Board -2021-Mtg -4-Doc 00a




G avi Alliance Board Meeting
30 November - 2 December 202 1 - Virtual Meeting

Tuesday 30 November : 14.30 -17.45 Genev a Time
Wednesday 1 December : 13.30 -18.30 Geneva Time
Thursday 2 December : 13.30 -18. 30 Geneva Time
Quorum: 14

Document list

No. Docu me nt
00a Document list
00b Agenda
01a Declarations of interest
01b Minutes
01c No Objection Consent Decisions
01d Consent Agenda
01 e Workplan
02 Committee Chair and IFFIm Board reports ? To follow
03 Financial Upda te, including forecast
04 Report from Audit & Investigations
05 CEO ?s Report ? To follow
06 Strategy, Programmes and Partnerships: Progress, Risks and Challenges
07a COVAX : Ke y Strategic Issues
07b COVAX: Resource Mobilisation Update
08 Malaria Vac cine Programme Investment Case
09 Risk Management Update
10 Strategic Partnership with India
11 Private Sector Engagement Strategy
12 Disease Surveillance and Diagnostics to Support Targeted Vaccination in Gavi 5.0
13 Review of decisions ? No paper
14 Closing remarks (including tri bute to departing Board M embers) ? No paper
No. Ad ditional Doc uments f or Informa tion (on Boa rdEffect )
A Board and Committee minutes (For i nformation only)
B CEPI 2020 Annual Progress Report

Board -2021-Mtg -04-Doc 00b








G avi Alliance Board Meeting
30 November ? 2 December 2021
Virtual Meeting



Tuesday 30 November : 14.30 -17.45 Geneva Time
Wednesday 1 December : 13.30 -18.30 Geneva Time
Thursday 2 December : 13.30 -18. 30 Geneva Time
Quorum: 14



A gend a








Nex t Board Me eting s: 6-7 April 2022 (Board Retreat )
22 -23 June 2022
7-8 D ecember 20 22

---
Brenda Killen , Director, Governance and Secretary t o the Board, +41 22 9 09 6680 , bkillen @gavi.org
Joanne Goetz , Head, Governa nce, + 41 22 9 09 6 544, jgoetz@gavi.org
Please note that the Board mee ting will be recorded. This recording will be used as an aid to minute t he meeting .
A transcr iptio n of the full proceedings will not normally be made . Shou ld a tr ansc riptio n be mad e it wil l be used
only as an aid to minute the meeting .




Boar d-2021-Mtg-04-Doc 00b 2

Board M eeting - D AY ONE ? Tuesday 30 November 2021

Item Sub ject Action Schedule

Closed Session: For Board Members and Alternate Board
Members only
14.30 -15. 15
1 Chair?s report
? Declarat ions of in terest
? Minutes
? No Objection Cons ent Decisions
? Consent Agenda 1,2
? Wor kpla n
Jos ? Ma nuel Barroso , Board Chair
DECISION 15. 15 -15. 30
2 Comm ittee Chair and IFFIm Board reports
? Go vernance Committe e ? Sarah Gou lding
? Audit and Finance Committee ? David Si dwell
? Inve stmen t Committee ? Afsaneh Beschloss
? Progr amme and Policy Committee ? Helen Re es
? Evalua tion Advisory Comm ittee ? James Hargreaves
? IFFI m Comp any ? Kenneth G Lay
15. 30 -16. 30
3 Financ ial Update, including forecast
Dav id Sidwe ll, Chair, Audit and F inance Com mittee
Assie tou Diou f, Managing Director , Finance & Oper ations
DECI SION 16. 30 -17.15
4 Re port from Audit & In vestigations
Simon Lamb, Managing Director, Audit & Investigations
17. 15 -17. 45
1 Any Board m ember can ask tha t an y item be removed from the consent agenda for f urth er dis cuss ion. S hould
there be any such reques t, the relevant discussion will take place on Day Three of the Board meet ing,
immedia tely precedin g t he R evie w o f Decisi ons. 2 Will include Board Vice Chair appointment, Committee Chair Appointments , Board and Committee
appointments, IRC appoin tments, Evaluat ion Policy, Corporate Treasur y Policies , Program me Funding Policy ,
AFC Ch art er, COVAX Shareholders Council To Rs, Meas urement Framework, CSCE Approach

Bo ard -2021-Mt g-4-Doc 0 1a




Gavi Alliance Board Meeting
30 November ? 2 December 202 1
Virtual Meeting
Quorum: 1 4
Declarations of Interest

Declarations
Section 5.5 of the Conflicts of Interest Policy for Governance Bodies states ?Members
involved in decisio n-makin g proce sses on b eha lf of Gavi must take appropriate action to
ensure disclosure of Interests and Conflicts of Inter est, and take the necessary action in
respect thereof.?
Section 6.2 of the Conflicts of Interest Policy for Governance Bodies further states , ?T he duty
to d isc lose [in 6.1 above] is a continuing obligation. This means that Members are obliged to
disclose any Interests and/or Conflict of Interest, whenever the Member comes to know the
relevant matter.?
The following declarations were made b y me mbe rs of the Bo ard on their most recent annual
statements .
Board members:
Member Org anisational Interest s

Financial/Personal/Advisor Int /
Others














Jos? Manuel Barroso , Chair




























Non e














Goldman Sachs I nter national
(Chairman and Non -Executive
Director -Advisor ); Princeton
University - Princeton School of
Public Policy, LISD, (Non
Residen t Fellow ); Catholic
Unive rsity o f Portugal (Visiting
Professor ); Centre fo r Euro pean
Stu die s (Director) ; Graduate
Insti tute of International and
Development Studies -Geneva,
(Visiting Professor ); The
EUROPEAUM (Board Member );
WPL -Women Political Leaders
(Advisory Board Member ); Je an
Monn et Foundation for Europe
(Honorary Committee Member );
Eur ope an C entre for C ulture,
(Honorary Co -President );
Portuguese Diaspora Council
(Chairman General Assembly );
Bilderberg Meetings (Steering
Committee Member ); Concordia
(Leade rship Member Council );
Wo rld Lea dership Alliance - Club
de Madrid (Memb er); Teatro Real
Ma drid (Internation al Council
member ); Royal Institute of
International Affairs (Chattam

Board -2021 -Mtg -02 1
Minutes




Gavi Alliance Board Meeting
23-24 June 2021
Virtual meeting


1. Chair?s Report

1.1 Finding a quorum of members present, the meeting commenced at 14. 00 Geneva
time on 23 June 2021 . Prof Jos? Manuel Barroso , Board Chair, chaired the
meeting.

1.2 The Chair welcomed one new Board member , Jeremy Konyndyk (United
States/Australia/Japan/ Korea (Rep. of)) . He also welcomed Zulfiqar Bhutta ,
interim Chair of the Evaluation Advisory Committee ; Ken neth Lay , Chair of the
International Finance Facility for Immunisation (IFFIm) ; and other directors of the
IFFIm Board , as we ll as Minister Harsh Vardhan (India) who was joining a Board
meeting for the first time.

1.3 Prof Bar roso reported that i n closed session earlier in the day, Board members
ha d approved a recommendation by the Governance Committee to reappoint Dr
Seth Berkley as Chief Executive Officer (CEO ) for a further exceptional one -year
term effective 3 August 2022.

1.4 He noted the exceptional ly busy agenda of the Board and its Committees and
referred to the Organisational Review update that had been shared with the Board
in advance of the Board meeting. He noted that a dedicated informal session for
Board members would be organised in the near future to further discuss the deta ils
of the review.

1.5 The Chair presented a short summary of the recent All Chairs Group (ACG)
meeting on 18 June 2021 , during which the Group had discussed the importance
of retaining Gavi?s focus on Gavi 5.0 commitments in addition to the Covax work .
He also reported that the Market Sensitive Decisions Committee (MSDC) had met
three times since the Board last convened.

1.6 Prof Barroso provided some personal reflections to the Board with regard to the
imperative of delivering on Gavi 5.0 and COVAX with the same level of ambition.
He noted that equity has not yet been achieved in COVID -19 vaccine coverage,
particularly in Africa. He made an urgent appeal in favour of Africa, particularly to
vaccine suppliers.

1.7 Standing declarations of interest were tabled to the Board (Doc 01a in the Board
pack).

1.8 The Board noted its minutes from 29 -30 September 2020 (Doc 01b) and 15 -17
December 2020 (Doc 01c) which were approved by no objection on 21 May 2021 ,

1



Board -2021 -Mtg -4-Doc 01c
Report to the Board
30 November - 2 December 2021



Since the June 2021 Board meeting, three decision s ha ve been circulated to the
Board electronically for approval by no -objection consent in line with Section 11 of
the Board and Board Committee Operating Procedures .

1) On 19 July 2021 , Board members were invited to consider approval of the
appointment of an Alternate Board Membe r.

No objections were received prior to the end of 29 July 2021 and the following
decision was therefore entered into the record:

In accordance with Section 11.3 of the Board and Board Committee Operating
Procedures, on a no -objection basis, the Gavi Alliance Board:

Appointed Gilbert Mokoki of Republic of Congo as Alternate Board Member
representing the implementing country constituency in the seat currently held
by Jacqueline Lydia Mikolo of Congo, effective immediately and until
31 December 2021 .

2) On 8 September 2021 , Board members were invited to consider approval of
the appointment of Board Members a nd a Governance Committee
Member.

No objections were received prior to the end of 21 September 2021 and the
following decision was therefore entered into the record:

In accordance with Section 11.3 of the Board and Board Committee Operating
Procedures, on a no -objection basis, the Gavi Alliance Board:

a) Appointed Faisal Sultan of Pakistan as Board Member representing the
implementing country constituency in the seat fo rmerly held by Assad
Hafeez of Pakistan, effective immediately and until 31 December 2023.

b) Appointed Mansukh Mandaviya of India as Board Member representing
the implementing country constituency in the seat currently held by Harsh
Vardhan of India, effective immediately and until 31 December 2023.

SUBJECT: NO -OBJECTION CONSENT DECISIONS
Agenda item: 01 c
Category: For Information

1



Board -2021 -Mtg -4-Doc 01d
Report to the Board
30 November - 2 December 2021

Section A: Introduction
Ten recommendations are being presented to the Board under the Consent
Agenda for consideration. Detailed information on the item s can be found in the
relevant Committee paper in a dedicated folder on BoardEffect at :
https://gavi.boardeffect.co.uk/workrooms/6459/resources/147743
Section B: Actions requested of the Board
The Gavi Alliance Board is requested to consider the following recommendation s
from the Gavi Alliance Governance Committee , Programme and Policy Committee
and Evaluation Advisory Committee .
Decision One ? Board Vice Chair Appointment

The Gavi Alliance Governance Committee recommend s to the Gavi Alliance
Board that it :

a) Reappoint Sarah Goulding as Board member representing Australia on the
donor constituency anchored by the United States, effective 1 January 2022
and until 31 December 2023; and

b) Reappoint Sarah Goulding as Vice Chair of the Board with individual signatory
authority, effective 1 January 2022 and until 31 December 2023 .
Decision Two ? Board and Committee Member Appointments
The Gavi Alliance Governance Committee recommend s to the Gavi Allian ce
Board:
a) That it appoint the following Board Members:
? Bernhard Braune as Board Member representing Germany on the donor
constituency anchored by Germany in the seat currently held by Joan
Valadou of France, effective 1 January 2022 and until 31 December 2 022.
? Rafael Vilasanjuan as Board Member representing the civil society
organisations constituency in the seat currently held by Maty Dia, effective
1 January 2021 and until 31 December 2023.
SUBJECT: CONSENT AGENDA ? UPDATED AS AT 30 NOV 2021
Agenda item: 01 d
Category: For Decision

1


Re port to the Board

Board -2021 -Mtg -4-Doc 01d -Annex A
Annex A : IR C members proposed for reappointment for a second term, until
March 2025

Name Nationality
1 Saidou Path? Barry Guinea
2 Blaise Bikandou Congo
3 Francois Boilloit France
4 Dah Cheikh Mauritania
5 Ren ? Dubbeldam Holland
6 Peter Fonkwo Cameroun
7 Mathieu Noirhomme Belgium
8 Cornelius Oepen Germany
9 Elisabeth Paul Belgium
10 Jim Setzer USA

1


Re port to the Board

Board -2021 -Mtg -4-Doc 01d -Annex B
Annex B: IRC members proposed for e xceptional extension until March 202 4

Name Nationality
1 Aleksandra Caric Croatia
2 Osman David Mansoor New Zealand
3 Benjamin Nkowane Zambia

December 2021
AUDIT AND FINANCE COMMITTEE CHARTER
1. P U RP O S E
The Audit and Finance Committee (?Committee? or ? the AFC?) is established by the
Board (?Board?) of the Gavi Alliance (?Gavi?) to support the Board in fulfilling its
oversight responsibilities in a timely manner in respect of Gavi?s financial
management, risk and control framework, including internal and external audit, and
adherence to appropriate standards of good practices and ethics.
The Committee will review, monitor and make recommendations to the Board on the
areas within its scope of responsibilities a nd on any other matters which the Board
may request.
Words and expressions used in this Charter shall, unless the context requires
otherwise, have the meaning attributed to them in the Gavi Board and Board
Committee Operating Procedures (?Operating Procedures?) .
2. M E M B E RS H I P
The membership , resources, responsibilities and authorities of the Committee to
perform its role effectively are stipulated in this Charter, which may be amended by
the Board as and when required or deemed necessary and are specifically governed
by Article 1 8 of the Statutes and Section 18 of the Operating Procedures.
A. Composition and size
The composition of the AFC shall allow it to function efficiently and effectively in
fulfilling its functions and responsibilities . The composition of the AFC is intended to
comprise individuals suitabl y competent in the affairs and issues falling within the
Charter so as to be able to provide the Board and the Secretariat with sound advice on
matters set out in this Charter.
The AFC shall comprise not less than three members . A majority of the AFC members
shall comprise Board M embers and Alternate Board M emb ers. This provision shall
exclude Committee members representing i mplementing country governments .
Committee D elegates, as defined in S ection 18.9 of the Operating Procedures, shall be
eligible for membership on the AFC and shall resign or be removed in accordance with
S ection 5 of the Operating Procedures .

Doc 01d - Annex C

December 2021
COVAX FACILITY SHAREHOLDERS COUNCIL
TERMS OF REFERENCE
1. Purpose
The COVAX Facility Shareholders Council (?the Council?) is established by the Board
(?Board?) of the Gavi Alliance (?Gavi?) to convene Participants 1
of the COVAX Facility with the
aim of providing strategic guidance and advice to the Office of the COVAX Facility (?the
Office?) on the operational aspects of the COVAX Facility .
The Council is not deemed to be a committee of the Board in th at its primary role is essentially
an advisory function as contemplated under Article 20 of the Statues. It is empowered by the
Board to undertake the responsibilities outlined in these terms of reference.
2. Membership
Membership of the COVAX Shareholders C ouncil is open to all Participants of the COVAX
Facility.
A representative each from UNICEF, WHO, PAHO, the World Bank, Civil Society and the
AMC92 group of implementing countries shall have a permanent observer seat on the
Shareholders Council.
A. Composition and size
Each Participant may appoint one formal representative to the Council. All members are
treated equally in terms of membership, rights and privileges .
B. Competencies and skills
Council representatives should be empowered to represent thei r government?s policies and
priorities, and reach agreements on their behalf. M embers are expected to be willing and able
to dedicate sufficient time to fulfil Council roles and responsibilities. All members are
expected to act in a manner consistent with the Facility?s goals.
1
Economies who have signed the SFP 2.0 F ramework A greement and fulfilled the necessary financial
requirements or economies who have signed the SFP Transition A greement

Doc 01d - Annex D

Board -2021 -Mtg -4-Doc 01d -Annex E
Gavi Alliance
Evaluation Policy
Version 4 .0



DOCUMENT ADMINISTRATION


VERSION
NUMBER APPROVAL PROCESS DATE
1.0 Prepared by:
Reviewed by:
Reviewed by:
Policy options reviewed by:
Reviewed and recommended by:
Approved by: Joint GAVI Alliance &
Fund Board
Effective from: 27 June 2008
2.0 Reviewed and recommended by:
Gavi Evaluation Advisory Committee

Approved by: Gavi Alliance Board Effective from: 1 July 2012
Next review: In 2014 or as and when required
3.0 Reviewed and recommended by:
Gavi Evaluation Advisory Committee
10 -11 April 2019
Approved by: Gavi Alliance Board Effective from: 1 July 201 9
Next review: Prior to next Gavi strategic period
(2025), or as and when required
4.0 Reviewed and recommended by:
Gavi Evaluation Advisory Committee
26 November 2021
Approved by: Gavi Alliance Board 30 November 2021
Effective from: 1 January 2022
Next review: Prior to next Gavi strategic period
(2025), or as and when required

Board -2021 -Mtg -4-Doc 01d -Annex F
Gavi Alliance
Treasury Governance Policy
Version 1.0




DOCUMENT ADMINISTRATION



VERSION
NUMBER APPROVAL PROCESS DATE
1.0 Prepared by: Treasury Team

Reviewed by:
Director, Finance & Chief Accounting
Officer
4 August 2021
Reviewed by:
Treasury Risk Management
Committee
30 September 2021
Reviewed and recommended by:
Gavi Audit and Finance Committee 19 October 2021
Approv ed by:
Gavi Alliance Board
2 December 2021
Effective from: 2 December 2021
Next review: As and when required





Board -2021 -Mtg -4-Doc 01d -Annex F 2
Gavi Alliance
Treasury Governance Policy
1. Purpose
1.1. The purpose of this Treasury Governance Policy ( the ? Policy ?) is to strengthen the
management of treasury -related activities at the Gavi Alliance (?Gavi?). The Policy
provides key guiding principles and defines primary roles and responsibilities for
the execution of these guidelines.
2. Scope
2.1. This Policy shall apply to all business units within Gavi which are undertaking or
are engaged in decisions impacting treasury -related activities in the areas of:
2.1.1. Cash and liquidity management;
2.1.2. Cash flow forecasting;
2.1.3. Financial risk management;
2.1.4. Financial guarantees;
2.1.5. Bank relationship management;
2.1.6. Treasury technology including bank connectivity.
2.2. The Treasury function spans across Gavi?s business activities . Therefore, the
Policy is applicable to current a nd future Gavi programmes.
3. Policy Statements
3.1. Treasury Team shall be ult imately responsible for recommending the treasury
improvement plan and operationally executing activities belonging to its remit.
3.2. The main Treasury Team? s objectives are to:
3.2.1. Manage liquidity in order to fulfil Gavi?s financial obligations in a timely and
cost -effective manner;
3.2.2. Identify financial risks and measure financial exposures to protect Gavi
against negative financial impact by recommending and implementing
suitable risk management strategies;
3.2.3. Define and maintain an efficient banking landscape to acc ommodate Gavi?s
business requirements, minimise operational complexity and maximise
flexibility;
3.2.4. Establish strict segregation of duties and controls to minimise operational
risks within treasury activities involving financial transactions;
3.3. Based on these p rimary objectives, detailed objectives are further formulated in
individual treasury policies. A complete treasury governance framework is
structured in three layers:
3.3.1. This Policy provides guiding principles and delegates responsibility to
different organis ational units to execute the treasury mandate;

Board -2021 -Mtg -4-Doc 01d -Annex G
Gavi Alliance
Treasury Risk Management Policy
Version 1.0




DOCUMENT ADMINISTRATION


VERSION
NUMBER APPROVAL PROCESS DATE
1.0 Prepared by: Treasury Team

Reviewed by:
Director, Finance & Chief Accounting
Officer
4 August 2021
Reviewed by:
Treasury Risk Management
Committee
30 September 2021
Reviewed and recommended by:
Gavi Audit and Finance Committee 19 October 2021
Approv ed by:
Gavi Alliance Board
2 December 2021
Effective from: 2 December 2021
Next review: As and when required





Board -2021 -Mtg -4-Doc 01d -Annex G 2
Gavi Alliance
Treasury Risk Management Policy
1. Purpose
1.1. The purpose of the Treasury Risk Management Policy (the ?Policy? ) is to define
how the Treasury team manages financial risks to which the Gavi is exposed,
namely, financial counterparty credit risk, sovereign counterparty credit risk and
foreign exchange (FX) risks.
1.2. Financial risk management is defined as the process of identification,
measurement, manag ement and reporting of financial risks. The Policy defines the
objectives, guiding statements and responsibilities with regards to counterparty
credit and FX risks.
2. Objectives
2.1. The objectives of the Policy are to:
2.1.1. Provide maximum predictability of funding when Gavi engages in
programmes. Gavi shall apply currency hedging to reduce its exposure to
potential decreases in the value of future net cash inflows due to exchange
rate fluctuations ;
2.1.2. Identify, measure and mana ge counterparty credit risks with approved
financial counterparties against approved counterparty credit limits to
safeguard the value of financial assets and minimise potential losses from
counterparty defaults ; and
2.1.3. Minimise Gavi?s risk to sovereign count erparties by implementing effective
risk mitigation mechanisms, including but not limiting to financial
guarantees or letter of credit.
3. Risk Assessment
3.1. FX risk. Gavi receives contributions and other inflows in a variety of currencies.
Gavi?s programme expe nditures for vaccine purchases and cash grants are mainly
incurred in USD. Business plan expenditures for staff costs, office facilities and
other services are incurred mainly in USD and CHF. Because FX rates fluctuate,
the value in a given currency of fut ure cash flows denominated in another currency
will vary over time, resulting in increases or decreases in th e value of these future
cash flows . These variations may be substantial, especially in periods of high FX
volatility.
3.2. Permitted hedging instruments (as defined in Section 9.1 ) enable reduction of the
risk of decreases in the value of future net cash inflows. This provides greater
certainty of the value of future cash flows in the currency to which they will
ultimat ely be converted.
3.3. Financial counterparty credit risk . This is the risk that a financial counterparty
will fail to meet its obligations. It applies whenever Gavi is exposed to a default by
financial counterparties. Financial transactions at Gavi include cas h on bank
accounts, term deposits, money market investments, financial guarantees, FX
derivatives and collateral payments. The credit exposure per financial counterparty
is measured by aggregating the following items:
? Cash balances on bank accounts
? Short -term investments
? Bank guarantees in favour of Gavi

Report to the Board

Board -2021 -Mtg -4-Doc 01d -Annex H

Annex H: Summary of approved and p roposed baselines /targets for Gavi 5.0 indicators
ID Indicator name Baseline 2025 target
MISSION INDICATORS
M.1 Under -five mortality 58 per 1,000 -10% reduction
M.2 Future deaths averted ? 7-8m
M.3 Future DALYs averted ? 320 -380m
M.4 Reduction in zero -dose 9.7m -25%
M.5 Unique children immunised ? 300m
M.6 Economic benefits unlocked ? US$80 -100b
STRATEGY GOAL 1: INTRODUCE AND SCALE UP VACCINES
S1. 1 Breadth of protection 56% +16pp
S1.2 SDG3.b.1
DTP3 81% +4pp
MCV2 58% +13pp
PCV3 53% 23pp
HPV2 8% +17pp
S1.3 Rate of scale up of new vaccines
PCV3
n/a 90% Rotac
MCV2
YF
S1.4 Vaccine introductions ? 82
S1.5 Country prioritisation ? ?1
S1.6 Preventative campaign reach (measles) ? 50%
S1.7 Timely outbreak detection and response 25% 50% increase
STRATEGY GOAL 2: STRENGTHEN HEALTH SYSTEMS AND EQUITY IN IMMUNISATION 2
S2.1 Geographic equity DTP3 coverage 67% +7pp
S2.2 DTP drop -out 7% -1pp
S2.3 MCV1 coverage 80% +4pp
S2.4 Number of immunisation sessions n/a n/a
S2.5 Stock availability at facility level n/a n/a
S2.6 EPI management capacity n/a n/a
S2.7 Plans to overcome demand barriers n/a n/a
S2.8 Gender -related barriers n/a n/a
STRATEGY GOAL 3: IMPROVE SUSTAINABILITY OF IMMUNISATION PROGRAMMES
S3.1 Co -financing fulfillment 100% 100%
S3.2 Preventing backsliding in Gavi -transitioned countries ?3 No decline 4
S3.3 (If applicable) Vaccine introductions ( PCV, Rota, HPV)
catalyzed in Gavi -transitioned countries TBD TBD
STRATEGY GOAL 4: ENSURE HEALTHY MARKETS FOR VACCINES AND RELATED PRODUCTS
S4.1 Healthy market dynamics ? 10
S4.2 Incentivise innovations ? 8
S4.3 Scale -up innovations ? 9
NB: Baselines and targets for greyed out indicators were approved by the Gavi Board in June 2021 .
1 Target not set for this indicator due to ongoing uncertainties regarding future implementation of the Vaccine Investment Stra tegy. 2 The Gavi Board approved (December 2020) to the proposal that no targets be set for indicators S2.4 to S2.8. They will be m onitored for directionality as the Alliance establishes and strengthens systems to consistently collect quality data. 3 Baseline for this indicator is 2021. The baseline will be set in 2022, once 2021 immunisation coverage estimates are published. 4 No num eric value for 2025 target , which is framed as the proportion of Gavi -transitioned countries at least sustaining performance.

Classified as Internal #
Gavi Alliance Board Workplan
Gavi Board Paper Type Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec
A. Strategy/Performance/Risk/MEL
CEO's Report CEO's Report Discussion
2021-2025 Strategy Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion
Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion
2021-2025 Strategy Gavi 5.0 Decision
Measurement Framework (Targets & Indicators) Measurement Framework Decision
Funding Policies* Gavi 5.0: Operationalisation Decision Decision
Innovation Gavi Innovation Strategy Decision Decision
Private Sector Engagement TBD Information Information Information Information Information
Middle Income Countries (MICs) TBD Decision Decision
Civil Society and Community Engagement Approach Civil Society and Community Engagement Approach Decision
Partners' Engagement Framework TBD Decision
Disease Surveillance and Diagnostics in Gavi 5.0 TBD Decision
Discussion
Risk and Asurance Report Risk and Assurance Report Decision Decision Decision Decision Decision
2026-2030 Strategy TBD Decision
Guidance Decision
Measurement Framework (Targets & Indicators) TBD Decision Guidance Decision
B. Vaccines & Sustainablity
Typhoid TBD Information
Pneumococcal AMC (Advance Market Commitment) TBD Information
Inactivated Polio Vaccine (IPV) co-financing approach TBD TBD
Guidance Decision
Malaria TBD Decision
Update on vaccines for epidemic preparedness and response TBD Discussion
Vaccine Investment Strategy TBD Decision
Guidance Decision
COVAX
COVAX Decision Decision Decision
C. Policy
Fragility, Emergencies, Refugees Policy TBD Decision Decision
Transparency and Accountability Policy Decision Decision
D. Country Programmes
Nigeria TBD Information Information Information Information Information
PNG TBD Information Information
Strategic Partnership with India Strategic Partnerships with India Decision
Post-Transition Support (e.g. Angola, Timor-Leste) TBD Information
Fiduciary risk assurance and financial management capacity building
Fiduciary risk assurance and financial management capacity building Decision Information
E. Finance/Audit & Investigations
Annual Accounts Annual Financial Report Decision Decision Decision Decision Decision
Financial Forecast Financial Update, including forecast Decision Decision Decision Decision Decision Decision
Budget Financial Update, including forecast Decision Decision Decision Decision
Audit & Investigations Report Audit & Investigations Report Information Information Information Information Information
F. Governance
Board Chair Appointment Board Chair Appointment Decision Decision
Board Vice Chair Appointment Consent Agenda Decision Decision Decision
Committee Chair Appointments Consent Agenda Decision Decision Decision Decision
Board and Committee Appointments Consent Agenda Decision Decision Decision
IRC Appointments Consent Agenda Decision
CEO Appointment Consent Agenda Decision Decision
Secretary Appointment Consent Agenda Decision
Treasurer Appointment Consent Agenda Decision
Appointment of MD A&I Consent Agenda Decision
Amendments to Governance Documents (Statutes, By-Laws, Committee Charters) Consent Agenda Decision
IRC Terms of Reference TBD Decision
Audit & Investigations Terms of Reference TBD Decision
G. Reporting
Committee Chair Reports Committee Chair and IFFIm Board reports Information Information Information Information Information Information Information Information Information
IFFIm Chair Reports Committee Chair and IFFIm Board reports Information Information Information Information Information Information Information Information Information
Replenishment/Resource Mobilisaton TBD Discussion
HR Report Closed Session Information Information Information Information Information
Annual Report on Implementation of the Gender Policy Annex to Strategy paper Information Information Information Information Information
CEPI Progress Report
Annex to Board pack/On BE as additional materials Information Information Information Information Information Information Information Information Information
Board and Committee minutes
Annex to Board pack/On BE as additional materials Information Information Information Information Information Information Information Information Information
H. Pre-Board Technical Briefing Sessions Discussion
Gender
*Includes Eligiblity & Transition Policy, Co-Financing Policy, HSIS Support Framework, CCEOP Last updated - 17 November 2021
Next Board Meetings
:
6-7 April 2022, Retreat
22-23 June 2022
7-8 December 2022 2022 2023 2024 2025
Board-2021-Mtg-4-Doc 01e

1



Board -2021 -Mtg -4-Doc 03


Section A: Executive Summary
Context
At its June 2021 meeting, the Gavi Alliance Board reviewed and approved the
Financial Forecasts for (i) Gavi (excluding COVAX) for the Strategic Period
2021 - 2025 ( ?Gavi 5.0 ?) and (ii) COVAX Advance Market Commitment (? AMC ?) for
the funded period 2020 -2022 . This paper presents the updated Financial
Forecast s for Gavi 5.0 and COVAX AMC including the impact of the additiona l Gavi
5.0 investment priorities presented for decision at this Board meeting . A
consolidated overview is also presented for the first time to reflect the full financial
portfolio of Gavi 5.0 and COVAX AMC.
Gavi 5.0 has begun amid some reversal of pre -pandemic gains and continued
uncertainty about the future evolution and impact of COVID -19 on routine
immunisation systems. Increasing global and country attention to the rollout of
COVID -19 vaccines makes the Alliance?s ambitious equity targets, such as the
reduction of zero -dose children by 25% by 2025, even more daunting. Gavi is
actively working with c ountries to maintain focus on routine immunisation while
delivering COVID -19 vaccines. Given countries are heterogeneous, demonstrating
variable impact of the pandemic on routine immunisation as well as capacity to
mount an effective response including vac cination, the Alliance is drawing on all
its levers to support tailored solutions for each country. In preparing the financial
forecast the Secretariat considered a number of uncertainties relating to continued
disruption of essential health services inclu ding routine immunisation from COVID -
19 pandemic and country efforts to scal e up COVID -19 vaccination . The current
assumptions underpinning the financial forecast consider, among other things, the
continued commitment to deliver Gavi 5.0 Strategic Objecti ves and the outcome of
the recent High Level Review Panel ( HLRP ) which, as supported by the 2020
WHO/UNICEF Estimates of National Immunisation Coverage ( WUENIC ) data
released in July 2021, indicate that implementing countries continue to prioritise
routine immunisation programmes and sustain vaccination of children.

At this point in time there are no material changes to the approved
expenditures nor phasing of key activities in the Gavi 5.0 financial forecast .
The Secretariat will continu e to engage with countries and partners to assess the
assumptions and, if circumstances change, will reflect them in the next reforecast
cycle. The Secretariat support and expenditure for Gavi 5.0 remains unchanged ,
although there is some phasing of costs from 2021 into the outer years reflecting
the lower spend in 2021 due to COVID -19 disruption.
SUBJECT : FINANCIAL UPDATE , INCLUDING FORECAST - REVISED
Agenda item: 03
Category: For Decision
Report to the Board
30 Nov ember - 2 Dec ember 2021

Report to the Board
Board -2021 -Mtg -4-Doc 03-Annex A

Annex A: Implications and Anticipated Impact
1. Impact on countries
Approval of the Financial Forecast enables funding to be allotted to
programmes in accordance with the Programme Funding Policy.
2. Risk implication and mitigation, including information on the risks
of inaction
Determination of Gavi?s financial capacity to approve the recommended
decisions relies on the Financial Forecast. Risks that may impact the reliability
of financial forecast are described below, as well as the mitigation strategies in
place to address these risks.
One of those risks arises from exposure to foreign currency exchange rate
fluctuations. In the forecast, non -US dollar denominated pledges are valued at
their USD equiv alents using the Bloomberg spot exchange rates when
compiling the forecast (consistent with the approach agreed with donors) or,
where hedged, at the hedge rate. Pledges are hedged progressively.
Gavi?s Cash and Investments Reserve as mandated by the Prog ramme
Funding Policy provides a cushion for adverse fluctuations in resources and
expenditures. Gavi can also decline or defer funding requests based on
resource availability.
3. Risks associated with the financial forecast and mitigation
Factors that may impact the expenditure forecast include:
Demand volumes can vary significantly based on small changes in country
introduction assumptions. While the introduction assumptions made in the
current forecasts leverage the information currently available, there remains an
inherent high degree of uncertainty on these assumptions. In addition, the
assumptions on introduction timing are often dependent on projections of when
a country will no longer be eligible for new Gavi support. This forecast
represents th e application of the current Board approved Eligibility
and Transition Policy. Changes or exceptions to this policy could vary demand
significantly.
Price forecasts reflect expected market dynamics specific to each vaccine.
The point forecast represents a moderate most likely scenario estimate
among a range of possible estimates and reflects information available at the
time of preparation of the forecast.
The forecast includes assumptions for supply availability as currently
anticipated.
Expenditure reductions may also be achieved through future vaccine price
reductions beyond the reductions already incorporated into the price
forecast and more efficient stock management at country level beyond the
reductions already incorporated into the volume forec ast.

Report to the Board
Board -2021 -Mtg -4-Doc 03-Annex B

Annex B: Terminology Used in Basis of Preparation

Terminology and rounding
Terms used in th e financial forecast update paper have the meanings described
below, and are relevant to Gavi?s Programme Funding Policy . Given the nature of
the COVAX Facility and the current Board mandate, not all concepts are applicable
to COVAX.
a) Assured Resources comprise:
? Cash and investments of Gavi, in the amount that exceeds the Cash and
Investments Reserve (see ( d) below)
? Expected proceeds from IFFIm, based on existing donor pledges
? Any other contributions that are contingent on programmatic expenditure
included in the expenditure forecast (ring -fenced funding)
? Confirmed direct contributions to Gavi that are pledged under already -
signed agreements or otherwise confirmed in writing
? Projected investment income
b) Allowance for Further Direct Contributions (for the purpose of approving
funding decisions): An allowance for further expected direct contributions
from existing donors who have not confirmed their pledges for each year,
based on current overall contribution levels. The allowance is mandated by
the Programme Funding P olicy and is important towards enabling programme
funding decisions to be made while pledges have yet to be completed
for particular years. The allowance assumes that in years where currently
confirmed direct contributions total less than the current level , further
contributions will bring the total to that level.
c) Qualifying Resources : The sum of Assured Resources and the Allowance for
Further Direct Contributions (i.e. (a) plus (b) above).
d) Cash and Investments Reserve : The reserve required by the Programme
Funding Policy to be maintained at a minimum equalling eight months
(currently nine) of expected annual expenditures.
Rounding:
In text and tables throughout th e financial forecast paper, numbers may be
rounded to shorter, signi ficant numbers in order to enhance readability and ease
of reference. Individual numbers and the totals they comprise are rounded
independently. Consequently, the individual numbers may appear not to sum to
their total because of rounding.
Vaccine programme acronyms
Pneumo / PCV : Pneumococcal conjugate vaccine
https://www.gavi.org/types -support/vaccine -support/pneumococcal

Report to the Board
Board -2021 -Mtg -4-Doc 04-Annex A

Annex A: Audit and Investigations - background
? In 2009 Gavi became an independent organisation ( having previously been
?hosted? by UNICEF), and Gavi?s Internal Audit function was first -established as a
single person activity. In December 2014, with a growing need for assurance, the
Board approved the reconstitution of audit as the 13 -person Audit and
Investigations (A&I) function. A&I comprises the third line of defence being
independent of Gavi?s core activities and oversight functions and reports to the
Board, which is achieved through routine reporting to the AFC, and the Chief
Executive Officer. Audits and other reviews are conducted against annual plans
approved by the AFC, drawn from a risk -ba sed assessment of priority.
? A&I operates under a charter approved by the Board, (?Audit and Investigations
Terms of Reference? , ToR ) which is reviewed and updated periodically. This sets
out the basis of operation of the function, its reporting relationshi p to the AFC and
Board, and critically, the basis of its independence. This was last amended in June
2020.
? The A&I function undertakes 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, control, and governance processes.
o Programme Audit which conducts audits of programmes in -country to assess
whether: a) programmes are operating with appropriate systems and processes
in a manner consistent with the requirements of the Partnership Framework
Agreement (PFA) agreed between country and Gavi, and is sufficient to support
an independent and sustainable programme after transition from Gavi support;
b) Gavi support, including cas h, 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 undertakes preventive activities to minimise the risk of such
conduct occurring and/or impacting the organisation.
o Whistleblower Reporting which receives reports from internal and external
sources, and follows up as appropriate, on potential concerns relating to :
financial or programmatic misuse ; sexual harassment, exploitation, and abuse ;
or other misconduct.
? A&I is required by the professio nal standards of the Institute of Internal Auditors
(?the Institute?) , a s embodied within the ToR, to undergo at least a five -yearly
independent assessment of its policies and procedures, and satisfactory
application of them . This was satisfactorily concluded in March 2020 by the
assessment arm of the French Institute without qualification against any of the 62
assessment criteria.

 

 

Board -2021 -Mtg -4-Doc 0 5 1

Report to the Board
30 Nov ember ?2 D ec ember 202 1


24 November 202 1

Dear Board members ,
We will soon be entering our third year of the pandemic, and Gavi?s work is
increasingly relevant and urgent. Throughout the pandemic , we have dedicated
ourselves to supporting countries in maintaining, restoring and strengthening
routine immunisation, to finding new ways of reaching the most marginali sed, and
to ending the acute phase of the pandemic with immunisation. Looking ahead to
2022, we remain steadfast in this ambition, while also being cognisant of the risks.
The Board will have an opportunity in this meeting to discuss the top risks
described in the new Risk & Assurance Report. As per Gavi?s upd ated Risk
Appetite Statement , approved by the Board in its June 2021 meeting, these risks
are worth taking , but we continue to actively monitor and mitigate them to the
extent possible. Importantly, we are seeking to maintain the right balance between
our suppo rt for routine immunisation , our Gavi 5.0 priorities and the need to put
COVID -19 behind us . This new COVID -19 era and Gavi?s engagement in the
global response has thrown the organi sation into the public spotlight in way s it has
not been previously. We have put our hard -won reputation on the line in an effort
to put equity at the cent re of the response and are still engaged in the upward
battle of filling the unconscionable gaps in COVID -19 coverage , particularly in
lower -income countries.
This past year was also the first year of Gavi 5.0 implementation . Building off
the Alliance?s strong ?Coverage & Equity? achievements from 2016 ?2019, we were
poised to kick -start this new strateg ic period with an even sharper focus on e quity,
with reaching zero -dose children and missed communities as our marker s of
success. Unfortunately, the effects of the COVID -19 pandemic are not over and
will likely continue for at least another few years. COVID -19 cases in Gavi -eligible
countries ac count for ~22% of the reported global burden, with continued increase
observed in some countries but with varying waves of disease in others. While
there is a high degree of variability across countries , these trends of continuing
disease, contracting fiscal space and the reduction in coverage reported in the
202 0 WUENIC estimates have profound implications for Gavi -supported countries
and our programmatic efforts. There are four key messages I would like to
emphasi se:
Report of the Chief Executive Officer

 

 

1



Board -2021 -Mtg -4-Doc 05

Rapport pour le Conseil
d?administration
30 novembre ?2 d?cembre 202 1


Le 24 novembre 202 1

Chers membres du Conseil d?administration,
Alors que nous allons bient?t entamer la troisi?me ann?e sous pand?mie, l a
pertinence et l?urgence de la t?che de Gavi ne font que cro?tre . Durant ces deux
ann?es de pand?mie, nous avons aid? les pays ? maintenir, restaurer et renforcer
la vaccination de routine , cherch? ? atteindre les plus m arginalis?s et ? mettre fin
? la phase aigu? de la pand?mie par la vaccination. Nous abordons 2022 avec la
m?me vision , tout en ?tant conscients des risques encourus . Lors de cette r?union,
le Conseil d'administration aura l'occasion de discuter des principaux risques
d?crits dans le nouveau rapport sur les risques et assurances . Comme indiqu?
dans la derni?re version de la d?claration de Gavi sur l?app?tit pour le risque ,
approuv?e par le Conseil d'administration lors de sa r?union de juin, cette pri se de
risques en vaut la peine , sachant que nous n?en continuons pas moins ? exercer
sur eux une surveillance active et cherchons ? les att?nuer autant que possible.
Nous nous effor?ons de maintenir un bon ?quilibre entre notre soutien ? la
vaccination syst?matique , les priorit?s d?finies pour Gavi 5.0 et la n?cessit? de
mettre fin ? la pand?mie . Avec la COVID -19, nous sommes entr?s dans une
nouvelle ?re , et Gavi s?est engag?e ? fond dans la riposte mon diale ? la pand?mie,
ce qui l?a plac?e sous les feux de la rampe comme jamais auparavant. En
inscrivant l'?quit? au centre de la riposte , nous avons engag? notre r?putation .
Nous sommes toujours en train de nous battre pour essayer de combler les failles
inadmissibles observ?es dans la couverture vaccinale contre la COVID -19, tout
particuli ?rement dans les pays ? faible revenu.

L'ann?e ?coul?e ?tait ?galement la premi?re ann?e de mise en ?uvre de Gavi
5.0 . Forts des succ?s obtenus entre 2016 et 2019 par l'Alliance en mati?re de
couverture vaccinale et d'?quit? , nous ?tions pr?ts ? donner le coup d'envoi de
cette nouvelle p?riode strat?gique en nous attachant encore davantage ? l'?quit?
dans la vaccination . Nous avions ?tabli comme marqueurs de succ?s le fait
d?atteindre les enfants z?ro dose et les communaut?s laiss?es pour compte .
Malheureusement, nous subissons toujours les effets de la pand?mie , qui vont
probablement se faire sentir encore pendant plusieurs ann?es. Dans les pays
?ligibles au soutien de Gavi , l es cas de COVID -19 repr?sentent autour de 22 %
des cas signal?s dans le monde . Dans certains pays, le nombre de cas augmente
Rapport du Directeur ex?cutif

1



Board -2021 -Mtg -4-Doc 06


Section A : Executive Summary

This report provides an initial progress update on Gavi 5.0 , associated
opportunities and risks 1 and a final update on progress made in Gavi 4.0,
informed by the updated WUENIC 2 data released in July 2021.
Despite pandemic related disruptions to immunisation services, the Alliance
achieved or exceeded all of its Gavi 4.0 mission targets. Although there was a
decline of 4 percentage points in DTP3 coverage between 2019 and 2020,
disruptions appear to have been c oncentrated in Q2 2020 with the majority of Gavi -
supported countries showing restoration of services to pre -pandemic levels by the
end of 2020. This is a testament to the dedication of countries, supported by the
Alliance, to protect immunisation services during these challenging times.
However, the outlook remains uncertain with monthly administrative data
showing potential disruption, mainly in some Asian countries in 2021.
Although it is too early to say the extent to which these trends represent real
disruption rather than reporting issues, it is clear that the situation remains tenuous .
A real risk of backsliding remains, not only from potential future waves of
COVID -19 infections but also from the diversion of resources to COVID -19 vaccine
delivery. A synergistic approach to COVID -19 vaccination and routine
immunisation , clear guidance to c ountries, flexible and tailored support based on
country needs, and enhanced advocacy will be critical to mitigate these risks.

In light of ongoing risks and uncertainty, priorities and targets for Gavi 5.0
continue to be reviewed and will be adapted as required . The Board endorsed
a recalibrated set of priorities in Dec ember 2020, with the Alliance prioritising
access to COVID -19 vaccines; maintaining, restoring and strengthening routine
immunisation; reaching zero dose children and missed communities; and
safeguarding domestic financing for immunisation. Other areas of Gavi 5.0,
including new vaccine introductions and the approach for engaging middle -income
countries (MICs) , will advance at a slower pace than initially planned.

In order to support countries to simultaneously deliver routine immunisation and
COVID -19 vaccinat ions , while also catching -up missed children to prevent
outbreaks , the Alliance is seeking to increasingly take a joined -up view of these
intertwined priorities. Concretely, t his will require further integration and
1 Associated risks refer to the top risks in the Risk & Assurance Report 2021 2 WHO/UNICEF Estimates of National Immunization Coverage
SUBJECT : STRATEGY, PROGRAMMES AND PARTNERSHIPS:
PROGRESS, RISKS AND CHALLENGES
Agenda item: 06
Category: For Guidance
Report to the Board
30 Nov ember - 2 Dec ember 2021

1

Re port to the Report to the Board
Board -2021 -Mtg -4-Doc 06-Annex A


Annex A : Updated Alliance KPI dashboard

Classified as Internal
BOARD & COMMITTEE ATTENDANCE
GENDER BALANCE
Partners 3
1
2
3
4
5
6
7
SFA/PEF ACHIEVEMENTS
CSO ENGAGEMENT
PLEDGE CONVERSION
DONOR ENGAGEMENT IN COUNTRY
END 2019 TARGET: N/A EVALUATION ALIGNMENT
END 2020 TARGET: N/A COUNTRY REPORTING
END 2020 TARGET: 85%
55%
END 2020 TARGET: 50%
END 2020 TARGET: 100%
END 2019 TARGET: N/A
END 2020 TARGET: 95%
Governance 4
1
Secretariat & partners 1
2
4
5
6
VACCINE INTRODUCTIONS
END 2020 TARGET: 54 NEW VACCINE COVERAGE
END 2019 TARGET: 90%
END 2019 TARGET: 90% HSS PROPOSAL QUALITY
END 2020 TARGET: 100 % HSS FUND UTILISATION
END 2019 TARGET: 7 5 % HSS GRANT TARGETS
END 2019 TARGET: 50%
26%
Secretariat
OPERATIONAL DEMAND FORECAST
PROGRAMME FINANCE FORECAST
SPEED OF CASH GRANT DISBURSEMENTS
END 2020 TARGET: 9 months AUDITS ON TRACK
END 2020 TARGET: 80% RISK MANAGEMENT PLAN PROGRESS
END 2020 TARGET: 60% OPERATING EFFICIENCY
TARGET: N/A?
END 2020 TARGET: +/ - 10%
END 2019 TARGET: +/ - 10%
1
2
2016 ? 2020 INDICATORS
ALLIANCE PROGRESS
4
Gavi Board UPDATED: 15 September 2021
PARTNER GROUP
PEF
PEF
CSO
DONORS
DONORS
COUNTRIES
TCA ACTIVITIES ON TRACK
0 EVALUATIONS
Health system strengthening Targeted country assistance Strategic focus area Partners' engagement framework Civil society organization
HSS TCA SFA PEF CSO
END 2019 TARGET: 90%
88%
END 2020 TARGET: 40%
100%
41%
END 2019 BASELINE: 56
END 2018 BASELINE: 96%
END 2018 BASELINE : 10%
END 2019 BASELINE: 71%
END 2018 BASELINE: 58%
2018 BASELINE : 50%
END 2019 BASELINE: 10.5 months
END 2019 BASELINE :86 %
END 2019 BASELINE : 88%
2017 BASELINE $283k:
END 2019 BASELINE : - 6%
END 2018 BASELINE : - 19%
END 2019 BASELINE: 50 %
END 2019 BASELINE :95 %
END 2018 BASELINE : 59%
END 2019 BASELINE : 95%
END 2018 BASELINE : 94%
END 2019 BASELINE : 0
2015 BASELINE : 26%
END 2018 BASELINE : 87%
END 2019 BASELINE : 45%
ON TRACK MODERATE DELAYS / CHALLENGES SIGNIFICANT DELAYS / CHALLENGES
4
TRACKING TREND ONLY
28%
69%
3 2 0
94% 61%
93%
90%
14%
278K
NO UPDATE AT THIS REPORTING PERIOD
3 MEASLES CAMPAIGN COVERAGE
9.7 months
4
5
6
3
2
1
2
48%
19
67%
+17%
100%
NB: Graphics not drawn to scale
No update

No update

+8%
No update

No update

No update
No update

No update

1

Re port to the Report to the Board
Board -2021 -Mtg -4-Doc 06-Annex B


Annex B : 2016 -2020 Strategy progress dashboard with original indicator definitions

Classified as Internal
21%
55%
2
3
Improve sustainability 3 Market shaping 4 Accelerate vaccines 1 Strengthen capacity 2
2016 ? 2020 INDICATORS
STRATEGY PROGRESS
5
Gavi Board UPDATED: 15 September 2021
1
EQUITY: GEOGRAPHIC DISTRIBUTION
ROUTINE IMMUNISATION COVERAGE 1
2
3
4
5
EFFECTIVE VACCINE MANAGEMENT
DATA QUALITY
PENTA1 COVERAGE & DROP -OUT
INTEGRATED HEALTH SERVICE DELIVERY
CIVIL SOCIETY ENGAGEMENT
2
3
4
1
COUNTRY INVESTMENT IN VACCINES 1
COUNTRIES ON TRACK TO TRANSITION
INSTITUTIONAL CAPACITY
CO - FINANCING COMMITMENTS
2
3
4
1
VACCINE PRICE REDUCTION
VACCINE INNOVATION
HEALTHY MARKET DYNAMICS
SUPPLY SECURITY
Measles - containing vaccine 1 st dose Percentage point Pentavalent 1 st dose Pentavalent 3 rd dose
MCV1
PP Penta1 Penta3
CURRENT: + 1PP 2020 TARGET PENTA3 85% MCV1: 83% 2015 BASELINE PENTA3: 80% MCV1: 78%
CURRENT: + 1PP 2020 TARGET 89% 2015 BASELINE 79%
2020 TARGET 43%** 2015 BASELINE 16%
2020 TARGET 38% 2015 BASELINE 28%
2020 TARGET PENTA1: 90% DROP - OUT: 4% 2015 BASELINE PENTA1: 86% DROP - OUT: 7%
2020 TARGET 100% 2015 BASELINE N/A 2020 TARGET 55%
100% 2020 TARGET 100% 2020 TARGET 11/11
$15.20 2020 TARGET N/A 2
2020 TARGET 10
2020 TARGET 6/11
2020 TARGET N/A
2020 TARGET N/A
2015 BASELINE 45%
2020 TARGET 75% 2015 BASELINE 63%
2015 BASELINE N/A
2015 BASELINE N/A
2015 BASELINE 85% 2015 BASELINE 7/11
2015 BASELINE $20
2015 BASELINE 0
2015 BASELINE 1/11
BREADTH OF PROTECTION
PENT A3 81%
CURRENT: + 1PP 2020 TARGET 63% 2015 BASELINE 31%
52%
81%
25% MCV1 81%
87%
45%
10/11
11
5/11 4 EQUITY: WEALTH
CURRENT: + 1PP 2020 TARGET 45% 2015 BASELINE 35%
5 EQUITY: MATERNAL EDUCATION
CURRENT: + 1PP 2020 TARGET 40% 2015 BASELINE 30%
ON TRACK MODERATE DELAYS / CHALLENGES SIGNIFICANT DELAYS / CHALLENGES
2
NO UPDATE AT THIS REPORTING PERIOD
2 4
40%
38%
65%
7 PP
35%
56%
1 Performance reporting lags by approximately 2 calendar years ? current result is for performance year 2019 2 Not published due to commercial sensitivity NB: Graphics not drawn to scale
N o update
N o update

Indicators reported
as originally defined
N o update

1
Report to the Board
Board -2021 -Mtg -4-Doc 06-Annex C
Annex C : IRC/HLRP Recommendations
Independent Review Committee (IRC)
The Independent Review Committee has had a significant uptick in activity in 2021,
largely driven by its engagement to support the roll -out of C OVID -19 vaccines. To -
date, the IRC has been involved in the review of 117 applications, composed of 46 for
core Gavi business and 71 1 Covax -related requests, largely for additional cold chain
equipment to roll -out C OVID -19 vaccines supplied via the C OVAX Facility 2 (see Figure
1 below for the distribution of request types). The value of the requests received 3 is
over US$ 140 million 4, with US$ 100 million recommended for funding (see Figure 2
below for value by support type). Support for MCV introductions and campaigns
continues to drive vaccine requests, with 9 requests 5 for support reviewed to -date
worth an estimated value of ~US$ 60 million . Gavi -supported countries further their
efforts to prepare for withdrawal of OPV through the introduction and scale -up of IPV,
with 7 requests for support of IPV second dose reviewed to -date and an additional 4
anticipated through the end of the year.

DPRK, Kyrgyzstan and Syria were able to complete their full portfolio planning process
during the first half of 2021, resulting in requests totalling US$ 19 million for HSS and
CCEOP support, all recommended for funding by the IRC. DPRK was the largest of
the three requests at US$ 8.75 million with investments focused on tracking un -
immunised children, achieving >97% coverage of Pentavalent 3 vaccines in under -
performing provinces and improving and sustaining immunisation coverage in
disaster -prone areas. The application from Syria also had a strong emphasis on
coverage and equity, with 62% of the US$ 6.8 million budget targeted to strengthening
1 Includes 69 CCE requests and 2 requests for Covid -19 campaign support. 2 The IRC also participated in country readiness assessments for roll -out of Covid -19 vaccines led by the WHO. 3 Estimated application value includes support for v accines, commodities, and cash support (e.g., VIGs, Ops). 4 Excludes application values for IPV second -dose introductions and new support for yellow fever diagnostics. 5 Including 3 MCV introductions and 6 campaign requests.

Report to the Board

Board -2021 -Mtg -4-Doc 05-Annex D


Annex D: Annual report on the implementation of the Gender Policy
Section A: Introduction
This report describes progress made in 2021, the first full year of implementing Gavi?s
new programmatic Gender Policy. The policy seeks to identify and overcome gender -
related barriers to reach zero -dose children and missed communities with the full range
of vaccines, encompassing: (1) identifying and addressing underlying gender -related
barriers faced by caregivers, adolescents and health workers; (2) overcoming any
differences in immunisation coverage between genders; (3) encouraging and advocating
for w omen?s and girls? full and equal participation in decision -making related to health and
health programmes.
With gender disparities deepening in the COVID -19 pandemic, identifying and addressing
gender -related barriers to immunisation ha s become even more critical. At the same time,
work to design new Gavi investments has slowed, with country and partner capacity
stretched by rolling out COVID -19 vaccines. In this challenging context, the Gavi
Secretariat has focused on laying a strong foundation to roll ou t the Gender Policy at
scale, advancing work in six key areas in a newly developed Action Framework:
understand, advocate, identify, reach, learn and partner. This report also highlights
progress made at country level through existing strategic focus area investments and
partnerships, as well as reporting on progress to institutionalise gender equality within the
Secretariat.
Section B: Implementation of Gavi Gender Policy
1. Understand: work with partners to enhance capacity to understand, recognise and
address gender -related barriers to immunisation.
1.1 The Vaccine Alliance is coordinating capacity enhancement of its staff and
partners . Six online learning events were held to increase understanding and skills
on gender and immunisation. Subjects ranged from addressing gender -related
barriers in the roll -out of COVID -19 vaccines and conducting gender analysis, to
indicators and methods to collect data on social and beha vioural drivers to
immunisation uptake.
1.2 The World Health Organization (WHO) integrated learning on addressing
gender -related barriers into the course content for the Immunization Agenda
2030 Academy which has already train ed a first cohort of 256 learners. The United
Nations Children's Fund (UNICEF) is developing an innovative ?Journey to
immunisation? learning tool for designing gender responsive and
transformative interventions . The Secretariat has partnered with the Global
Wo men?s Institute to design and implement a short GenderPro course for country -
facing staff across the Alliance as well as a longer expert course for Alliance
gender focal points.
1.3 UNICEF is also building the capacity of Ministry of Health (MoH) staff in seven
countries in the use of human -centred design (HCD) , a highly effective approach

1



Board -2021 -Mtg -4-Doc 07a
Report to the Board
30 November - 2 December 2021


Section A: Executive Summary
Context
In the context of evolving epidemiological, supply and demand uncertainties, and
of COVAX supply ramping up over the end of 2021 and into 2022, this paper
present s an update of the COVAX Facility?s approach to procurement and the
Alliance ?s role in COVID -19 vaccine delivery through to the end of 2021 and into
2022 . This paper builds on previous Board discussions and on two Programme
and Policy Committee (PPC) discussion s in October 2021 and November 2021 ,
and presents recommendations to the Board for approval.
Questions this paper addresses
What is the scope of Gavi's support to AMC countries in achieving their COVID -19
vaccination goals , in view of the WHO Global Vaccination Target of 70% by mid -
2022 and taking into account sources of supply beyond COVAX ?
What is the COVAX F acility?s approach to procurement of COVID -19 vaccine for
2022?
What are the key delivery challenges faced by AMC countries ? W hat has been the
Alliance?s role so far in the delivery space and how would it evolve going forward ?
What are the risks and trade -offs of Gav i?s continued involvement in COVID -19
vaccination ?
How is Gavi enga ging in ongoing discussions in pandemic preparedness,
response and financing?
Conclusions
Given the global goal , set by WHO, to achieve 70% C OVID -19 vaccination
coverage in all countries by mid -2022 , as well as the tight fiscal space and weak
health systems in many AMC countries , the Gavi Alliance has been provid ing vital
supply of COVID -19 vaccines and support for their delivery to meet countries?
vaccination ambitions . Basing ourselves on the lessons learned from 2021, Gavi
will s harpen its focus in 2022 on lower income countries who urgently need
support , while also putting in place solution s such as the Pandemic Vaccine Pool
to strengthen resilience in the face of potential supply and demand shocks . The
COVAX Facility is secur ing supply through Advance Purchase Agreements , which
enable flexibility in response to changing circumstances through the use of options
and make effic ient use of both donor funding and cost -sharing from countries . The
COVAX Facility will also continue to use dose -sharing as required. Overall, the
SUBJECT : COVAX: KEY STRATEGIC ISSUES
Agenda item: 07a
Category: For Decision

Report to the Board
Board -2021 -Mtg -4-Doc 07a -Annex A

Annex A: COVAX Reporting Framework
Section A: Update on *DvL?V &29$; )DFLOLWy DQG &29$; $0& 0RQLWRULQJ,
Evaluation and Learning (MEL) strategy
The Gavi Secretariat presented its proposed MEL approach to the Gavi Board in
December 2020. Since then, we have further refined this approach and begun
implementing key aspects of the strategy. The approach is intended to be holistic in
nature, spanning from inputs through to impact across the COVAX Facility and COVAX
AMC , and complementary to work being led by other COVAX partners and the wider
global health community . It is intended to support both accountability and learning
perspective s and will need to evolve and adapt over time to reflect the changing nature
and needs of COVAX. It has close linkages to the Secretariat?s and broader COVAX Risk
Management and Assurance work .
The table below provides some of the key highlights and update s on progress against the
core elements of Gavi?s COVAX Facility and COVAX AMC MEL Strategy since the June
2021 Gavi Board.

MEL
strategy
component
Key activity Highlights / update (December 2021)
Cross -cutting COVAX Theory of Chang e Revision and further improvements to the core
COVAX Facility and COVAX AMC Theory of
Change is included within the scope of work for the
COVAX Facility and COVAX AMC evaluability and
evaluation design phase.
Updates will be made to reflect the COVAX Facility
2022 strat egy.
Monitoring COVAX Reporting Framework Reporting against COVAX Reporting Framework
made available for PPC and Board
The COVAX Reporting Framework will be updated
to align with the COVAX Facility and AMC vision
for 2022 (see summary below)
Complementary monitoring to
COVAX Reporting Framework
COVAX Facility, Gavi Secretariat teams and core
COVAX partners continue to monitor aspects of the
Facility and AMC to a much greater extent beyond
the metrics currently captured in the topline
Reporting Framework .
One key example is through the Country
Readiness and Delivery (CRD) Implementation
Monitoring Review, which triangulates data from a
number of sources to inform a weekly review of
progress or challenges across key delivery areas.
Examples incl ude vaccination uptake, absorption
and expiry, costing and financing and vaccine
safety.

R Report to the Board
1
Board -2021 -Mtg -4-Doc 07a -Annex B

Annex B: Update on the Operation alisation of the Humanitarian Buffer
1. Background
In March 2021, the Board approved the Secretariat reporting back to the Programme and
Policy Committee and Board by end 2021 on the operationalisation of the COVAX
Humanitarian Buffer. The Board requested that this report include available key
performance metrics, the number of requests received, and update on delivery support
funding , a s well as a report back on activities undertaken to ensure the Humanitarian
Buffer is a measure of last resort.
Financing for the COVAX Buffer , which includes both the Humanitarian Buffer and the
Contingency Provision 1, at 5% of COVAX AMC funding , was approved by the Board in
March 2021. The Board also approved in March delegating decision making on
Humanitarian Buffer dose allocation to the Inter -Agency Standing Committee (IASC)
Emergency Directors Group, following which, applications for the Huma nitarian Buffer
opened in May 2021. Gavi has work ed closely with Alliance partners, UNICEF and WHO,
as well as the humanitarian sector to operationalise the Humanitarian Buffer.
2. Humanitarian Buffer as last resort
The Humanitarian Buffer is a mechanism established within the COVAX Facility to act as
a measu re of ?last resort? to ensure access to COVID -19 vaccines for high -risk and
vulnerable populations in humanitarian settings. It is a real -time allocation of up to 5% of
doses procured through the COVAX Facility , based on demand. The Humanitarian Buffer
is only to be used where there are unavoidable gaps in coverage in national vaccination
plans and micro -plans, despite advocacy efforts. National governments are responsible
for ensuring access to COVID -19 vaccines for all people within their respective terri tory.
The ?first resort? for all populations of concern, irrespective of legal status, is that they are
included in national vaccination plans and reached during the implementation of those
plans. Gavi Alliance , IASC partners, civil society and others have been and will continue
to advocate with national governments to ensure the inclusion of all populations
regardless of their legal status in line with the WHO Strategic Advisory Group of Experts
on Immunization (SAGE) ?Values Framework? and ?Roadmap for Prioritizing Uses of
COVID -19 Vaccines in The Context of Limited Supply? and will advocate for the revision
of national plans and micro -plans if required.

Since the outset of 2021, both high -level global advocacy and national level advocacy
has been carried out to ask for the in clusion of populations at risk of being left behind in
national vaccination plans and to remind governments that the COVAX Humanitar ian
Buffer is not an alternative to state obligations. This has included, for example, inclusion
of relevant language in the UN Security Council resolution 2565, COVAX briefing UN
Resident Coordinators in priority contexts, and country level bi-lateral advocacy by
1 As reported to the Board in September 2021, given the current levels of vaccine coverage among Facility participants
and the global prevalence of the new variants, the Contingency Provision is not considered an appropriate intervention
at this point, and in its absence the Humanitarian Buffer will continue to form the full scope of the COVAX Buffer.

1

Board -2021 -Mtg -4-Doc 07b

Report to the Board
30 November - 2 December 2021

Section A: Summary
Context
To support the COVAX Advance Market Commitment (AMC) goal of frontloading
financing to encourage vaccine development and reserve access to support 92
AMC economies, a flexible fundraising approach was adopted to respond to an
ever -changing global environment, pandemic trajectory and vaccine landscape.
Two successive resource mobilisation rounds were organi sed within a year,
culminating in June 2021 with an event hosted by the Prime Minister of Japan
bringing the total amount mobilised to da te to US $ 10.1 billio n for the procurement
of 1.7 billion vaccine doses. In addition, US $ 799 m illion were mobilised to support
delivery.
Key lessons from a year of intense uncertainty driven by the pandemic evolution
point to the need for upfront cash as a prerequisite for supply security for AMC
economies. Despite an impressive mobili sation of support, cash has not been
provided fast enough to priorit ise COVAX vis a vis suppliers in a very competitive
market. With the foreseen evolution of the pandemic, m oney is need ed upfront to
mitigate significant uncertainty as we enter 2022 .
Questions this paper addresses
To support the implementation of COVAX Strategy (see paper 07a )
? What is the rationale for further resource mobilisation efforts in 2022, the
potent ial scenarios and sources of funding?
? How might Gavi proceed with a campaign with Board members? support to
achieve the resources needed for these scenarios?
Conclusions
The COVAX AMC fundraising strategy will focus on guaranteeing the certainty of
supply and mitigate risks for AMC economies into 2022 in three ways: a) ensuring
the existence of a financially frontloaded Pandemic Vaccine Pool of diversified
vaccines to manage risks and uncertainties as we enter a new phase of the
pandemic, building on lessons to date, saving additional lives , and supporting
lower income economies to get back on a path towards growth, with a particular
focus on low income countries ; b) funding the ancillary costs of dose donations,
ensuring a steady supply of syringes, safety boxes and global freight services ; and
c) in pursuit of country priorities, supplying funding for essential delivery rollout in
SUBJECT : COVAX : RESOURCE MOBILISATION UPDATE
Agenda item: 07b
Category: For Information

1



Board -2021 -Mtg -4-Doc 08


Section A: Executive Summary
Context
Malaria remains one of the deadliest diseases for children under five years old,
particularly those living in communities facing deprivation and exclusion. Over 90%
of cases and deaths occur in Africa; six Gavi -eligible countries 1 account for 50%
of global mortality. In 2015, the first vacci ne for malaria, RTS,S/ AS01 E, was
authorised; that year, Gavi, the Global Fund and Unitaid agreed to support pilot
vaccine implementation at WHO?s request to generate evidence for wider use of
the vaccine. The Gavi Board also considered and approved a cost -share
mechanism to enable continued production of the antigen to assure access in the
event of positive policy and funding decisions . In October 2021, WH O issued a
recommendation for wider use based on the evidence from the pilot
implementation, and the Gavi Programme and Policy Committee (PP C)
considered the case for investment in a malaria vaccine programme.
Question this paper addresses
What is the projected value, impact and strategic considerations of a Gavi
investment in a malaria vaccine programme?
Conclusions
As part of a ?toolbox? of malaria control interventions, a malaria vaccin e will further
reduce child mortality on the African continen t but is likely to incur a high cost to
Gavi and countries under current assumptions . A successful malaria vaccine
programme sh ould support deliberate and intensive coordination between malaria
control and immunisation programmes at global and country levels to ensure most
impactful deployment of the vaccine alongside other interventions . Finally, there is
a need and opportunity for market -shaping efforts to support the development of a
healthy m alaria vaccine mar ket .
Section B: Background
1.1 Malaria (particularly the Plasmodium falciparum parasite species) is one of
the leading causes of death globally. In 2019, there were 229 million cases
1 Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Burkina
Faso (4%), Mozambique (4%) and Niger (4%); World Malaria Report 2020
SUBJECT : MALARIA VACCINE PROGRAMME INVESTMENT CASE
Agenda item: 08
Category: For Decision
Report to the Board
30 Nov ember - 2 Dec ember 2021

Report to the Board
Board -2021 -Mtg -4-Doc 08-Annex A


Annex A: WHO background note on operationalisation: supply allocation
framework, technical guidance and integration between malaria control and
immunisation
1. Development of allocation framework for limited supply
Supply is likely be insufficient in the medium term, with a constrain t expected in the
first 4 -6 years following anticipated first introductions in 2023. This could potentially
extend to 9 years should there be demand for additional seasonal doses or if no action
is taken to accelerate supply availability. While efforts to address the supply limitations
and achieve healthy mark et goals are expected to intensify if and when a Gavi malaria
vaccine programme is approved, a prioriti sation process will be required at the onset
to allocate limited vaccine supply in the initial years.
Process to develop the allocation framework for lim ited supply
Given the extent and potential duration of the supply -demand imbalance, difficult
choices will have to be made by countries and their global partners on how to best use
limited resources. The process, i.e. how choices and decisions are made, will be as
important as the underlying scientific rationale. Legitimacy is proposed as the
overarching guiding principle for the development of the allocation Framework: global
decisions about vaccine allocation should be made throu gh transparent processes
that are based on shared values, best available scientific evidence, and
appropriate representation and input by key parties , drawing heavily on the
expertise and views of public health leaders from malaria endemic area.
WHO is co ordinating the development of the framework, ensuring appropriate
representation and consultation of stakeholders. Ministries of Health in affected
countries will be informed of and engaged in the development of the framework.
Convenings to establish the p rinciples and objectives of the framework will include
leadership from Africa and other affected countries, international funding bodies (e.g.
Gavi and Global Fund), key malaria partners (e.g. P MI, RBM regional institutions),
civil -society organi sations, e thics and human rights specialists, PATH, and others.
The Framework is expected to be in place by Q1 2022, and will guide decision making
on vaccine allocation, including where and in which countries limited vaccine doses
might best be allocated initially. Once developed, the framework will be used by
malaria and EPI stakeholders, as they make decisions on malaria control interventions
for a given country or provide support to countries. It will be important for all relevant
stakeholders to adhere to the framework , e.g. , Gavi in its application guidance and
process; partners in their financial, technical and regulatory support to countries; etc.
Inputs to inform decision -making
The graphic below summari ses the proposed process. Different work area s provide
the scientific / public health, implementation and social value considerations as inputs
to decision -making. Stakeholders will be convened to consider the objectives and
principles of the Framework and the pros and cons and trade -offs of differen t options.

1



Board -2021 -Mtg -4-Doc 09


Section A: Executive Summary
Context
The Gavi Board has ultimate responsibility for risk oversight in the Alliance and is
responsible for agreeing on overall risk appetite and understanding and agreeing
the most significant risks and related mitigation. It therefore receives an annual
comprehensive Risk & Assurance Report (see Annex A ).
Questions this paper addresses
The Risk & Assurance Report discusses the most critical risks that could potentially
have an impact on the ability of the Alliance to achieve its mission and strategic
goals . The report has been reviewed and recommended for a pproval by the Audit
& Finance Committee (AFC). The Gavi Alliance Board is requested to approve the
report and to provide guidance on the questions outlined below.
Conclusions
This year?s report shows that Gavi?s overall risk profile ha s remained stable with
most top risks continuing to be elevated due to the current environment, Gavi?s
ambitious strategy and the mission of the COVAX Facility. Two top risks have
decreased, two increased, and last year?s single aggregate COVAX -related ris k
has now been disaggregated into four risks as the Facility has moved from design
to operationalisation and delivery. Three risk exposures are deemed to be outside
of Gavi?s updated risk appetite as long as intensive mitigation is still ongoing.
Section B : Risk and Assurance Report 2021
Portfolio discussion on top risks to the Alliance
1.1 This is the 6th annual Risk & Assurance Report which discusses the most
critical risks that could potentially have an impact on the ability of the
Alliance to achieve its mission and strategic goals. The report provides an
update on risk management across the Alliance, an analysis of macro -
trends affecting Gavi?s risk profile, an overview of key changes in top risks
compared to last year, and an overview of how current levels of risk
compare to Gavi?s risk appetite (i.e. its willingness to accept being exposed
SUBJECT : RISK MANAGEMENT UPDATE
Agenda item: 09
Category: For Decision
Report to the Board
30 Nov ember - 2 Dec ember 2021

Gavi

1



Board -2021 -Mtg -4-Doc 10
Report to the Board
30 November - 2 December 202 1

Section A: Executive Summary
In June 2021 , the Board signalled strong support to continue Gavi?s strategic
partnership with India for five years (from 2022 to 2026) . Since then, a better
understanding of COVID -19 impact s on routine immunisation systems (resulting in
an increase in zero -dose children in 2020 ), has reinforced the case for supporting
India?s ambitious immunisation agenda. This paper presents the case for catalytic
investment s in reaching zero -dose and under -immunised children , as well as
equity -focused vaccine introductions , in India during the p eriod 2022 to 2026.
Timelines and proposed investment amounts were refined b ased on Programme
and Policy Committee (PPC) and Board guidance and further consultations with
the Government of India and partner s, resulting in a modest shift of ~US$ 20 million
from vaccine introductions to the zero -dose agenda.
Based on the October PPC recommendation, t he Board is requested to
approve the renewal of the strategic partnership with India , including
proposed investments of US$ 250 million to introduce the two equity -
focused vac cines ( human papillo mavirus ( HPV ) and typhoid conjugate
vaccine ( TCV )) and to reduce the number of zero -dose children by 30% in the
period 2022 -2026 .
Section B: Content
Context
1.1 At its June 2021 meeting , t he Board signalled universal support to
renew Gavi?s strategic partnership with India for five years from 2022
to 2026 . It agreed that the partnership should focus on zero -dose and
under -immunised children , as well as on missing introductions of HPV and
TCV . The Board provided guidance to ref ine timelines , recalibrate
investment amounts for vaccine introductions in light of the pandemic , and
to keep some level of flexibility with regards to the allocation of funding
within the new vaccine support (NVS) and health systems support (HSS)
envelopes. On zero -dose, the Board reiterated the importance of
sustainably reaching missed children with a full course of vaccines and
highlighted the need to work more extensively with commun ity -based and
civil society organisations (CSOs) at the local level . Th is updated proposal
incorporates this guidance.
SUBJECT : STRATEGIC PARTNERSHIP WITH INDIA
Agenda item: 10
Category: For Decision

Report to the Board
Board -2021 -Mtg -4-Doc 10-Annex A

Annex A: Proposed strategic approach
1. Proposed investment priorities
1.1 Continued support to India will be focused on targeted, catalytic support
guided by seven overarching principles, which were endorsed by the PPC
and Board in May and June 2021: equity; time -bound support; sustainability;
learning; innovation; alignment with national plans and donors; and
accountabili ty and transparency 1.
1.2 The Alliance has an opportunity to support India in reaching 1.4 million
zero dose children and save ~118,000 lives through the introduction of
equity -focused vaccines with modest catalytic investments of
US$ 250 million over t he next five years 2. Based on PPC and Board
guidance and further consultations with the Government of India and partners,
the investment amounts proposed earlier this year were recalibrated , resulting
in a modest shift of ~US$ 20 million from vaccine introductions (primarily f rom
TCV) to the zero -dose agenda. Therefore, the proposal is that ~US$ 129 million
in funding would be invested in reaching zero dose children, and
~US$ 122 million would be earmarked for vaccine introductions 3. Figure 1
summarises the updated investment proposal.
Figure 1
Zero -dose children & missed communities
1.3 Building on its impressive progress in expanding the reach of immunisation
services before the pandemic, Gavi?s strategic partnership with India will
aim to further decrease the number of zero -dose and under -immunised
children and expand full immunisation coverage (FIC) in the next five
years. The proposed target of a 30% reduction in zero -dose children by 2026
against the 2019 pre -pandemic baseline aligns with the Alliance?s ambitious
1 For more details, see the May 2021 PPC Paper on the Strategic Partnership with India 2 Approximately US $ 200 million of this total amount are expected to be disbursed in Gavi 5.0 (2021 to 2025). An
additional US$ 10 million in vaccine funding for HPV are being rolled over from the last strategic period. 3 Rounded numbers explain that US$122 million and US$ 129 million equal US$ 250 million. Modest investments can save thousands of lives and
catalyse long -term impact
Zero -dose & missed communities
? Reduce # of zero -dose children in line with Immunisation Agenda 2030 (IA2030) goals ( -30% by 2026) through targeted sub -national strategies
? Human papillomavirus (HPV): avert ~66?000 future deaths 2
? Typhoid conjugate vaccine (TCV):avert ~52?000 future deaths 2
Select investments in national and subnational institutions Continued engagement on vaccine and cold chain equipment market shaping Alignment with separate COVID -19 vaccine support through COVAX +
Strategic focus and objectives Gavi support 1
US$ 116 million 3 New & underused vaccine support (NVS) US$ 6 millionTCV surveillance
Equity -focused vaccine introductions
US$ 119 million Health systems strengthening (HSS) US$ 10 million Targeted Country Assistance (TCA)
1 Flexibility will be retained for reallocation within each funding envelope; figures don?t add up to US$250m due to rounding errors 2 Excludes impact from self -financed doses 3 Excludes $10m for HPV rolled over from the last strategic period

Report to the Board
Board -2021 -Mtg -4-Doc 10-Annex B

Annex B: High level Theory of Change

Outcomes Objectives Key Activities
These outcomes
represent the elements of
an effective and
sustainable national
immunisation system.
What changes in the
immunisation
programme are needed
to achieve the outcome?
What key activities are needed to achieve the
objective?
INTRODUCE & SCALE
Breadth and equity of
protection against
vaccine -preventable
diseases are expanded
through effective
prioritisation, introduction,
and scaling of vaccines
via the routine
immunisation system.
1. Introduction of
Typhoid and Cervical
Cancer Vaccine
1.1 Introduction of TCV vaccine in states
- Sub -national prioriti sation for vaccine roll -out
to ~20% of the target population (~80% for
catching up to the previous cohorts, and
remaining for RI)
1.2 Surveillance sites for TCV
- Additional surveillance sites for more data
on vaccine efficacy and disease burden: 3 in
UP, 1 each in Rajasthan, MP and Bihar
1.3 Introduction of HPV vaccine in states
- Identification and alignment on roll -out
strategy (catch -up, RI, timelines, etc.)

EXTEND & REACH
Community -centred
immunisation services
build resilient demand for
immunisation, including
addressing gender -related
barriers, and regularly
reach zero -dose children
and missed communities
integrating them into the
routine system.
2. Building resilient
demand for Routine
Immunisation Services
2.1 Behavioural intervention for generating
demand
- National centre of excellence on demand
(NCED) (strengthening a domestic institution)
for planning and coordination
on comprehensive demand intervention s
- Continue evidence based and data
driven investments in SBCC
2.2 Demand Generation for new vaccine
introductions
- Partnership with UNICEF, local CSOs and
private sector organisation s for demand
generation for the new vaccines (TCV and
HPV), under the coordination of the NCED
2.3 Organi sed mobili sation and reminder
process:
- Integration of reminder process with
electronic micro plan s
- Mechanisms like mobile reminders to track
individual household mobilization
2.4 Evidence generation for demand
- 10 -12% of the demand budget for impact
assessment studies and evidence generation
through pre -post evaluation surveys and
regular monitoring
3. Delivering routine
immunisation service in
hard -to-reach areas
3.1 Digiti sation of beneficiary and due -list
process creation
- Expansion of C oWIN app for RI: providing
technical ass istance and capability building
- Strengthening annual micro
census/community level headcount in the
planning unit area

Report to the Board
Board -2021 -Mtg -4-Doc 10-Annex C
Annex C: High level budget




Gavi 5.0 Assumption - Risk &
Opportunities (especially in the
context of COVID/COVAX)
Total Gavi 5.0 2022 2023 2024 2025 Gavi 6.0 (
2026-2030)
Total Gavi
5.0 & 6.0
Expenditure type
(millions) $199 $32 $34 $52 $82 $51 $250
Vaccine programmes
HPV & TCV risk: limited capacity of the
country to introduce new vaccines in the
context of Covid given severity of last wave
HPV specific risk: risk of delayed
introduction pending the resolution of court
case on HPV;
HPV specific opportunity to introduce HPV
to the states which are ready and in demand
$66 $0 $0 $18 $48 $49 $116
HSS (see break-down below) $133 $32 $34 $34 $34 $2 $134
Core HSS $118 $30 $30 $30 $30 $0 $118
TCV surveillance $5 $0 $2 $2 $2 $2 $6
TA $10 $3 $3 $3 $3 $0 $10
Total disbursements
Risks: Inablity for the country to bring its
focus beyond maintain and restore activities
due to prolonged Covid 19 impact
Continued Covid impact on health systems
may also present a challenge in moving back
to 2019 baseline and country trajectory for
zero-dose reductions

Report to the Board

Board -2021 -Mtg -4-Doc 10-Annex D
1


Annex D: India Accountability Framework
Overview
Gavi intends to build upon the strong foundations from previous strategies with India
as they relate to measurement, reporting, and accountability . The accountability
framework will be grounded in the final India Strategy Theory of Change and will
encompass the more detailed monitoring and learning plan developed for the strategy.
The framework speaks to both accountabilities across fund implementing entities and
Government of India (Go I).
Programmatic monitoring and accountability
While the final set of metrics, baselines and targets will be agreed upon over the
coming months as interventions are finalised and the monitoring and learning plan
elaborated upon , the following topics will be included at a minimum:
? Zero dose: Reduction in zero -dose children over the strategy period
? Vaccine introductions: Vaccine introductions and rate of scale -up across States
? Vaccine programmes: Coverage and drop -out
? Programmatic investments : A selection of metrics mapped to the finalised theory
of change, to include demand, role of CSOs, service delivery and data related
investments
? Sustainability: Such as the t ransition of human resources / role s to GoI budgets
over the course of the strateg y and integration of programmes into State budgets
? Oversight and accountability: Monitoring of IAGs
Progress against t hese metrics will be regularly reviewed as part of the accountability
and reporting mechanisms described below and formally reported to the Gavi
Secretariat.
GoI have previously raised their support and willingness to facil itate more
documentation around lessons learned and particularly best practices that may be of
interest to the broader Gavi portfolio. This is something we are seeking to capitalise
upon to a greater degree in the next strategy . This may involve further reviews, case
studies, efforts to capture learnings for peer -reviewed journals, evaluations and impact
assessments.
Financial monitoring and accountability:
As part of the quarterly financial reporting, the G oI will continue to take responsibility
to complete the consolidation exercise of a tailored financial reporting template across
the funding recipients and submit to Gavi for approval .
Operating in heightened fiduciary risk environments may be required to achieve the
objectives of the new strategy. In such cases additional assurance mechanisms
should be discussed with Gavi and implemented to ensure appropriate oversight is in
place .
In addition to the annual performance reviews (e.g. JA?s MSD?s) , the detailed budget
and workplan will be thoroughly reviewed and updated as required but at a minimum
on a bienn ial basis.

1



Board -2021 -Mtg -4-Doc 11


Section A : Executive Summary
Context
For the past two decades, Gavi has effectively leveraged its unique
comparative advantage to rally the public and private sectors to achieve
sustainable impact. The Alliance?s engagement with the private sector has
helped secure financial resources, expertise, and innovative solutions to support
implementing countries in accessing and delivering an increased number of
lifesaving vaccines, with a coverage level that most other essential health
interventions are yet to achieve.
The 2016 -2020 period saw a concerted effort to deepen Gavi ?s engagement
with the private sector, allowing it to tap into underutilised assets, networks,
and tools to support the mission. In 2020, an independent evaluation concluded
that the Secretariat?s approach was la rgely successful, with key targets either
being met or exceeded as shown in Figure 1. For an overview of the partnerships
developed during the 4.0 period, refer to Annex A.
Figure 1: Private Sector Engagement key targets and achievements identified by the independent Evaluation

However, both the independent evaluation and the Secretariat?s own
reflections from unsuccessful projects noted areas for improvement.
Specifically, that the Secretariat should: (i) intensify its focus on fundraising, (ii)
ground n on -financial partnerships firmly in country needs, and (iii) establish a
robust and fit for purpose monitoring, evaluation, and learning system.
In October 2021, the Programme and Policy Committee (PPC) recommended
for Board approval the principles of Gavi?s 5.0 private sector engagement (PSE)
strategy, namely that it is country driven, aligned to Gavi?s zero -dose agenda,
vaccine delivery, and immunisation system strengthening. In addition, the PPC
also recommended the Secretariat fur ther elaborate on the operationalisation in
fragile and conflict contexts, and the alignment between Gavi?s existing
governance mechanisms and the proposed private sector structures, while
addressing the following questions :
SUBJECT : PRIVATE SECTOR ENGAGEMENT STRATEGY
Agenda item: 11
Category: For Decision
Report to the Board
30 Nov ember - 2 Dec ember 2021

Gavi

Report to the Board
Board -2021 -Mtg -4-Doc 11-Annex B

Annex B: Implications and Anticipated Impact
Impact on countries
Approval of the PSE strategy enables the Secretariat to mobilise additional finances
and resources in support of Gavi ?s strategic objectives and identified country needs.
The private sector has a range of assets that can be harnesses and directed to achieve
programmatic impact by increasing the quality of immunisation services in
implementing countries, ensuring sustainability, and contributing to the efficiency of
Gavi?s mission.
Risk implication s and mitigation
As Gavi moves into the 5.0 period, private sector engagement represents a critical
opportunity. However, it is prudent to recognise that, in a fast -moving environment,
opportunities can take multiple forms and that private sector engagement can be
complex, with a series of interconnected sets of actors and agendas. Inherent to this
is the managing and mitigation of risk to Gavi, countries, and the immunisation
programme.

In 2020, the Secretariat?s Risk and Assurance Report assessed its PSE as a low -risk
activity. However, the Secreta riat?s r isk appetite should be balanced against its level
of ambition . An analysis of the Secretariat?s PSE work falls into two risk categories:
1. Risk of inaction related to developing private sector partnerships
2. Risk of action related to developing private sector partnerships
1. Risk of inaction related to developing private sector partnerships
Regarding the a bove, inaction can affect Gavi?s and countries ambition s for impact, as
well as affect Gavi?s brand reputatio n as a leading Public Private Partnership ,
innovative development model, and appeal to donors who are attracted to its unique
PPP model.
2. Risk of action to developing private sector partnerships
To ensure a thorough review of the risks associated with this segment, the Secretariat
commissioned PwC to conduct a risk assessment. This segment can be reviewed in
further sub risk categories:
a) Shift in donor priorities
b) Costs of partnerships management
c) Limited clarit y on operational structure
d) Reputational risk
e) Limited private sector involvement
f) Risk of dispersion
g) Resourcing risk

Report to the Board
Board -2021 -Mtg -4-Doc 11-Annex C

Annex C: PSE Theory of Change

The Private Sector Engagement (PSE) high -level Theory of Change (ToC) explains
how the Secretariat sees impact level change happening across the course of the PSE
strategy implementation from 2021 -2025. The foundation for this Private Sector
Strategy, and for PSE theory of change, is Gavi?s new five year -strategy, Gavi 5.0
with a vision of ?Leaving no one behind with immunisation?. It is also linked to Gavi?s
Innovation Strategy (currently under development).
The Secretariat?s PSE operating model is underpinned by a set of principles built
on our commitment to development effectiveness: country led, community owned,
differentiated, catalytic and sustainable, i ntegrated, adaptive and resilient, innovative,
collaborative, and accountable.
The PSE theory of change is based on Gavi ?s commitment to work with partners to
save lives and protect people?s health by increasing equitable and sustainable use of
vaccine s. To this envisaged impact the PS will be contributing to three of Gavi Goals:
(Goal 1) I ntroduce and scale up vaccines , (Goal 2), Strengthen health systems to
increase equity in immunisation , (Goal 3) Improve sustainability of immunisation
programmes .
The T oC intervention is built on a mutually reinforcing set of Gavi and PS assets
(funding, advocacy, expertise, innovation, and technology) and are intended to
produce a series of results that contribute to achieving the final intended impacts.
These levers of change will lead to the achievement of the outputs, while the outputs
will be contributing to each of the outcomes identified through a dynamic process.
To contribute to impact -level change, the strategy identified 7 immediate outcomes
and 3 intermediate outcomes that will guide the organization?s work for 2021 ?2025.
The outcomes achieved through the dynamic change process will reflect the
successful achievement of the 3 PSE strategic objectives: increase the level of
funding, identify and direct PS appropriate expertise, tools, and networks
towards specific immunisation challenges, and help surface scalable and
sustainable innovative approaches.
For each of the immediate outcomes, we have identified several outputs that require
the organisation?s le adership and contribution to secure immediate outcome -level
change and by extension to the related intermediate outcomes. The output -level
results capture the full range of support that Gavi will provide , to optimise its existing
approach to diversify the funding base and amplify Gavi?s reach and advocacy
in key markets . For this, actions will be taken to identify new innovative financing
mechanisms and explore targeted cause -related marketing initiatives. Also, efforts will
be made within the secretariat t o streamline processes and policies to promote greater
PS engagement. For mobilising private sector expertise , a robust supply -demand -
framework for expertise -based partnerships will be developed. Gavi will reinforce its
work on aligning PS work to programm atic areas and thus will seek to establish
governance mechanisms to ground PS engagement in country needs. In collaboration
with the private sector Gavi will work on establishing a structured learning agenda to
improve ways of working, the efficiency and e ffectiveness of partnerships, and ensure
that partnership outcomes are geared towards equity, efficiency, and quality, and

Report to the Board
Board -2021 -Mtg -4-Doc 11-Annex D

Annex D: Expertise Based Partnership Supply Demand Framework
Gavi?s engagement with the private sector has been framed against a demand
and supply dynamic . Private sector investments are relevant to Gavi only if they
match the core priorities and contribute to the accelerated delivery of demand -side
needs. On the other hand, t he supply -side perspective is based on an understanding
that the private sector need s a sound case for investment that is aligned with their
specific values and priorities.
This category of partnership s aim s to channel the assets, unique expertise , and
know -how of private partners to wards addressing specific demand -side needs ,
define d by their context . As s uch , these contributions are based on a balanced
assessment of demand and supply needs . In order to ensure consistency in
balancing ou t demand and supply needs, these expertise -based partnerships will
follow a responsive /structured partnership life cycle , based on the following
framework.


This framework highlights the relevance of starting with a demand driven
approach that articulates country needs and priorities . Importantly, the framework
provides an opportunity to foster greater collaboration between Country and PSE
teams at multiple stages of the PSE life cycle . This is important to ensure
partnerships are grounded in countries? needs and cognisant of context specific
challenges. First ly, country facing teams, led by the Senior Country Manager,
should be empowered to lead the definition phase by articulating countries? needs
and priorities to the PSE team. Secondly, a feedback loop could be established
with country, technical, and PSE teams once a potential opportun ity has been
identified to ensure continu ous alignment of PSE support with countries? needs .
Furthermore, this feedback loop enhances the process of defining the partner
ecosystem at country level; highlighting potential implementing -countr y-based solution
providers ; carrying out joint fact -finding missions to fully understand the landscape of
potential partners ; and engaging with Ministries of Technology , ICT, Innovation, etc.
Finally, based on a robust analysis and landscaping, country, technical, and PSE
team s could be involved in the initiation and design phase of partnership s and projects,

Report to the Board
Board -2021 -Mtg -4-Doc 11-Annex E

Annex E: Implementation Landscaping: Regional and Industry Sector
Considerations
The Secretariat recognises PSE in Africa offers momentum beyond the 5.0
period and is an investment for the longer term . Unprecedented political will is
driving a pan -African digitali sation agenda that is being spurred on by opening markets
under the auspices of a continental free trade area . This digitalisation agenda is
ca ptured in the African Union?s Digital Transformation Strategy 2020 -2030 and was
most recently reiterated during the AU -EU Foreign Ministers Summit 2021 where
digitalisation was sustained as one of four regional priorities 1; Africa?s private sector is
at t he heart of this momentum.
Historically, the business community have channelled fragmented and sporadic
corporate social investments towards interventions in HIV/AIDS, Polio, Malaria,
Education and Nutrition . However, support for and investment in immunis ation has not
kept pace due to a misalignment of business interests and societal objectives, a need
for greater transparency and accountability, and a preference to work with reputed
international organisations. Furthermore, the experience under Gavi 4.0 highlighted
the importance of engaging with national and regional business coalitions as the
preferred platforms for corporate social investment.
There is therefore an opportunity for the Secretariat to position immunisation and
investments in health withi n the broader context of the continent?s economic
transformation agenda. The ongoing COVID -19 pandemic has reinforced the
importance of vaccines in preserving and restarting economic activity and the value of
Gavi ?s ability to convene the public and privat e sector and highlighting areas of need;
a role that has been recognised by African business leaders. 2
The Secretariat?s African PSE approach will tap into the continent?s growing
businesses sectors such as Finance, Telecommunications, Fast Moving Consumer
Goods and Diversified Investment Companies . The largest businesses in these
emerging sectors are clustered around the economic hubs of Cote d?Ivoire, Egypt,
Ghana, Kenya, Morocco, Nigeria, Rwanda, and South Africa. Engaging these hubs ,
through p rominent business coalitions such as the African CEO Forum, and
consolidating high -level political commitments via pan continental forums, such as the
Africa Leadership Meeting (the African Union?s private sector coordination platform )
will allow Gavi to create a trusted link between global and regional multinationals and
focus the resources and expertise of the African private sector on Gavi?s objectives
and country needs .
The Secretariat also extends outreach to key private sector leaders in Asia
through targeted collaboration with existing business community platforms.
Although the industrial structure and the content of cooperation between sectors differ
depending on the economic maturity of each country, the Asian region generally has
established priv ate sector communities both at a country level and regional level and
there is a close partnership with respective governments. The Secretariat will continue
1 AU -EU Foreign Ministers Summit, 2021, Joint Press Statement,
https://www.consilium.europa.eu/media/52674/2021 -10 -27-joint -press -statement -final.pdf

Report to the Board
Board -2021 -Mtg -4-Doc 11-Annex F

Annex F: Due Diligence and Governance Overview
Private sector partnership review process
In response to the need for stronger coordination, specifically for expertise -based
partnerships, a cross -secretariat New Business Committee (NBC) was created in
2017. The NBC employs a stage gate review process which assesses partnerships
against country needs and operational feasibility. Partnerships are then reviewed by
a committee of Secretariat Managing Directors against strategic prioriti es and
reputational risk reviews before final approval by Gavi?s CEO.
This phased approach is further elaborated in Figure 1 below:
Figure 1: Gavi's standard process for private sector partnership development



Private sector governance
Firstly, the Secretariat will strengthen its existing partnership management system
(NBC) . Jointly owned by resource mobilisation and country programme managing
directors, this revised system will provide oversight from the end -to-end partnership
development. Furthermore, it will ensure that expertise -based partnerships are
embedded in country needs. As such, the Secretariat envisages reporting back on
these partnerships via programmatic updates.

For innovative approaches and engagements, the Secretariat will ensure coordination
with the innovation governance mechanisms as they are developed.

Report to the Board
Board -2021 -Mtg -4-Doc 12-Annex A

Annex A: Summary of implications and risks for Gavi Alliance
Financial implications
? A Gavi Alliance programme to strengthen typhoid, cholera, meningococcus,
measles, and rubella diagnostic capacity, focused on availability of improved
diagnostic tools would require up to an estimated US$ 55 million during
2022 - 2025 . For yellow fever, US $ 5 million would be for for yellow fever
diagnostic procurem ent and US $ 4 million for diagnostic test validation,
guidance development, multi -country technical assistance, and quality
assurance through the Partner Engagement Framework (PEF) Strategic Focus
Area (SFA) mechanism . For cholera, meningococcus, measles, rubella, and
typhoid, US $ 27 million would be for diagnos tic procurement and US $ 17 million
would be for PEF SFA diagnostic test validation, guidance development, multi -
country technical assistance, and quality assura nce . An indicative breakdown
by disease is shown in table 1. In addition, US$ 2 million is needed during
2022 - 2025 (i.e., US$ 500,000 per year) for Gavi secretariat coordination and
monitoring of the programme, for example, programme design, application a nd
review processes, cross -partner coordination, and programme monitoring.

Table 1: Illustrative Financial Forecast of Diagnostic Capacity Strengthening Costs by
Disease for 2022 -2025 *
Disease Procurement (US$ million ) PEF SFA (US$ million )
Cholera 7 6
Meningococcus 5 3
Measles 4 1
Rubella 4 1
Typhoid 7 6
Yellow Fever 5 4
Total 32 21
*Excludes any cost implications from co -financing
? The procurement financial forecast in table 1 is based on the projected numbers
of tests required to address the diagnostic gaps for the specific diseases in
countries currently eligible for Gavi new vaccine support and the projected unit
cost for the relevant tests . The PEF SFA financial forecast is ba sed on the
experience of the YF diagnostic tools initiative with test validation, guideline
development, quality assurance, and multi -country technical assistance,
adjusted for the number of potentially eligible countries and current status of
laboratory n etworks for each disease. Typhoid, cholera, measles, and rubella
diagnostic capacity strengthening will likely be relevant for a larger number of
countries than for yellow fever and meningococcus, but diagnostic options for
yellow fever and meningococcus w ill likely be more expensive. Also, the Global
Measles and Rubella Laboratory Network already does a great deal of work on
test validation, guidance development, technical assistance, and quality
assurance which will not require Gavi funding support.
? Howe ver, savings from making Gavi targeted vaccine support programmes
more efficient may help offset the costs of this programme, potentially to the
extent that the savings to vaccine support programmes could be greater than
the cost of the diagnostics and dis ease surveillance programme. The relevant
Gavi targeted vaccine support programmes are forecasted to cost more than

1 Board -2021 -Mtg -4-Doc 12

Report to the Board
30 November - 2 December 2021


Section A : Executive Summary
In November 2018, the Gavi Board authori sed creation of a Yellow Fever (YF)
diagnostic tools procurement support window to operate during 2019 -2021 to
improve the efficiency, effectiveness, and equity of the delivery of YF vaccines and
to strengthen health care systems? abilities to prevent, detect, and respond to YF .
In December 2020, the Gavi Board noted that additional Gavi resources would
potentially be required during 20 21 -20 25 to similarly enhance countr ies? abilit ies to
detect and diagnose other select diseases that also require rapid and targeted
vaccination to prevent their spread . In light of the progress to date in improving the
availability of validated commercial YF test kits , the capacity of YF public health
laboratories in Africa, and the timeliness and reliability of results from those
laboratories as well as the importance of those results for immuni sation decision
making , in June 2021 the Board authori sed extension of YF diagnostic
procurement support through the end of 2022 to provide time for a broad er
discussion of Gavi?s role with diagnostic procurement and disease surveillance
during Gavi 5.0. At its 20 -22 October 2021 and 12 November 2021 meeting s, the
Gavi Policy and Programme Committee (PPC) recommended an extension of the
YF diagnostic tools procurement support window through the duration of Gavi 5.0
as well as its expansion to include cholera, typhoid, meningococcus , measles, and
rubella .
Fit for purpose diagnostic tools are critical for countries? abilities to plan and
implement targeted vaccination programmes, but there are current ly market
failures for such tools. This proposal addresses those market failures so that
accurate, reliable diagnostic tools are available to countries and Gav i investments
in these vaccine programmes , currently projected at over US $ 1.6 billion during
2021 -20 25, can be more efficient, effective, and equitable.
The PPC has recommend ed to the Board that it approve :
? Up to US$ 5 million during 2022 -2025 for costs related to the procurement and
distribution of yellow fever diagnostic test kits, reagents, supplies, and
equipment and up to US $ 27 million during 2022 -2025 for procurement and
distribution of cholera , typhoid , meningoc occus , measles , and rubella
diagnostic test kits, reagents, supplies, and equipment , all for countries eligible
for Gavi new vaccine support
? Additional funding through the Partners? Engagement Framework (PEF)
Strategic Focus Area (SFA) mechanism of up to US$ 4 million during
2022 - 2025 to support yellow fever diagnostic test validation, guidance
SUBJECT:
DISEASE SURVEILLANCE AND DIAGNOSTIC S TO
SUPPORT TARGETED VACCINATON IN GAVI 5.0
Agenda item: 12
Category: For Decision
Report to the Board
30 November - 2 December 2021

Board -2021 -Mtg -4-Doc 13 1
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30 November - 2 December 20 21

















SUBJECT: RE VIEW OF DECISIONS
Agenda item: 13
No paper

Board -2021 -Mtg -4-Doc 14 1
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30 November - 2 December 20 21

















SUBJECT: CLOSING REMARKS
Agenda item: 14
No paper

1



Board -2021 -Mtg -4-Doc 04


Section A: Executive Summary
Context
The Managing Director Audit and Investigations (A&I) is required to report to the
Board at least annually (detailed reports are made regularly to the Audit and
Finance Committee (AFC) throughout the year including special meetings on
COVAX ). Annex A presents a summary background on the activit ies of A&I for
newer Board members who may be unfamiliar with its scope of work and operation.
Questions this paper addresses
What is A&I doing to assess the risks related to the operation of COVAX and
COVID -19 delivery, and to evaluate management?s risk mitigation ?
What is A&I doing to assess the on -going risks of ?core Gavi ? and management?s
risk mitigation (recognising the significant focus within the Secretariat on COVAX)?
How is this affected by the ne ed for A&I to work remotely , especially with respect
to programme audits conducted in country?
What activity is being noted through Gavi?s whistleblower channels given the public
profile of COVAX?
Conclusions
A&I has undertaken significant work ? across audit, counter -fraud, and advisory
assignments - to understand the special risks, and their mitigation, on the COVAX
facility and the distribution of COVID -19 vaccines.
Whilst there has been significant focus on COVA X operations and COVID -19
vaccine deployment, A&I has maintained a regula r programme of activity , as
agreed with AFC, ensuring that there has been on -going coverage of the core Gavi
activities . T his balance will be maintained into 2022. Following suspension of
programme audits in 2020, these have recommenced in 2021 utilising local
consultants and , increasingly , with A&I staff travelling to country to engage with
programme and ministry management directly.
Regarding the receipt of whistleblower reports in 2021, th ese have increased
significa ntly compared to prior years ? though a large number are non -substantive,
misdirected, or anti -vaxxer in nature. Nonetheless, th os e which are well -intended
and well -directed provide insights which have been followed through, in
SUBJECT : REPORT FROM AUDIT AND INVESTIGATIONS
Agenda item: 04
Category: For Information
Report to the Board
30 Nov ember - 2 Dec ember 2021

Gavi

1



Board -2021 -Mtg -4-EAC Committee Chair Report


Section A: Introduction
? This report provides the Board with an overview of the activities of the
Evaluation Advisory Committee ( EAC ) since the interim Committee Chair
last reported to the Board in June 2021 . Since then, Professor James
Hargreaves has joined the committee as the new EAC Chair.
? The EAC met virtually on 29 and 30 September to provide guidance on
progress on on -going evaluations and approve updates to the multi -year
evaluation workplan for Gavi 5.0; provide guidance on the Evaluation
Operational Guidelines (EOGs) an d on progress of the COVAX Facility and
Advance Market Commitment (AMC) evaluability and evaluation design
study and on the challenges identified at this early stage of the evaluation .
o The EAC approved a revised multi -year evaluation workplan, which
includ ed a modified timeline for the development of the request for
proposal (RFP) for the zero -dose evaluation . This has been
postponed until Q1 2022 given the limited bandwidth and shifting
priorities at the country level, largely due to the COVID -19 pandemic .
o In relation to Gavi?s EOGs, EAC members considered it important to
remove the portion of Clause 7.5.1 in Gavi?s Evaluation Policy that
restricts EAC members from sitting on evaluation Steering
Committees (SCs) on the basis that this prevents the EAC from
ensuring the independence and quality of evaluations ; and that
participating throughout t he evaluation process, including on SCs,
would enable the EAC to maintain the oversight required to fulfil its
Terms of Reference. The EAC Chair sought guidance on the
proposed modification to the Evaluation Policy from the Governance
Committee on 23 Novem ber 2021. The EAC will reconvene on 26
November 2021 to consider formally recommend ing an amendment
to the policy . The EAC Chair will provide an update during the Board
meeting on the outcome of the se discussions.
o The EAC provided guidance on how to stren gthen reporting channels
with the Board and increasing the visibility and utility of centralised
evaluations. EAC members also noted that it would be worth
engaging more with the PPC and to consider using technical
briefings to share findings from evaluations.
o On the COVAX Facility and AMC evaluability and evaluation design
study, the EAC provided guidance to address challenges that include
SUBJECT : EVALUATION ADVISORY COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
30 November - 2 December 2021

1



Board -2021 -Mtg -4-Governance Committee Chair Report

Section A: Introduction
? This report provides the Board with an overview of the activities of the
Governance Committee (GC) since the Committee Chair last reported to
the Board in June 2021.
? The GC met virtually on 30 September 2021 and 23 November 2021 .
? In addition to some routine business such as Board and Committee
nominations and the recruitment of Unaffiliated Board members, Committee
discussions focused on work in relation to (i) Vice Chair nomination process ;
(ii) COVAX Facility Governance ; (iii) Board and Committee Self -Evaluation ;
(iv) Implementation of the Conflicts of Interest Polic y for Gov ernance
Bodies ; (v) annual HR report ; (vi) refinements to the Evaluation Advisory
Committee Policy and Audit and Finance Committee Charter s; and (vii) the
process to support leadership transition for the appointment of a new CEO
in 2023. .
? In addition, a number of nominations for Board and Committee members
submitted electronically to the Governance Committee for consideration
have already been circulated to the Board for no -objection consent and
were approved on 29 July 2021, 21 September 2021 and 13 O ctober 2021.
? The GC Chair report is attached in the form of a presentation as Annex A .
Annexes
Annex A : Governance Committee Chair report
SUBJECT : GOVERNANCE COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
30 November - 2 December 2021

1



Bo ard -2021 -Mtg -4-In vestmen t Co mmittee Ch air Rep o rt


Section A: Introduction
? This report provides the Board with a summary of preliminary investment
portf olio perf ormance through October 2021 and recent Investment
Committee (?Committee?) activities and accomplishments, with a f ocus on
those completed since the last Board update in June 2021. The Commit tee
met f our times in 2021.
? The total portf olio value is US$ 1.7 billion of which US$ 1.2 billion is invested
in the long -term portf olio. Another US$ 112 million is cash pending
investment in the long -term portf olio. The remaining US$ 461 million in the
short -term portf olio represents donor contributions invested in high qualit y
money market f unds and deposits. While the short -term portf olio is under
the purview of the Treasury team , it is included in this paper to provide the
Board with a view into unrest ricted assets. The af orementioned total does
not include the UNICEF Procurement Account, COVAX f unding or asset s
managed by the World Bank on behalf of the International Financing Facility
f or Immunisation ( IFFIm ).
? The estimated year -to-date long -term por tf olio perf ormance as of 31
October is +7.2% versus a policy index return of 3.7 % . In September , the
long -term portf olio exceeded its policy benchmark +5.9% versus 2.4%. The
estimated year -to-date net investment income is US$ 80 million. The f our
major com ponents of the long -term portf olio ? Equity, Fixed Income,
Tactical and Multi -Exposure ? all made positive contributions. However,
Gavi?s Tactical and Multi -Exposure allocations which together constitut e
about a quarter of the portf olio had muted returns. Overall , the portf olio
orientation has a heavier allocation to credit based on past Committee
evaluation s of risk and return s appropriate f or Gavi . A re -calibration of risk
and return is underway and will be covered later in the paper.
? Global equities emb raced the upswing in global economic growth and solid
corporate earnings reports , march ing upward bef ore paus ing brief ly in
September to assess the risk of inf lation . Key equity markets ascended to
historic highs in October. The growth comparisons to a low base f rom the
prior year mattered little to equity investors. Gavi?s equity allocation
benef itted f rom the general equity trend returning +16.3% versus its
benchmark of +16.8%. A hedged equity str ategy was a drag on
perf ormance.
? The f ixed income markets, on the other hand, vacillated. Using the US
Treasury curve as a proxy , yields spiked in the f irst quarter, eased in the
SUBJECT : INVEST MENT COMMIT TEE CHAIR REPORT
Category: For Inf ormation
Report to the Board
30 November - 2 December 2021

1



Bo ard -2021 -Mtg -4-IFFIm Ch air Rep o rt


Section A: Introduction
? This report provides an overview of IFFIm?s contribution to Gavi in the 2016 -
2020 strategic period and the outlook on 2021 -2025 activity.
? IFFIm remains a valuable tool f or Gavi to f inance both COVAX AMC
activities and 5.0 core programmes.
? IFFIm?s f inancing model has proven well -suited to the current environment ,
which calls f or f lexibility and the means to provide ?surge ? f inancing.
? IFFIm has raised US$ 1 billion in 2021 . It has increased its April 2021
transaction f or US$ 750 million with an additional US$ 250 million in
November . Both were oversubscribed and priced on very attractive terms.
? As IFFIm celebrates 15 years since its inaugural bond, i nvestor interest
continues to grow, especially among those looking to invest in social or
susta inable sectors.
? The IFFIm Board has recruited three new members bringing a new depth of
expertise in global development and f inance while also expanding
geographic perspectives f rom Asia, Af rica and Europe . We are in the
process of considering candidates f or another vacancy arising at the end of
this year.
? The IFFIm Chair report is attached in the f orm of a presentation as Annex
A.
Annexes
Annex A : IFF Im Chair report
SUBJECT : IFFIM CHAIR REPORT
Category: For Inf ormation
Report to the Gavi Board
30 November - 2 December 2021

1



Board -2021 -Mtg -4-PPC Committee Chair Report


Section A: Introduction
? This report provides the Board with an overview of the activities of the
Programme and Policy Committee ( PPC ) since the Committee Chair last
reported to the Board in June 2021 .
? The PPC met virtually on 20 -22 October 2021 . During the meeting, the
Committee discussed a number of important topics for the Alliance and
agreed on recommendations which are being put forward to the Board at its
November -December 2021 meeting for consideration.
? To follow up on discussions at the October 2021 meeting, the PPC
reconvened on 12 November 2021 to further discuss and consider two
recommendations which are also being put forward to the Board at this
meeting , namely i) COVAX : Key Strategic Issues, and ii) Disease
Surveillance and Diagnost ics to Support Targeted Vaccination in Gavi 5.0 .
? 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
30 November - 2 December 2021

Gavi

www.gavi.org
CEO BOARD UPDATE
Seth Berkley, CEO
Board meeting
30 November ?2 December 2021
Gavi 5.0 year 1, pandemic year 2:
risks, uncertainties persist
Source: John Hopkins University CSSE COVID -19 Data ?Last updated 30 November, 08:05 (London time) OurWorldInData.org/coronavirus ?CC BY
The bimonthly growth rate on any given date measures the percentage change in number of
new confirmed cases over the last 14 days relative to the number in the previous 14 days.
Bimonthly change in confirmed COVID -19 cases
(29 November 2021)
Need for variant -adapted vaccines
in case of variant -escaping immunity
Evidence of detrimental change in COVID -19 epidemiology
B.1.1.529 designated as VOC

Gavi

Gavi

Gavi

Gavi

Gavi

Gavi

Gavi