainability model is a pathfinder for the broader community.
We continue to see strong progress on sustainability with countries co -financing
a record amount in 2017 and 17 countries due to have transitioned by the end of
the year. We will meet in Lao PDR which is an example of the success of the
model. Since 2000, it has raised coverage with three doses of DTP -containing
vaccine (referred to as DTP3 in the re st of the report) from 51% to 82% and has
introduced pentavalent, pneumococcal, inactivated polio, rubella and Japanese
Encephalitis vaccines, a second dose of measles and conducted a human
papillomavirus (HPV) demonstration project. This has averted over 25,000
deaths (from a population of less than seven million) and significantly contributed
to Lao PDR nearly halving child mortality since 2000. The country is on course to
transition successfully at the end of 2021 and has an ambitious agenda for the
futu re including introducing rotavirus and HPV vaccines nationwide in 2019,
increasing domestic investment in health and immunisation and improving health
service delivery. Nonetheless, it continues to face coverage and equity
challenges exacerbated by its geo graphy, language barriers and transport
infrastructure which limit access to health services for non -Lao ethnic groups, as
well as programme management capacity and human resources capacity. The
country has experienced outbreaks of vaccine -derived poliovir us, diphtheria,
pertussis and measles in recent years and the response, including ten polio

1



Board -2017 -Mtg -3-Doc 05
Report to the Board
29 -30 November 2017

Section A: Summary
? This report asks the Gavi Alliance Board (?Board?) to approve the update d
financial forecast of resources and expenditure for 2016 -2020 , and provides
an indicative expenditure forecast for 2021 -2025.
? The forecast includes the financial implications of previous funding
de cisions , highlights the financial implications of the decisions that have
been recommended to the Gavi Board for approval at this meeting and
indicates potential future investments yet to be considered .
? Compared to the previous forecast approved by the Board in December
2016, the estimated amount available for future investments, through 2020,
has increased by US$ 1 98 million (excluding the decisions to be considered
by the Board in November 2017 ). This is due to the estimated expenditure
for 2016 -2020 d ecreasing by US$ 452 million which is offset by a reduction
in the estimated qualifying resources of US$ 254 million (due to the
postponement of IFFIm proceeds).
? The reduction in the expenditure estimate for 2016 -2020 is largely due to
market shaping that has reduced vaccine prices (by US$ 0.6 billion), while
better management of vaccine stocks has reduced the volume of vaccines
required by countries . These savings have allowed the Board to approve
new programmes ? such as a new measles strategy, investmen ts in
CCEOP, enhanced support for yellow fever, and a new HPV strategy. The
scale -up of these new programmes has been less predictable than for the
more mature programmes (penta, rota and pneumococcal), with some
delays in implementation.
? The forecast indicates that sufficient resources are available such that all
the decisions recommended for approval can be made in accordance with
the Gavi Programme Funding Policy.
? The report provides an update on the evolution of the estimates of resources
and expenditure in 2017 and reports back on utilisation of the Board -
approved programme funding envelopes . It also includes an overview of
cash balances of Gavi -support held in countries , for information.
SUBJECT: FINANCIAL UPDATE , INCLUDING FORECAST
Agenda item: 05
Category: For Decision

1



Board -2017 -Mtg -3-Doc 06

Section A: Introduction
? At the end of each year, the Board reviews and approves the Alliance?s Risk
& Assurance Report. The 2017 Risk & Assurance Report has been
reviewed and recommended for approv al by the Audit & Finance Committee
(AFC) and guidance from both the Audit and Fina nce Committee and the
Programme and Policy Committee (PPC) have been incorporated in the
final version annexed to this paper.
? The Gavi Alliance Board is requested to approve the report and to provide
guidance on the questions outlined below .
Section B: Ris k & Assurance Report
This year?s Risk & Assurance R eport
1.1 The Gavi Alliance Board has ultimate responsibility for risk oversight in the
Alliance and is responsible for agr eeing on overall risk appetite and
understanding and agreeing with the most significan t risks and related
mitigation. It therefore has an annual in -depth discussion on risk, based on
a comprehensive Risk & Assurance Report.
1.2 Gavi?s last Risk & Assurance r eport prioritised 15 top risks that are most
important for the Alliance to manage. The focus of this year?s report is on
how Gavi?s top risk profile has evolved since last year and on how Gavi?s
actual risk exposure compares to risk appetite , informed by the Risk
Appetite Statement approved by the Board at its last June meeting. I t also
provides an update on risk mana gement at Gavi . Responding to feedback
on last year?s report, this year?s report is more concise (with more detailed
information moved to the annexes) and includes an expanded analysis on
exogenous factors and how these may i mpact Gavi?s risk profile .
1.3 This year?s report show s that Gavi?s overall risk profile has remained
relatively stable with 15 top risks and few new risks ? although the level of
individual risks has evolved and the understanding of risks prioritised last
yea r further enhanced . It also highlights three key risks which are currently
outside risk appetite for Board discussion. The Secretariat is seeking Board
guidance on whether it feels existing mitigation measures can bring risk
exposure within appetite fast e nough, whether it is necessary to accelerate
SUBJECT : RISK & ASSURANCE REPORT
Agenda item: 06
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 07
Report to the Board
29 -30 November 2017

Purpose
? This paper provides an update on the Partners? Engagement Framework
(PEF ) and seek s Board approval of the PEF as well as Secretariat budget
for 2018 -2019 .
Section A: Partners? Engagement Framework
? PEF leverages the comparative strengths of Alliance partners and places
special emphasis on providing high quality, targeted technical assistance
tailored to meet the specific needs of countries.
? PEF?s country -centric approach and emphasis on transparency and
accountability seek to empower Ministries of He alth to take greater
ownership for the type and quality of technical assistance being provided
through partners.
? Continuous improvement and learning is essential to the PEF model. The
future design and implementation of the PEF is being informed by findin gs
from the prospective Deloitte Evaluation of technical assistance as well as
recommendations and guidanc e from the PEF Management Team and
feedback from stakeholders .
? Of the US$ 128.5 million projected to be spent for technical assistance by
partners in 2017 , 55% relates to Targeted Country A ssistance (TCA ), 19%
to Special Investments in Strategic Focus A reas (SFAs) a nd 26% to
Foundational S upport .

SUBJECT : PARTNERS ? ENGAGEMENT FRAMEWORK AND
SECRETARIAT AND PARTNERS BUDGET 2018 -20 19
Agenda item: 07
Category: For Decision

Report to the Board

Annex A: Implications/Anticipated impact
Although op ening a window for TCV is still proving to be a solid investment, the
original decision was made in 2008. The mitigating strategy was to revise all of the
demand forecasts, impact analyses, and financial forecasts according to Gavi?s
current approved polic ies. These results were then compared against Gavi?s
current investments 1, which showed that an investment in TCV is comparable to
Gavi?s current investments from a health impact and value for money perspective ,
Annex B provides additional information.
Th e TCV market will continue to face market shaping risks, most urgent being the
need to improve supply and supply security and ensure an appropriate and
sustainable price for Gavi countries. If efforts are unsuccessful, the Gavi market
will continue to expe rience supply constraints beyond 2022, ultimately decreasing
ability to introduce the vaccine and Gavi?s impact. This risk will be mitigated by the
development and implementation of an Alliance supply and procurement roadmap
as well as the Alliance?s activ e engagement with manufacturers. Further opening
a funding window now will continue the current momentum and further catalyse
the market.
The opening of an application window will accelerate vaccine uptake in countries
that are plagued with typhoid fever burden. As TCVs will be competing with other
vaccines, countries will need additional support from the Alliance to ensure
appropriate prioritisation of vaccine introductions and to evaluate the implications
on health outcomes, fiscal space, and sustainabil ity. This is anticipated to be
particularly important for countries in Africa.
Adding another vaccine into already resource -constrained environments, TCVs
may be considered of marginal value even at relatively low costs and perceived to
contribute to problems of financial sustainability. Further, sustainability risks may
decrease the number of countries choosing to introduce as well as affecting the
quality of these introductions. The Alliance will actively engage with countries to
gene rate data and an alyses (e.g. burden data, cost effectiveness, fiscal space)
that will inform decision making and provide, if needed, technical assistance for
implementation as well as monitoring activities.
Further, the Alliance will also be expected to continue identifyi ng and filling gaps
in knowledge (e.g. long term duration of protection, co -administration), monitoring
the achievements and challenges of the programme (e.g. country -specific burden,
sub -national and outbreak use) to use this information to develop optima l
operational guidance, and reporting those back to the PPC and Board.

1 Gavi?s existing portfolio was calculated using impact and cost from operational forecast v14.

Report to the Board

Annex B: Background and Overview of Analyses
Gavi? s Historical Decisions on TCV
In the 2008 VIS, the Board prioritised TCVs for Gavi ?s portfolio along with Rubella,
HPV, and JE vacc ines. Although no financial commitments were made at the time,
the decision to prioritise TCVs was made under the assumption that an appropriate
vaccine would obtain WHO PQ by 2011.
TCV has been included as part of Gavi?s financial forecasts and was reviewed by
the Audit and Finance committee in October 2017, which noted that it had reviewed
the financial implications of this and other potential funding decisions that may be
considere d by the Board and concluded that these decisions could be approved
by the Board in accordance with the Programme Funding Policy.
In 2011, following delays in the PQ timelines largely driven by the discontinued
development of a lead vaccine candidate, the Board considered the temporary
introduction of typhoid polysaccharide (Vi -PS) vaccine as a bridging strategy, but
ultimately chose not to reconsider the 2008 decision and reaffirmed its preference
for TCVs.
As part of the 2013 VIS process, it was agreed not to review TCVs as it was already
prioritised and included in Gavi ?s financial forecast. At the Board meeting in
November 2013, the Board was reminded that a support window would be opened
for TCVs once a suitable vaccine obtained WHO PQ.
In the June 201 7 meeting, the Board was informed that the Secretariat would
refresh the original analyses and ask the Board to consider opening a funding
window if TCVs were WHO recommended and received PQ by the end of 2017.
Typhoid Fever Overview
Typhoid fever is a sy stemic infection caused by the enteric pathogen Salmonella
Typhi enterica serovar Typhi. The pathogen is generally spread through ingestion
of fecally contaminated food or water. Although typhoid fever is largely considered
an endemic disease, epidemics do occur. 2 Acute illness is characterised by
prolonged fever, headache, and nausea, loss of appetite and constipation or
sometimes diarrhoea. Serious complications occur in up to 10% of typhoid fever
patients. 3 The symptoms of typhoid fever are difficult to differentiate from other
febrile illnesses e.g. non -specific viral illness, malaria, dengue fever, or influenza.
New evidence indicates that major burden of severe disease exists in younger age
groups - 27% of typhoid fever occurred in children under 5 years of age. While data
sources likely reflect high typhoid incidence locations, they confirm that typhoid
fever with severity sufficient for an outpatient visit or hospital admission is common
in the under 5 year age group with a notable proportion of disease occurring
between 6 months and 2 years of age.
2 Typhoid vaccines: WHO Posi tion paper. W eekly epidemiological record. 2008; 6:49 -60. 3 ibid

Re port to the Board

Annex C: Investment Framework

Board -2017 -Mtg -3-Doc 08-Annex C

Dimension Description Typhoid Conjugate Vaccines
Strategic
rationale
Trigger for investment
proposal
? In 2008 VIS, the Board prioritised TCVs with other vaccines. June 2017?s meeting informed the Board that the Secretariat would
update analyses and propose a funding window if TCV was WHO recommended and PQed by the end of 2017. Both are
anticipated before the end of 2017.
Fit with Gavi strategic
goals
? Estimates of 145,000 to 223,000 deaths per year and 11 million to 22 million cases per year, burden has been persistent in Gavi
countries while industrialised nations have eliminated this disease
? 27% of typhoid fever cases in ? Aligns to Gavi?s mission as well as strategic goals 1 and 4
Fit with Gavi
comparative advantage
? Significant opportunity to shape the market
? Currently strong momentum on TCV development.
? Initially heavily supply constrained but with 5 pipeline manufacturers, there is a need to focus on supplier base, sustainable
supply, and appropriate and sustainabl e pricing
? Although treatable through antibiotics - CFR for typhoid fever in pre -antibiotic era may have been as high as 20%. Vaccines serve
as a preventative measure to combat the antimicrobial resistance (AMR) threat
Portfolio
balance
Cost as % of total
funding
? Gavi costs, including vaccine, VIG, and op costs by programmatic year (2019 -2020) forecasted to be $85m 1 or programme spend (vs v14 FF $136m)
? Gavi costs, including vaccine, VIG, and op costs by programmatic year (2021 -2025) forecasted to be $865m 1 (vs v14 FF $540m)
anticipated to be

1

Board -2017 -Mtg -3-Doc 08

Section A: Introduction
The purpose of this paper is to review the case for typhoid conjugate vaccine (TCV)
and summaris e the discussions of the Programme and Policy Committee (PPC)
on TCV to request the Board to approve the opening of a country support window
for TCVs.
TCVs have a long history:
? TCVs were prioritised in the 2008 Vaccine Investment Strategy (VIS);
? TCV was not reviewed in the 2013 VIS as it was already prioritised and
included in Gavi?s financial forecast . The Board was reminded that a support
window would be opened once a suitable vaccine obtained WHO pre -
qualification (PQ);
? At the 2017 June meeting, the Board was informed that the Secretariat
would update analyses if WHO recommendations and PQ were obtained
before the end of 2017 ; and
? The Strategic Advisory Group of Experts on Immunization (SAGE) October
2017 meeting provided strong recommendations on TCV use and one
vaccine is anticipated to receive WHO PQ in Q4 2017. As WHO PQ is
imminent and to avoid delays in opening a funding window, the Secretariat
prese nted updated analyses and proposed to the October 2017 PPC the
opening of a funding window. 1
The October 2017 PPC recommends to the Board to approve the opening of a
country support window given that TCV is comparable to current Gavi funded
vaccines on me asures of health impact and costs per deaths averted 2 and is
strongly aligned to Gavi?s mission and strategic goals focusing on health impact,
equity, new vaccine uptake and market shaping.
The Audit and Finance Committee at its meeting on 19 October 2017 noted that it
had reviewed the financial implications of this and other potential funding decisions
that may be considered by the Board and concluded that these decisions could be
approved by the Board in accordance with the Programme Funding Policy.
1 Previous decisions were made on the condition of obtaining WHO PQ (e.g. Japanese
encephalitis) to avoid delays in opening a funding window. 2 These metrics were used in the 2013 VIS and are planned to be used in the 2018 VIS.
SUBJECT: TYPHOID CONJUGATE VACCINE SUPPORT WINDOW
Agenda item: 08
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 09
Report to the Board
29 -30 November 201 7

















SUBJECT: CHAIR?S REFLECTION S ON THE DAY
Agenda item: 09
No paper

1



Board -2017 -Mtg -3-Doc 10
Report to the Board
29 -30 November 201 7

















SUBJECT: CHAIR?S OVERVIEW
Agenda item: 10
No paper

1



Board -2017 -Mtg -3-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 June 2017 .
? The AFC met twice (27 July and 19 October ) and will be meeting on
27 November 2017. Subjects reviewed in July and October are noted below
under Section B and those m atters to be reviewed on 27 November 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 as Annex B .

Section B: Subj ect matters reviewed
1) Audit & financial reporting
? External a udits were completed on time , with no significant audit issues
identified by KPMG.
? The 2016 Annual Financial Report (AFR), was completed and published on -
time, with no significant issues identified by KPMG .
? Gavi's annual tax return (Form 990) was filed in November. The AFC
reviewed calculations of compensation included in the Filing.
? Quarterly abridged consolidated and standalone financial statements.
2) Financial Update
? A financial update covering 2017 actuals and an outlook for 2017 -2025 .
Changes since last forecast were discussed and the amount available for
future investments agreed.
? Concluded that all programme funding decisions to be taken at November
Board meeting can be approved by the Board as qua lifying resources are
available.
? Agreed to recommend to the Board the approval of the updated financial
forecast for 2016 -2025 (version 15Fb) , the Partners Engagement
Framework for 2018 and 2019 and the capital expenditure budget.
3) Financia l Risk Management
SUBJECT : AUDIT AND FINANCE COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-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 June 201 7.
? The EAC met in Geneva on the 24 -25 October 2017 where the members:

a. W ere updated on ongoing Gavi evaluation activities including those related
to strengthening the Gavi Evaluation function;

b. Discussed the quality and usefulness of the baseline assessment report
for the Evaluation of Targeted Country Assistance (TCA) provided through
the Partne rs? Engagement Framework (PEF) ;
(i) Th e PEF TCA evaluation was highlighted as a n example of how Gavi
is learning and in real -time making changes. The baseline findings
were discu ssed at an Alliance workshop which ide ntified priority areas
for action. Areas for improvement include capacity building
approa ches for TCA and skill transfer and improving TCA
accountability measurement . These lessons learned are informing the
2018 TCA planning and improvements on delivery.

c. Discussed the quality and usefulness of the assessment of the Full
Country Evaluations first phase reports and were updated on the Full
Country Evaluations second phase :

(i) The FCE s econd phase was presented as an example of how Gavi is
strengthening collaboration with other institutions , in this case The
Global Fund. Identified areas of collaboration : sharing best practices
and considering joint efforts for planning, monitoring, i mplementing the
evaluation and in -country evaluation capacity strengthe ning activities ,
specifically in two countries (Mozambique and Uganda) were both
projects are ongoing simultaneously.

d. Discussed the potential approach for Health System and Immunisation
Strengthening evaluation based on the evidence needs ;

e. Discussed the results of the P eer review of Gavi?s e valuation function
presented by Nick York , which aim s to inform the review of the Gavi
Evaluation Policy , the review of the EAC Charter and improve th e
evaluation function within Gavi ;
SUBJECT : EVALUATION ADVISORY COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Governance Committee Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the
Governance Committee ( GC ) since the Board last met in June 2017 .
? The GC met by teleconference on 22 June 2017 and 26 July 2017 and had
an in -person meeting in Geneva on 5 October 2017 . During the June and
July meetings, discussions focused on the reappointment s of both the
Board Chair and the CEO.
? During the October meeting, in addition to some routine business such as
Board and Committee nominations, the Committee discussed a number of
topics in the context of the continued implementation of the
recommendations of the 2016 Board and Committee self -evaluation. They
agreed on a number of recommendations, some of which have already been
circulated to the Board for no objection consent, a nd others which are being
put forward to the Board at its November meeting for consideration.
? The GC will meet on 27 November 2017, preceding the Board meeting, and
it is expected that further recommendations will be put forward to the
Board for its approva l at the November meeting.
? The GC Chair report is attached in the form of a presentation as Annex A
and the GC recommendations to the Board are attached as Annex B.
Annexes
Annex A: GC Chair report
Annex B: GC recommendations to Gavi Alliance Board
SUBJECT : GOVERNANCE COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Investment Committee Report

Section A: Introduction
? This report provides the Board with a n overview of the macroeconomic
environment , portfolio performance , and the activities of the Investment
Committee since the Board last met in June 201 7.
? In calendar year 2017, the Committee met 4 times (February, May, August
and Novembe r). As mentioned in the June report, the Investment
Committee charter underwent a review in 2016 as part of a broader review
associated with the Board and Committee self -evaluation process. The
Investment Committee charter required additional edits in orde r to keep it
consistent with other Gavi charters. The Investment Committee approved
the editorial changes in August.
? The global economy sustained its growth trajectory into the second half o f
201 7 on the back of solid corporate earnings , low unemploym ent and
improving consumer confidence levels . The IMF?s October 2017 World
Economic Outlook publication lifted both its 2017 and 2018 forecasts of
global economic growth by 0.1% to 3.6% and 3.7% respectively, well ahead
of 3.2% achieved in 2016.
? After the 2008 financial crisis, major central banks pursued exceptionally
loose monetary policy to encourage borrowing , increase risk appetite and
raise asset prices. In a ddition, they purchased bonds to flood their
ec onomies with liquidity , which resul ted in massive increases in their
balance sheets. With economic recovery firmly in place, t he major central
banks have begun to increase rates and/or reduce monetary stimulus
programmes . Since the last Gavi Alliance B oard meeting in June , major
central banks have announced the following :
o The US Federal Res erve began to reduce its US$ 4.5 trillion balance
sheet;
o The European Central Bank will reduce the amount of its monthly
bon d purchases but also extend the duration of this QE programme;
o The Bank of England increased interest rates by 0.25 %, the first rise
in a decade.
? The change in leadership of the US Federal Reserve in February 2018 is
another development being closely watched by investors. The outgoing
Federal Reserve chairwoman Janet Yellen and the incoming Federal
SUBJECT : INVESTMENT COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-IFFIm Chair Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the
International Finance Facility for Immunisation ( IFFIm) since the last Board
meeting in June 2017 .
? IFFIm continues to be a valuable tool for Gavi and its financial position
remains st rong.
? On 9 November, IFFIm successfully issued a US$ 300 million floating rate
benchmark bond issuance. The bond was oversubscribed and placed with
investors w orld wide.
? IFFIm Vaccine B onds helped pioneer socially responsible investing , and
growth in the S RI sector has gai ned traction in the past years. The Social
Bond Principles (?SBP?) , adopted in June 2017, recommend a clear process
and disclosure for issuers, investors and banks which emphasises
transparency, accuracy and integrity of information.
? IF FIm is well -aligned with the SPB allowing Board members it to re -connect
with existing investors and reach out to new ones through roadshows and
financial conferences.
? The IFFIm Board plans on adopting a diversity statement at its December
Board meeting. Beginning in 2018, the Board will work to develo p an
updated communications strategy and begin recruitment for two board
seats.
? Significant progress has been made in developing potential additional roles
for IFFIm to support Gavi?s strategic goals.
? At an IFFIm Donors? meeting on 12 June, IFFIm received feedback on the
proposed roles:
o Financial commitments for market shaping: designated as a priority
and development continues.
o Supporting CCEOP: work will continue on the development of this
role in alignment with CCEOP progress and needs while ensuring
coordination with the HSIS programme.
SUBJECT : IFFIm Chair Report
Agenda item: 11
Category: For Information
Report to the Gavi Board
29 -30 November 2017

1 1
Report to the Board
Annex A: Implications/Anticipated impact

Annex es

Annex A : Implications/Anticipated impact
? Risk implication and mitigation . There is some uncertainty regarding data
availability for a number of the candidates, such as around disease burden,
licensure timelines or a clear vaccination policy. The Secretariat will consult with
relevant experts to ensure that analyses are informe d by latest evidence. Outputs
of these analyses will include clear explanations of any drivers of uncertainty. Risks
related to specific VIS investment recommendations will be reflected in future
papers.
? Impact on countries . Impact in Gavi countries is a key criterion in deciding on new
vaccines. All vaccines under consideration have potential for public health impact
in Gavi countries. The evaluation criteria also include indicators around
implementation feasibility, to capture the potential additional ne eds or challenges
that new vaccines with novel delivery strategies might pose in countries. If the
menu is expanded, financial sustainability considerations will be even more critical
for country decisions to access support for a new vaccine.
? Impact on A lliance . The VIS is an Alliance -wide process with significant
stakeholder engagement. This will include extensive consultations with Board
members and technical stakeholders from across the Alliance. VIS
recommendations will consider roles and responsibili ties of Allliance partners in the
implementation of new programmes.
? Legal and governance implications . There are no legal implications with respect
to the recommendations presented in this report.

1 1

Annex B: VIS candidates

Annex B : VIS candidates
Category Candidate Likely Vaccination Strategy Licensure Status
Vaccines for endemic disease prevention

through routine immunisation

Diphtheria Routine Diphtheria -containing
Booster Licensed
Tetanus Routine Tetanus Toxoid -
containing Booster Licensed
Pertussis Routine Pertussis -containing
Booster Licensed
Hepatitis B Birth Dose Licensed
Oral cholera vaccine Preventive Campaigns in
Endemic Settings Licensed
Meningitis C, Y, W, X Multivalent Conjugate Vaccines
in Routine & Campaigns Licensed
Hepatitis E Campaigns in Humanitarian
Settings Licensed
Hepatitis A Routine Immunisation Licensed
Dengue Routine Immunisation Licensed
Influenza Routine Maternal Immunisation Licensed
RSV Routine Maternal Immunisation Under Development
(Phase 3)
RSV mAb Prophylactic Neonatal Use in
High -risk Populations Licensed
Rabies Post -exposure Prophylaxis Licensed
Rabies Ig/mAb Post -exposure Prophylaxis Licensed (mAb in
development)
Malaria (RTS,S) Implementation Pilot Phase 2;
Future Routine Use
Licensed
(Implementation
pilots)
Vaccine investments
for epidemic preparedness
Chikungunya Outbreak Response Under Development
(Phase 2)
Zika virus Outbreak Response Under Development
(Phase 2)
Ebola Outbreak Response Under Development
(Phase 3)
Influenza Pandemic Response Licensed
IPV
IPV post -eradication Routine Immunisation Licensed

Report to the Board
Annex C : Criteria for vaccines for endemic disease prevention through routine immunisation

Annex C : Criteria for vaccines for endemic disease prevention through routine
immunisation
Criteria Draft indicators (to be further developed)
Ranking criteria

Health impact
Total future deaths averted 2020 -2035, and per 100,000
vaccinated
Total future cases averted 2020 -2035, and per 100,000
vaccinated
Economic impact Financial risk protection (e.g. cases of poverty or catastrophic
health expenditure averted)
Equity and social
protection impact
Disproportionate impact of disease on vulnerable groups, e.g.,
rural poor, urban slum residents, internally displaced populations
Special benefits of vaccination for women and girls
Potential to increase geographical equity in Ga vi support
(between countries/regions)
Global health
security impact
Epidemic potential of disease
Impact of antimicrobial resistance (AMR) on disease treatment
and impact of vaccination on antimicrobial use
Value for money Vaccine procurement cost per death averted
Vaccine procurement cost per case averted
Secondary criteria

Other impact
Total U5 deaths averted 2020 -2035, and per 100,000 vaccinated
Total DALYs averted 2020 -2035, and per 100,000 vaccinated
Vaccine procurement cost per DALY averted
Gavi comparative
advantage
Degree of vaccine market challenges / Gavi market shaping need
Potential for catalytic effect from Gavi investment
Broader health
systems benefits Fit with prioritised immunisation delivery platforms
Implementation
feasibility
Ease of supply chain integration
Need for health care worker behaviour change
Feasibility of vaccination time point
Need for demand promotion (e.g., acceptability, understanding of
disease burden)
Long -term fiscal space implications
Alternate
interventions
Optimal use of current and future alternative interventions
(prevention and treatment)
Cost

Vaccine cost Total procurement cost to Gavi and countries, 2020 -2035
Operational cost Incremental in -country operational costs per vaccinated person
Additional
implementation
costs
Additional costs for introduction, monitoring, etc. (e.g.
surveillance costs; training costs; partner or technical assistance
costs)

Excerpt from PPC paper section 4 (sections 4.2 -4.4) as relevant to the criteria in
proposed decision):
The proposed criteria reflect alignment with Gavi?s mission, strategic and global
priorities identified in consultations, lessons learned in the 2013 VIS, additional
analyses on measures of value and impact (e.g., economic impact and global health
security), and SC guidance. T he table includes preliminary indicators to illustrate

1



Board -2017 -Mtg -3-Doc 12

Section A: Introduction
? The Vaccine Investment Strategy ( VIS ) is Gavi?s bespoke prioritisation
approach for new investments in vaccines. It is developed every five years
to inform Gavi?s strategic and funding cycle. Twice before, Gavi has
developed a VIS and as a result added ne w vaccines to its portfolio and
committed to other types of vaccine investments .1
? The VIS 2018 ha s three phases: 1) development of an evaluation approach
for v accines for endemic disease prevention through routine immunisation
(for decision at this meeting ); 2) narrow ing of these candidates to a shortlist ,
and development of an evaluation approach for vaccine investments for
epidemic response ; (for Board decision in June 2018 ); 3) final
recommendations including details on the scope and nature of Gavi?s
investment (for decision at the end of 2018).
? A Steering Committee (SC) 2 provides scientific and technical input into the
VIS process. The SC met on 11 -12 September 2017 (meeting summary in
Appendix 5) and provided guidance on the overall VIS methodology, the list
of candidates and the evaluation approach as described below.
Section B: Vaccine Investment Strategy: methodology
Stakeholder consultations
1.1 The Secretariat conducted initial consultations with Gavi Board members
and via a survey to Alliance stakehold ers (160 responses) . S ummary
findings from these consultations are in A ppendix 2. Questions focused on
the relative importance of different types of vaccine investment s (e.g.
routine immunisation versus outbreak response), strategic consideration of
specif ic development objectives (e.g. global health security) , evaluat ion

1 In 2008, Gavi?s Board prioritised Japanese encephalitis (JE), rubella, HPV and typhoid conjugate
vaccines. In 2013, Gavi?s Board made investment decisions for three vaccines: expanded yellow
fever campaigns; support for a global stockpile of oral cholera vaccine, including the opportunity to
generate impact data; and investment in a ?learning agenda? for rabies vaccine. The Board
requested monitoring of new data on maternal influenza vaccine impact and a re -assessment of
the RTS,S malaria vaccine once it h ad been recommended for use by SAGE, and subsequently in
2015 approved funding for implementation pilots conducted by WHO. 2 List of members in Appendix 4
SUBJECT : VACCINE INVESTMENT STRATEGY: METHODOLOGY
Agenda item: 12
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 13

Section A: Introduction
? Based on the discussions at the Programme and Policy Committee (PPC)
in October, this paper provides an update to the Board on channelling
funding away from and back to government systems in the context of
ensuring programmatic sustainability and country o wnership.

? Annex A provides an update on the implementation of the Policy on
Fragility, Emergencies and Refugees (approved by the Board in June 2017).
The Operational Guideline (OG) that operationalises this Policy was
presented to the PPC (Appendix 6 to t he October 2017 Alliance update on
Country Programmes). During the development of this OG, relevant
stakeholders, including the CSO community, were consulted, and their
feedback has been reflected in the final document. The issues raised by the
Board at it s June meeting have all been clarified in the OG. The PPC also
reviewed measures that the Alliance will further explore to improve the
planning and implementation of campaigns and Supplementary
Immunisation Activities (SIAs) with a view to strengthening ro utine
immunisation (RI) efforts (see October 2017 Alliance update on Country
Programmes) .1 An update on the Secretariat?s thinking on the sustainability
tracers was also presented to the PPC (see Annex A to the October 2017
Alliance update on Country Progr ammes).
Section B: Alliance Update on Country Programmes
1. Channelling funds away from and back to government systems
1.1 In June 2017 the Board discussed that Gavi is increasingly channelling
funding through partners and other agents as a risk management measure,
which is not always conducive to the timeliness and predictability of funding
nor always easily reconcilable with the principles of country ownership and
sustainability. Since the last Board meeting the trend of channelling funding
away from government systems has further increased with a number of
additional grants being transitioned ? in part or in full ? away from funding

1 The Board has identified frequent or unplanned mass campaigns as one of the top 15 risks facing
the Alliance. See the 2017 updated Board risk appetite statement.
SUBJECT : COUNTRY PROGRAMMES: STRATEGIC ISSUES
Agenda item: 13
Category: For Information
Report to the Board
29 -30 November 2017

Re port to the Board

Annex A: Update on the i mplementation of the Policy on Fragility,
Emergencies and Refugees
1. The Policy on Fragility, Emergencies and Refugees (approved by the Board
in June 2017) outlines the principles guiding Gavi's approach in countri es
facing fragility challenges/ emergencies, or hosting refugees and enables
Gavi to offer greater flexibility and tailored support to better meet these
countries? specific needs. The Secretariat de veloped an internal Operational
Guideline (OG) ( Appendix 6 to the October 2017 Alliance update on Country
Programmes ) to guide Country Programmes staff to identify needs in these
countries and to follow the appropriate process for approving flexibilities
under the policy.
2. An overview of the decision making process and the approval authority for
granting flexibilities is included in the OG. Stakeholders 1 dealing with
immunisation in emergencies and for refugees reviewed the draft OG and
suggested that in so me time -constrained circumstances a leaner review and
recommendation process may be required to ensure a timely decision by
the CEO on certain flexibilities. Notably, when a faster and simplified
process is warranted the Managing Director, Country Programm es, in
consultation with the Alliance Coordination Team, would make a
recommendation to the CEO. In addition, the procedure for approval of
additional no -cost extensions is consistent with what has already been
detailed in a separate Secretariat OG. 2 Addit ional no -cost extensions are
considered during the quarterly regional review group meetings, chaired by
the Managing Director, Country Programmes.
3. Internal and external stakeholders have been consulted in the development
of the OG including relevant Secret ariat teams, Alliance partners, and the
Gavi CSO Constituency. The OG also describes how to track flexibilities at
the Secretariat level for monitoring and evaluating the implementation of the
policy. Examples of recently approved flexibilities include:
a) In May 2017 UNICEF in Rwanda requested vaccines to cover
approximately 3000 refugees from Burundi. Gavi will provide support for
PCV, Penta, Rota, MR and syringes , with UNICEF or UNHCR
potentially meeting the associ ated co -financing requirements.
b) In 2016 Uganda received an unprecedented influx of almost one million
refugees from South Sudan. In May 2017 the Ugandan EPI, together
with UNICEF, requested support for an immunisation campaign
targeting refugee children up to the age of 5 (PCV , Penta and Measle s
-2nd dose) and for additional doses for routine immunisation of refugees
to be added to the country?s 2018 Annual Vaccine Renewals request.
In -country partners during the Joint Appraisal in July 2017 agreed on
the importance of this undertaking and UNICE F has committed to share
the costs of the vaccines. Gavi has agreed to grant support for additional
doses (routine and campaign) targeting the refugee children.

1 Including relevant Secretariat teams, Alliance partners, and the Gavi CSO Constituency 2 OG on Reprogramming, Reallocation and No -cost Extension

7


Re port to the Board

Board -2017 -Mtg -3-Doc 14



Annex A : Transition Analysis ? Countries Transitioning 2016 -2025


Note: DTP3 coverage: green: >90%, amber: >80 -90%, red: 2pp. No change: -2pp to 2pp. Decreasing coverage: 90% of districts have >80% DTP 3 coverage; amber: >80 -90% of districts >80%; red: 80%; Vaccines introduced : green if 4 core vaccines introduced (Penta , PCV, Rota, HPV), amber if 3, red if 2 or 1; institutional capacity : World Bank CPIA Index data for ?Quality Public Administration ? and ?Building HR ?; green: avg. score >3 and none =0.1% or share of GE > =1% Red: If GE and GHE above threshold; n/a: reference ata source not available; Timor -Leste: coverage data likely artificially low; Source: WUENIC 2016, survey, WHO repository, UNICEF, World Bank, Gavi strategic demand forecast
Transition year (last year of support)

2015
? 2020

2021
-2025

1



Board -2017 -Mtg -3-Doc 14

Section A: Introduction
? The Gavi Alliance model is grounded i n the principles of country ownership
and sustainability. For Gavi, sustainability means ensuring that countries
continue to self -finance their immunisation programmes and maintain or
improve coverage gains post -transition. Gavi?s approa ch to transition and
sustainability is unique and represents an experiment for both Gavi and the
broader global health community. Gavi has been a pathfinder on
sustainability, has learned from the early stages of engagement with
countries and has used its experience to refine its approach over time.
? This strategy period is the first time that countries are transitioning out of
Gavi support under the current transition policy. By the end of 2020, 2 0
countries will have fully transitioned. 1 Eight have already transitioned, and
by the end of 2017 this number will rise to 16 . Given the large number of
countries transitioning in this period and the importance of sustainability to
Gavi?s model , the Board conducted a deep dive on transition progress an d
risks at its retreat in April . Participants agreed that the transition policy is
working well and most countries are on -track for a successful transition out
of Gavi support . They identified a subset of countries that may require
tailored strategies to s upport successful transition , and also asked the
Secretariat to explore options for engaging countries post -transition. The
CEO presented initial thinking on this at the June Board and the Secretariat
subsequently proposed a set of options to the October PPC. This paper
describes the recommendations of the PPC on how the Alliance should
engage with countries post -transition.
Section B: Facts and Data
Evolution of Gavi?s s ustainability and transition model
1.1 Sustainability is at the heart of the Gavi model. It is ingrained in all its support
to countries:

1 It does not include Ukraine as well as the number of transitioned countries.
SUBJECT : ENGAGEMENT WITH COUNTRIES POST -TRANSITION
Agenda item: 14
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 15a

Section A: Introduction
? At its Retreat in April 2017, the Board discussed the significant risks to
Nigeria?s upcoming transition and asked the Secretariat to consider if a
tailore d strategy was required. Nigeria is in a particularly fragile situation,
with poor health outcomes and very low coverage rates (2016 coverage with
three doses of pentavalent vaccine (penta3) of 33% based on the latest
coverage survey ), a constrained macroeconomic environment , multiple
outbreaks ( Measles, Yellow Fever, Meningitis, Cholera, Monkeypox, Lassa
Fever ), one of the 3 remaining polio endemic countries, persisting vaccine
hesitancy, and insecurity in large parts of the North . Substantial bilateral and
multilateral support has been provided to increase coverage but with little
tangible effect. As the Board has discussed, Nigeria may therefore not be
on track for successful transition, due at the end of 2021. Yet, recent political
shifts within the health sector, and the National Primary Health Care
Development Agency (NPHCDA) in particular, give cause for cautious
optimism and a renewed opportunity for greater engagement by Gavi. Such
an engagement must be underpinned by demonstrated political
commitment, including the resolution of outstanding audit issues.
? Having declared immunisation a national emer gency, Nigeria is now
working to finalise an ambitious plan aiming to strengthen its programme
and achieve national penta3 coverage of 80% by 2025 (with differentiated
targets for different states). If implemented well, this could significantly
increase co verage and sustainability over the next few years.
? Building on lessons learnt and the increased political commitment , the Gavi
Alliance is planning to work differently in Nigeria, at all levels. At the national
level we will increase the Alliance?s strateg ic and political engagement, seek
greater partner alignment and invest in strengthening the leadership,
management, supervision and coordination capabilities of the newly
established National Emergency Routine Immunisation Coordination
Centre (NERICC) . Giv en that health programmes are primarily managed at
State level, we would also plan to target a limited number of low performing
states with a focus on building local leadership and management capacities
and experimenting with and rapidly learning from inno vative approaches.
These would focus on areas such as use of data, demand -generation
approaches, vaccine management, and improving service delivery through
SUBJECT : SUCCESSFULLY TRANSITIONING NIGERIA FROM GAVI
SUPPORT
Agenda item: 15a
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 15b

Section A: Executive Summary
? Papua New Guinea ( PNG ) is an extremely fragile country with a weak health
system and poor immunisation outcomes. Despite considerable economic
growth driven by the extractive industries over the past decade, PNG has largely
failed to capitalise on that growth, and future progress is now threatened by the
country?s dependence on declining commodity prices. The lack of domestic
resources available to support health and immunisation, in combination with the
sector?s weak governance and management have left PNG?s health system at
a crisis point, putting its Gavi transition by end of 2020 at risk. Vaccine c overage
rates have declined annually in recent years, and official estimates place penta3
coverage at 61% and MCV1 coverage at 51 % nationally, paving the way for
outbreaks of vaccine -preventable diseases . PNG is classified as a country in
fragility as per Gavi?s latest Fragility, Emergencies and Refugees Policy .
? However, a new Government was elected in PNG in July 2 017. The new
Minister for Health and HIV/AIDS has set an ambitious plan to start to address
key gaps in the health sector, and has voiced his commitment to immunisa tion
in particular. The National Department of Health ( NDOH ), with support from
Alliance par tners, has recruited an EPI Manager after a two year gap and
develop ed a plan t o raise coverage rates and strengthen EPI, with the goal of
achieving 75% coverage of penta3 by the time it transitions at the end of 2020.
With this renewed demonstration of po litical will from the Government, there is
now a real opportunity for Gavi support to achieve transformational outcomes in
PNG.
? Based on PNG?s EPI Transition Strategy, Gavi has developed a proposal for a n
innovative package of suppo rt that could be provid ed over the course of its
accelerated transition . Exceptions to Gavi?s policies are sought , namely around
the HSS ceiling, vaccine introductions and campaign costs, and co -financing
ramp -up. The PPC discussed the request , and agreed with the proposed way
forward in PNG. A minority opinion was expressed by the representative of one
constituency regarding the potential for PNG to request NVS support after its
Grace Year (for further details see Section C) . PPC members also noted that it
may remain unrealistic for PNG to successfully transition by 2021 ; therefore
close monitoring of progress will be need ed for possible course corrections .
? Subject to the m inority position mentioned above, the PPC is re commending
that the Board approve measures to continue engagement with PNG as
SUBJECT : SUCCESSFULLY TRANSITIONING PAPUA NEW GUINEA
FROM GAVI SUPPORT
Agenda item: 15b
Category: For Decision
Report to the Board
29 -30 November 2017

1



Board -2017 -Mtg -3-Doc 16
Report to the Board
29 -30 November 201 7

















SUBJECT: REVIEW OF DECISIONS
Agenda item: 16
No paper

1



Board -2017 -Mtg -3-Doc 17
Report to the Board
29 -30 November 201 7

















SUBJECT: CLOSING REMARKS AND A NY OTHER BUSINESS
Agenda item: 17
No paper

1



Board -2017 -Mtg -3-Doc A

Section A: Introduction
? This report is an update on progress made in 2017 on imp lementing Gavi?s
gender policy. It covers the programmatic, corporate, governance,
communications and advocacy dimensions of Gavi?s gender focused work.
? The Sustainable Development Goals (SDGs) have brough t a greater focus
on gender equality and women?s empowerment. Gender plays an important
role in immunisation and is a strong component of Gavi?s commitment to
equity in immunisation.
? The goal of Gavi?s gender policy is to 1) increase immunisation coverage by
supporting countries overcome gender -related barriers to ac cessing
immunisation services and 2) promote equal access and utilisation for all
girls and boys, women and men to immunisation and related health services
that respond to their different healt h need s.
? In 2017 , the Secretariat enhanc ed its focus on engagement on gender.
Section B: Facts and Data
Gender Policy at a glance
1.1 Gavi?s gender policy calls for gender -sensitive funding and programmatic
approaches, generating new data and evidence, exercising leadership and
advocating for gender equality, and increasing accountability for gender
related results.
1.2 Research shows that due to socio -cultural and economic factors, women
tend to have low er access to available social services , including health
services. Gender -related barriers, including education level , decision -
making power and economic dependen cy among women are important
predictors of their children ?s vaccinat ion status 1.
1.3 Per available evidence, there is no significant difference at global level in
immunisation coverage for boys and girls . Differences favouring either boys
or girls, do exist in some regions, countries and socio -economic groups and
1 Hilber AM, McKenzie O, Gari S et al. Project Gender and Immunisation. Qualitative Systematic Review.
Geneva: STPH and WHO, 2010, 44 -48.
SUBJECT : ANNUAL REPORT ON IMPLEMENTATION OF THE
GENDER POLICY
Agenda item: A
Category: For Information
Report to the Board
29 -30 November 2017

Board -2017 -Mtg -01 1
Minutes




Gavi Alliance Board Meeting
29 -30 November 2017
Crowne Plaza Hotel, Vientiane, Lao PDR


1. Chair?s report

1.1 Finding a quorum of members present, the meeting commenced at 09. 13 local
time on 29 November 2017 . Ngozi Okonjo -Iweala , Board Chair , chaired the
meeting .

1.2 The Chair started by expressing, on behalf of the Board, her appreciation and
gratitude to the gover nment of Lao PDR for hosting the meeting.

1.3 The Chair welcomed new Board member s and Alternate Board member s, as well
as Rob Moodie, Chair of the Evaluation 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. She regretted that a number of representatives
from the developing country constituency had not been able to attend this meeting.

1.4 She recalled that as WHO leadership is currently transitioning, and that WHO
representation to the Gavi Board is being finalised, she had exercised her
discretion as Board Chair to exceptionally permit Dr Princess Nothemba (Nono)
Simelela, Assistant Director General, Family, Women, Children and Adolescents,
to join the Boa rd at the main table for this meeting . Dr Simelela would be w elcome
to participate in the discussions but as an observer would not be permitted to vote.

1.5 The Board met in closed session on the evening of 28 November to discu ss a
number of items including the CEO?s annual performance review, a s well as a
preliminary discussion relating to successfully transition ing Nigeria from Gavi
support , which would be discussed further at this meeting .

1.6 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 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.

1.7 The Board noted its minutes from 14 -15 June 2017 (Doc 01b) and 7 July 2017
(Doc 01c) , which were approved by no objection on 15 August 2017 . The Board
also noted decisions approved by them by no -objection consent since the last
meeting (Doc 01d), namely the 2016 Annual Financial Report and appointments
to the Board and Board Committees.

Gavi

1.
2.

www.gavi.org
UPDATE ON IMPLEMENTATION OF
GAVI?S STRATEGY
Seth Berkley, MD
29 November 2017, Vientiane, Lao PDR
GAVI BOARD
29 -30 NOVEMBER 2017
2016 ?2020 INDICATORS
MISSION PROGRESS
Gavi BoardUPDATED: 11 October 2017
ON TRACK
MODERATE DELAYS / CHALLENGES
SIGNIFICANT DELAYS / CHALLENGES
5
0
0
The Vaccine Alliance tracks five key targets to help
achieve our mission: to save children's lives and
protect people's health by increasing equitable use
of vaccines in lower -income countries.
?Baseline value reset to ?0? at the start of the strategy period. Targets for 2020 represent anticipated cumulative achievement over the duration of the strategy period.
MA
MA
MA
MA
MA
UNDER -5 MORTALITY
FUTURE DEATHS AVERTED
FUTURE DISABILITY -ADJUSTED LIFE YEARS (DALYS) AVERTED
CHILDREN IMMUNISED WITH GAVI SUPPORT
VACCINES SUSTAINED AFTER GAVI SUPPORT ENDS
2020 TARGET
59 per 1,000
2015 BASELINE
65 per 1,000
2020 TARGET
300 million
2015 BASELINE ?
0
2020 TARGET
250 million
2015 BASELINE ?
0
2020 TARGET
5-6 million
100%
2020 TARGET
100%
2015 BASELINE ?
0
2015 BASELINE
100%
62 m
1.2 m
56 m
62 per 1,000
1
2
3
4
5

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1 Conseil d?administration -2017 -Mtg -3-Doc 04b_FR
Rapport pour le Conseil
d?administration de Gavi
29-30 novembre 2017

Rapport du directeur ex?cutif

Le 22 novemb re 2017

Chers membres du Conseil d?administration ,
C?est pour moi un honneur d?avoir ?t? reconduit par le Conseil d?administration
dans mes fonctions de Directeur ex?cutif de l?Alliance. Je suis tr?s heureux de ce
que notre mod?le innovant nous a permis de r?aliser ? ce jour et plein d?humilit?
face aux d?fis qu ?il nous faut encore affronter pour que tous les enfants re?oivent
tous les vaccins dont ils ont besoin. Je me r?jouis ?galement du fait que nous
allons pouvoir continuer ? b?n?ficier du leadership du Dr Ngozi pour relever ces
d?fis, suite au renouvellement de son mandat de Pr?sidente du Conseil
d?administration.
Ma priorit? absolue est de r?ussir ? atteindre tous les enfants ? d?une part en
continuant ? d?ployer de nouveaux vaccins pour promouvoir l??quit? ? l?int?rieur
des pays et d?autre part en am?liorant la couverture vaccinale et l??quit? ? et
d?assurer le succ?s de notre mod?le de p?rennisation . Nous devons r?ussir, c?est
crucial pour l?Alliance aussi bien que pour l?ensemble de la population . En
?largissant la vaccination syst?matique pour atteindre ceux qui ont ?t? d?laiss?s
jus qu?ici , nous construisons les bases de la couverture sanitaire universelle,
comme je l?explique plus loin. Et en exp?rimentant une nouvelle d?marche
syst?matique avec les pays en passe de s?affranchir de l?aide au d?veloppement ,
le mod?le de Gavi en mati?re de d?veloppement durable joue le r?le d??claireur
pour la communaut? ?largie.
Nous continuons ? voir une forte progression en mati?re de p?rennisation : le
cofinancement des pays a atteint un montant record en 2017 et 17 pays
devraient sortir de la phase de transition d?s la fin de l?ann?e. Nous allons nous
rencontrer en R?publique d?mocratique populaire lao, pays qui constitue un
exemple du succ?s de notre mod?le. La couverture avec trois doses de vaccin
contenant les valences dipht?rie -t?tanos -coqueluche (ou DTC3, d?nomination
que nous utiliserons par la suite dans ce rapport) n??tait que de 51% dans ce
pays en 2000 ; elle atteint maintenant 82%. Le Laos a en outre introduit les
vaccins pentavalent et antipneumoccique, le vaccin polio inactiv?, les vaccins
contre la rub?ole et l?enc?phalite japonaise, une seconde dose de vaccin contre
la rougeole , et men? une ?tude pilote de vaccination contre le virus du papillome
humain (VPH). Cela a permis de pr?venir plus de 25 000 d?c?s (pour une
po pulation de moins de sept millions d?habitants) et contribu? de fa?on notable ?
r?duire pratiquement de moiti? la mortalit? infantile depuis 2000. Le pays , qui est

Gavi

Gavi

Gavi

www.gavi.org
PARTNERS' ENGAGEMENT
FRAMEWORK AND SECRETARIAT
AND PARTNERS BUDGET
2018 -2019
BOARD MEETING
Anuradha Gupta & Barry Greene
29 -30 November 2017, Vientiane, Lao PDR
Reach every child
Source: TCA baseline assessment report, 2017. Independent evaluation conducted by Deloitte.

www.gavi.org
TYPHOID CONJUGATE VACCINE
SUPPORT WINDOW
BOARD MEETING
Michael F Thomas
29 -30 November 2017, Vientiane, Lao PDR
Reach every child
Agenda
Why TCVs?
Historical decisions and update
Results of updated analyses
Key opportunities, learning agenda, PPC discussion
Recommendations
2
1
2
3
4
5
Board meeting
29 -30 November 2017

www.gavi.orgPROGRAMME AND POLICY
COMMITTEE CHAIR REPORT
Reach every childBOARD MEETING
Richard Sezibera
29 - 30 November 2017 , Vientiane, Lao PDR
Annex A
PPC Meeting, 26 - 27 October 2017
? Discussion, Information and Guidance Items
? CEO Update and Update on Implementation of Gavi?s Strategy
? Partners? Engagement Framework
? Alliance Update on Country Programmes
? Polio Transition Planning
? Risk & Assurance Report
? Update on Key Recommendations of the Independent Review Committee and High
Level Review Panel
2 Board meeting
29 - 30 November 2017
Annex A

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