gavi.org
FINANCIAL UPDATE, INCLUDING FORECAST
BOARD MEETING
Ian MacTavish
6-7 June 2024, Geneva, Switzerland
•2023 Statutory Financial Statements recommended to the
Board for approval by the AFC
• Majority of Gavi 5.1 Resources fully committed
• COVAX AMC Repurposing ongoing, outcome will be
significant
• It’s time for Organisational Effectiveness decisions!
2
Key Messages
Board Meeting, 6- 7 June 2024

Board -2024 -Mtg -02-Doc 03a -Annex A 1
Report to the Board
6-7 June 202 4
Annex A: Technical report on Gavi 5.0/5.1 indicators
This is a technical report providing definitions of and progress against Mission and
Strategy Goal indicators in the Gavi 5.0/5.1 measurement framework. The technical
report is populated based on available data and updated bi -annually. The newly
available data for 2023 included in this report relates to Mission Goal M1 and Strategy
Goals S1.4, S3.1, S3.3, and SG4.
Note on target trajectories:
In the below graphs, the dotted lines represent the projected annual trajectory that was
forecasted when we set 2025 targets with the PPC/Board in May 2021; our assumption
was that coverage would return to 2019 coverage levels in 2021, with the exception o f
India which would take until 2022. This was noted in a footnote in the PPC paper at
the time (in May 2021 PPC meeting book: Doc 04 Gavi 5.0 Measurement Framework ):

To account for COVID -19 -related disruptions and recovery, it is assumed that vaccine
coverage returns to 2019 levels by 2021, with the exception of India, which we assume
returns to 2019 levels in 2022 and sub -national three doses of pneumococcal conjugate
vaccine (PCV3) scale up takes an additional year.


Gavi 5.0 Mission Indicators

M.1: Under -five mortality rate – Updated April 2024


By increasing access to immunisation and
enabling equal access to new and underused
vaccines, Gavi support is contributing to the
reduction in under -five deaths from vaccine -
preventable diseases.

Gavi countries saw an under -five mortality rate of
53.6 deaths per 1,000 live births in 202 2. At the
portfolio level we are well o n track to reach the
10% reduction target by 2025 – as of 202 2, Gavi
countries have achieved a 9% reduction from
baseline.


M.2: Number of future deaths averted with Gavi support – Updated September 202 3


This indicator estimates the impact of Gavi -
supported vaccinations in terms of averting future
deaths from vaccine -preventable diseases.
More than 2.4 million future deaths have been
averted by Gavi -supported vaccinations in 5.0
through 2022. The cumulative number of deaths
averted from 2000 through 2022 is more than 17.3
million .

This indicator will be updated in September 2024.

Classified as Internal #
Gavi Alliance Board Workplan
Gavi Board Paper July-NovDecMar/Apr JuneNov/Dec Mar/Apr JuneNov/Dec Mar/Apr JuneNov/Dec
A.Strategy/Performance/Risk/MEL CEO's Report CEO's Report
DiscussionDiscussionDiscussion DiscussionDiscussion DiscussionDiscussion 2021-2025 Strategy Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion DiscussionDiscussion Discussion Innovation TBD Information
Private Sector Engagement TBDInformationInformation
Civil Society and Community Engagement Approach TBD
Partners' Engagement Framework Strategy, Programmes and Partnerships: Progress, Risks and Challenges
Discussion DiscussionDiscussion DiscussionDiscussion DiscussionDiscussion Disease Surveillance and Diagnostics in Gavi 5.0 TBD
Risk and Asurance Report Risk and Assurance ReportDecisionDecisionDecisionDecision
2026-2030 Strategy TBD
Discussion DiscussionDiscussionDiscussion Funding Policy Review (Elegiblity, Transiation & Co-financing; Middle-Income Countries Approach; HSS Allocation Formula) TBDDecisionDecision
Health Systems strategy TBDDecision
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Discussion Measurement Framework (Targets & Indicators) TBDGuidanceDecisionDecision B.Vaccines & Sustainablity Typhoid TBD Pneumococcal AMC (Advance Market Commitment) TBD Vaccine Investment Strategy Vaccine Investment Strategy COVID-19 Vaccine Programme Update Country Programmes Delivery Update Information Gavi's role in Pandemic Prevention, Preparedness and Response TBD Day Zero Facility - First Response Fund TBDDecisionInformationInformationInformation African Vaccine Manufacturing Accelerator TBD DecisionInformationInformationInformation RSV Investment Case TBD Decision Market Shaping Strategy TBDGuidance
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Nigeria TBD
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PNG TBD
Information
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Programme Funding Policy Consent Agenda
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Board Chair Appointment Consent Agenda DecisionDecision
Board Vice Chair Appointment Consent Agenda DecisionDecision
Committee Chair Appointments Consent AgendaDecisionDecision Decision
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G. Reporting
Committee Chair Reports Committee Chair and IFFIm Board reports InformationInformationInformation InformationInformation InformationInformation IFFIm Chair Reports Committee Chair and IFFIm Board reports InformationInformationInformation InformationInformation InformationInformation Replenishment/Resource Mobilisaton Resource Mobilisation Update Discussion
Discussion Collaboration with other organisations TBD InformationInformation HR Report Closed Session InformationInformationInformation InformationInformation InformationInformation Annual Report on Implementation of the Gender Policy Annex to Strategy paper InformationInformationInformationInformation Board and Committee minutes Annex to Board pack/On BE as additional materials Information
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Evaluations
Gavi Forecasting/Resource Allocation
Country Performance - High Impact Countries
Country Performance - Fragile Countries
2026 2027
Last updated - 23 May 2024
Next Board Meetings: 4-5 December 2024
9-10 April 2025 (Retreat)
25-26 June 2025
3-4 December 2025
2024
2025
Board-2024-Mtg-02-Doc 01f

gavi.org
FINANCIAL UPDATE, INCLUDING FORECAST
BOARD MEETING
Ian MacTavish
6-7 June 2024, Geneva, Switzerland
•2023 Statutory Financial Statements recommended to the
Board for approval by the AFC
• Majority of Gavi 5.1 Resources fully committed
• COVAX AMC Repurposing ongoing, outcome will be
significant
• It’s time for Organisational Effectiveness decisions!
2
Key Messages
Board Meeting, 6- 7 June 2024

gavi.org
COVAX UPDATE
BOARD MEETING
Derrick Sim
6-7 December 2023, Accra, Ghana
Health care workers
COVAX has made considerable achievements to date
2 Board Meeting, 6-7 December 2023
Source: WHO COVID -19 vaccine information hub as of 23 Sept 2023; Imperial College estimates of the impact of COVID- 19 vaccination in COVAX AMC countries, 27 Feb 2024
•57% coverage with complete primary series among
AMC participants • 17% coverage with booster dose
• Only 6 countries remain under 10% coverage
COVID -19 coverage
• 84% vaccinated with the complete primary series
• 57% reached with a booster dose
Older adults
•72% vaccinated with the complete primary series
• 24% reached with a booster dose
As of end 2022, estimated 2.7 million deaths averted due
to COVAX -supported doses among AMC participants
COVID -19 impact

Board -2023 -Mtg -04 -Doc 10b -Annex A 1
Report to the Board
6-7 December 202 3
Annex A : AVMA Base Proposal – key terms
This Annex serves as an overview of the key terms of the base proposal for the design
of the AVMA, to be approved by the Gavi Board, as set out in Doc 10 b.
Design element Proposal
Size Funding requirement of US$ 750 -1,000 million – with the
upper end of the range set to accommodate an ambitious
outcome for African products in terms of number of
incentivised manufacturers and their commercial volumes
Scope All Gavi Alliance supported vaccines (with differences in
payments, see “Incentives”), fill & finish -only (i.e. drug
product) , and “end -to -end” drug substance + drug product .
Duration To be launch ed in 2024 with a proposed duration of 10 years
(payments can continue for a period beyond the 10 -year
mark, depending on tender length s)
Eligibility Vaccines manufactured (drug substance and/or drug product)
on the African continent *
Procurement
pathway
Via successful Gavi -UNICEF tenders (a potential AU pooled
procurement mechanism may be accommodated in future)
Incentives Structure Two incentive types:
• Milestone payment at WHO Prequalification
• Per -dose accelerator payment , paid upon delivery of
vaccines purchased
Priorities Although all Gavi -supported vaccines are included in scope,
the following vaccines and drug substance platforms of
specific relevance to pandemic preparedness receive
additional incentives ( as below in values):
“Priority Vaccines” : Oral Cholera, Malaria, Measles -Rubella,
Hexavalent (wP) , Yellow Fever ; Ebola ( required profile:
indication against at least 2 Ebola species and
thermostability a s from – 20C); Rotavirus ( required profile:
single -dose blow -fill -seal presentation ); Pneumococcal
(required profile: m inimum 13 valent)
Priority pandemic preparedness drug substance platforms:
mRNA, Viral Vector

1



Board -2023 -Mtg -04-Doc 10a
Report to the Board
6-7 December 2023
Subject Pandemic Prevention , Preparedness and Response Approach
Agenda item 10 a
Category For Decision
Section A : Executive Summary
Gavi, the Vaccine Alliance (the Alliance) is a critical contributor to pandemic
prevention, preparedness, and response (PPPR) through its support of routine
immunisation and outbreak response. In the aftermath of the COVID -19 pandemic,
multiple global and regional initiatives are on -going to address gaps in the global
response. The Secretariat is collaborating with Alliance members , the Coalition for
Epidemic Preparedness Innovations ( CEPI ) and additional regional and global
partners on PPPR to build upon the lessons from COVID -19 and contribute to the
evolving PPPR architecture. These contributions build on the four areas for targeted
additional roles in PPPR presented to the Board, as part of the approval of the Gavi
5.1 Strategy : i) retain and enhance required capabilities for the next pandemic;
ii) financial innovation; iii) resilient routine immunisation program me s; and
iv) diversification of regional manufacturing.
This paper provides an update on the Alliance’s approach to PPPR and proposes
investments for the remainder of Gavi 5.1 aligned with the approach . In June 2023,
the Board requested the Secretariat to present options for the use of remaining
COVAX Advance Market Commitment (AMC) Pandemic Vaccine Pool (PVP) funding,
that include but are not limited to preparing for and responding to COVID -19 and future
health emergencies. The Programme and Policy Committee considered three PPPR
proposals during its October 20 23 meeting: the proposal on support for a coalition of
vaccine partners is being recommended for Board approval; the proposal on the Day
Zero Financing Facility for Pandemics received guidance from the PPC and elements
of this facility are being taken t o the December meeting of the Audit and Finance
Committee ( AFC ) ahead of the Board meeting for its recommendation as is the
practice with financial instruments; and a third proposal on a healthcare worker
immunisation platform will be discussed in the context of Gavi 6.0. The Board will have
an opportunity to consider the level of ambition for Gavi ’s approach for PPPR more
broadly as part of the process of developing the 6.0 Strategy. The PPPR approach
and associated investment proposals have been developed in consultation with
Alliance and additional partners.
Questions this paper addresses
• What is the vision and theory of change for Gavi’s PPPR approach?
• What are the recommended investment options for use of COVAX AMC PVP
funding to support the PPPR approach?

Board -2023 -Mtg -04-Doc 10a -Annex A
Report to the Board
6-7 December 2023
Annex A : Investment Proposals

As requested by the Board in June 2023 , t he Secretariat is propos ing investment s to
advance the approach to pandemic prevention, preparedness, and response (PPPR),
building on the Alliance’s expertise and historic contribution to PPPR. These
investments cover a spectrum of public health events (PHEs) to strengthen the Gavi
Alliance’s approach to outbreaks, epidemics, and pandemics and demonstrate the
Alliance’s critical role in preventing, preparing for, and responding to PHEs . These
proposals align with the PPPR priority areas for the Gavi 5.1 strategy and support the
ambition of ‘Country Ready’, ‘Vaccines Ready’ and ‘Coalition Ready’, as illustrated in
Figure 1 below .

Six proposals were presented to the COVAX AMC Investors Group for funding
consideration using COVAX AMC PVP funding. They consider current grant
agreements and possibilities for reprogramming, relate to preparing and responding
to COVID -19 and future health emergencies, and were developed in full consideration
of enhanced collaboration with other pandemic recovery and pandemic prevention,
preparedness, and response initiatives.
Figure 1 : Proposals in support of the Countries Ready, Vaccines Ready, Coalition Ready ambition
Of the six proposals presented , three proposals align ed with funding terms for the
COVAX AMC PVP and were subsequently considered by the PPC . At its meeting in
October 2023, t he PPC considered proposals B and G (Figure 1 ) for Board
recommendation and proposal H for guidance. It recommended one (G) for Board
approval . The other proposals which do not meet funding criteria for COVAX AMC
PVP funds and/or the PPC chose not to recommend at this time, are presented for
Board awareness and transparency and may be considered for Gavi 6.0 . PPPR is a
critical area under consideration for Gavi 6.0 , and t hese proposals do not constitute
the full extent of the future ambition .

1


Board -2023 -Mtg -04-Doc 07

Report to the Board
6-7 December 202 3
Subject Financial Update, including forecast
Agenda item 07
Category For Decision
Section A: Executive Summary
Context
This paper presents the updated Financial Forecasts for Gavi 5.1 (2021 -2025) and
COVAX A dvance Market Commitment ( AMC ) (2020 -2023 and 2024 -2025 for the
COVID -19 immunisation programme) to the Board for approval based on
recommendation from the Audit and Finance Committee (AFC).
The Gavi 5.1 forecast confirms US$ 103 million available for future investments . T he
Secretariat continues to actively monitor risks and opportunities not yet crystallised
(including programmatic choices at the discretion of the Alliance) , noting that as we
near the end of the strategic period, with resources approaching full utilisation, there
is limited financial flexibility and any significant additional commitments would need to
come with new funding or a reprioritisation of programm atic expenditure . The forecast
reflects an increase of US$ 157 million in resources and an increase in programmatic
expenditures of US$ 21 million - before decision s submitted for approval .
• Changes to forecast: the increase in Qualifying Resources of US $157 million is
driven by actual investment income returns and favourable impact of foreign
exchange rates. Forecast Expenditure is increasing by US$ 21 million, driven
primarily by acceleration of programmatic activity supporting Gavi 5.1 must wins
(US$ 171 million) largely offset by more efficient use of vaccine working capital
(US$ 150 million) with the Alliance procurement partner, UNICEF S upply Division
(UNICEF SD) .
• Items for decision: the Board is asked to approve US$ 136 million funding for the
launch of the Multivalent Meningococcal Conjugate vaccine (MMCV) programme
(noting this represent s US$ 34 million incremental funding as US$ 102 million of
the US$ 136 million presented for decision was included in the prior forecast). The
impact on Gavi 6.0 is forecast between US$ 326 to US$ 577 million noting that all
Gavi 6.0 requests are contingent on financial resources being made available. The
Board is also asked to exceptionally approve the extension of post -transition
support for Timor -Leste , resulting in US$ 4 million of undisbursed funds being
included in the updated forecast .
The COVAX Facility closes at the end of 2023 however the COVID -19 programme
(Vaccine and C ovid -19 Delivery Support ( CDS )) will continue until the end of the Gavi
5.1 forecast period via the Board approved COVID -19 immunisation programme
(2024 -2025) . The 2024 -25 COVID -19 programme expectation (US$ 813 million)
remains aligned with the prior Board -approved forecast.

gavi.org
COVAX UPDATE
BOARD MEETING
Derrick Sim
6-7 December 2023, Accra, Ghana
Health care workers
COVAX has made considerable achievements to date
2 Board Meeting, 6-7 December 2023
Source: WHO COVID -19 vaccine information hub as of 23 Sept 2023; Imperial College estimates of the impact of COVID- 19 vaccination in COVAX AMC countries, 27 Feb 2024
•57% coverage with complete primary series among
AMC participants • 17% coverage with booster dose
• Only 6 countries remain under 10% coverage
COVID -19 coverage
• 84% vaccinated with the complete primary series
• 57% reached with a booster dose
Older adults
•72% vaccinated with the complete primary series
• 24% reached with a booster dose
As of end 2022, estimated 2.7 million deaths averted due
to COVAX -supported doses among AMC participants
COVID -19 impact

Board -2023 -Mtg -04-Doc 04 -Annex A 1
Report to the Board
6-7 December 202 3
Annex A: Technical report on Gavi 5.0/5.1 indicators
This is a technical report providing definitions of and progress against Mission and
Strategy Goal indicators in the Gavi 5.0/5.1 measurement framework. The technical
report is populated based on available data and updated bi -annually. The newly
available data for 2022 included in this report relates to Mission Goals M2, M3, M4,
M5, and M6, and Strategy Goals 1, 2, and 3.2.
Note on target trajectories:
In the below graphs, the dotted lines represent the projected annual trajectory that was
forecast when we set 2025 targets with the PPC/Board in May/June 2021; our
assumption was that coverage would return to 2019 coverage levels in 2021, with the
exceptio n of India which would take until 2022. This was noted in a footnote in the
PPC paper on the 5.0 Measurement Framework at the time (PPC -2021 -Mtg -2-Doc
04):
• To account for COVID -19 -related disruptions and recovery, it is assumed that
vaccine coverage returns to 2019 levels by 2021, with the exception of India,
which we assume returns to 2019 levels in 2022 and sub -national three doses
of pneumococcal conjugate vaccine (PCV3) scale up takes an additional year.

Gavi 5.0 Mission Indicators
M.1: Under -five mortality rate – Updated
April 2023


By increasing access to immunisation
and enabling equal access to new
and underused vaccines, Gavi
support is contributing to the
reduction in under -five deaths from
vaccine -preventable diseases.
Gavi countries saw an under -five
mortality rate of 55.7 deaths per
1,000 live births in 2021. At the
portfolio level we are on track to
reach the 10% reduction target by
2025 – in 2021, Gavi countries have
achieved a 6% reduction from
baseline.
This indicator will be updated in April
2024.

Classified as Internal #
Gavi Alliance Board Workplan
Gavi Board Paper Type Jan-MarAprMay JuneJuly-Nov DecMar/Apr JuneNov/Dec Mar/Apr JuneNov/Dec Mar/Apr JuneNov/Dec
A.Strategy/Performance/Risk/MEL CEO's Report CEO's Report Discussion
DiscussionDiscussionDiscussionDiscussion DiscussionDiscussion DiscussionDiscussion 2021-2025 Strategy Strategy, Programmes and Partnerships: Progress, Risks and ChallengesDiscussion Discussion DiscussionDiscussionDiscussion Discussion Innovation TBDInformation Information
Private Sector Engagement TBDInformation InformationInformation
Civil Society and Community Engagement Approach TBDInformation
Partners' Engagement Framework Strategy, Programmes and Partnerships: Progress, Risks and ChallengesDiscussion
Discussion DiscussionDiscussionDiscussion DiscussionDiscussion DiscussionDiscussion Disease Surveillance and Diagnostics in Gavi 5.0 TBDDiscussion
Risk and Asurance Report Risk and Assurance ReportDecision DecisionDecisionDecisionDecision
2026-2030 Strategy TBDDecisionDecision
Discussion DiscussionDiscussionDiscussion Funding Policy Review TBDDecisionGuidanceDecision
Health Systems strategy TBDDecisionGuidanceDecision
Measurement Framework (Targets & Indicators) TBD DecisionGuidanceDecision Decision B.Vaccines & Sustainablity Typhoid TBD Information Pneumococcal AMC (Advance Market Commitment) TBDInformation Vaccine Investment Strategy Vaccine Investment StrategyDecisionDecision COVID-19 Vaccine Programme Update TBD InformationInformation Gavi's role in Pandemic Prevention, Preparedness and Response TBD TBDTBD Gavi's role in support to Regional and African manufacturing TBD TBDTBD C.
Policy Transparency and Accountability Policy Decision D.Country Programmes
Nigeria TBD
InformationInformationInformation
PNG TBD
Information Information
Strategic Partnership with India Strategic Partnerships with India
Information
Fiduciary risk assurance and financial management capacity building Fiduciary risk assurance and financial management capacity building
Information
Middle-Income Countries approach TBDInformation E.Finance/Audit & Investigations Annual Accounts Annual Financial Report DecisionDecisionDecisionDecisionDecision Financial Forecast Financial Update, including forecastDecisionDecisionDecisionDecisionDecision DecisionDecision DecisionDecision
Budget Financial Update, including forecastDecision DecisionDecisionDecisionDecision
Programme Funding Policy Consent AgendaDecision
Treasury Governance Policy Consent AgendaDecision
Treasury Risk Management Policy Consent AgendaDecision
Independent Auditor Selection and Evaluation Policy Consent AgendaDecision
Audit & Investigations Report Audit & Investigations ReportInformation InformationInformationInformationInformation F.Governance
Board Chair Appointment Consent AgendaDecision Decision
Board Vice Chair Appointment Consent AgendaDecision DecisionDecision
Committee Chair Appointments Consent AgendaDecisionDecision Decision Decision
Board and Committee Appointments Consent AgendaDecision DecisionDecision
IRC Appointments Consent AgendaDecision
CEO Appointment Consent AgendaDecision Decision
Secretary Appointment Consent AgendaDecision
Treasurer Appointment Consent AgendaDecision
Appointment of MD A&I Consent AgendaDecision
Amendments to Governance Documents (Statutes, By-Laws, Committee Charters) Consent AgendaDecision
IRC Terms of Reference Consent AgendaDecisionDecision
Audit & Investigations Terms of Reference Consent AgendaDecision
G. Reporting
Committee Chair Reports Committee Chair and IFFIm Board reports InformationInformationInformationInformationInformation InformationInformation InformationInformation IFFIm Chair Reports Committee Chair and IFFIm Board reports InformationInformationInformationInformationInformation InformationInformation InformationInformation Replenishment/Resource Mobilisaton Resource Mobilisation Update Discussion
DiscussionDiscussion
Discussion HR Report Closed Session InformationInformationInformationInformationInformation InformationInformation InformationInformation Annual Report on Implementation of the Gender Policy Annex to Strategy paper Information InformationInformationInformationInformation Board and Committee minutes Annex to Board pack/On BE as additional materials Information
InformationInformationInformationInformation InformationInformation InformationInformation H.Technical Briefing Sessions/Deep Dives
Malaria - Joint session with the Global Fund Discussion
Gavi 6.0 Deep Dive (TBD) Discussion
Gavi Forecasting/Resource Allocation Discussion
Complexity of Vaccine Manufacturing - presented by IFPMA/DCVMN Discussion
Country Performance - High Impact Countries Discussion
Country Performance - Fragile Countries Discussion
Mid-Term Evaluation Discussion
Discussion
2026 2027
Last updated - 22 November 2023
Next Board Meetings: 17-18 April 2024, Retreat
26-27 June 2024
4-5 December 2024
2024
2025
Board-2023-Mtg-04-Doc 01f