gavi.org
FINANCIAL UPDATE, INCLUDING FORECAST
BOARD MEETING
Assietou Diouf
26 -27 June 2023, Geneva, Switzerland
Table of contents
COVAX AMC and COVID -19 forecast
F orecast risks and opportunities
Gavi Core 5.1 financial forecast 1
2
4
3
5
Gavi 6.0 forecast
Annex
Board Meeting, 26 -27 June 2023

1


Board -2023 -Mtg -02-Evaluation Advisory Committee Chair Report
Report to the Board
26 -27 June 2023

Subject Evaluation Advisory Committee Chair Report
Category For Information
Section A: Introduction
? This report provides the Board with an overview of the activities of, and
guidance provided by, the Evaluation Advisory Committee (EAC) since the
Committee Chair last reported to the Board in December 2022.
? At the in -person EAC meeting on 22 -23 March 2023, the EAC provided
guidance on: (i) the approach to assessing partners? role s across the Alliance
Strategy in evaluation s; (ii) the COVAX Facility and COVAX Advance Market
Commitment (AMC) Formative Review and Baseline Study; (iii) the proposed
scope, approach, and key questions of the next phase of the COVAX Facility
and COVAX AMC evaluation; (iv) progress of the commissio ned Gavi 5. 1
centralised evaluations; (v) the Zero -Dose learning agenda and related ongoing
evaluation; (vi) the operationali sation of the changes to the Gavi Evaluation
Policy; and (vii) EAC engagement in Gavi 5. 1 evaluations.
? Overarching issues and guidance
? As reported at previous Board meetings, the EAC continues to reflect on its
Remit, Voice and Practice in supporting a G avi evaluation portfolio of optimal
Independence, Credibility and Utility. The Multilateral Organisation
Performance Assess ment Network (MOPAN ) assessment, a potential further
independent assessment of the Evaluation function, and planning for Gavi 6.0
all offer opportunities to support this work.
? Recogni sing the importance of partnerships given the nature of Gavi as an
Allia nce, EAC members advised that Gavi Alliance partners should be
considered within the scope of the evaluations where their roles, responsibilities
and delivery contributes to the area of Gavi's work or Theory of Change (ToC)
being evaluated, and the focus f or evaluations should be on learning rather than
accountability of specific partners. The discussion focused on: (i) developing
and promoting an approach to enhanced engagement with partners on the
scope and questions for evaluations, to promote shared own ership of findings
and recommendations; and (ii) ensuring independent evaluators undertaking
evaluations are well briefed on the Gavi Alliance model and on the assumptions
related to the roles and responsibilities of partners within the ToC being
evaluated . The EAC further advised that the latter should be conducted as part
of the inception process - rather than as a condition of bidding - and validated
by relevant Alliance stakeholders.
? The EAC reviewed findings from an After Action Review on the
operati onali sation of the changes to the Gavi Evaluation Policy which was
revised in December 2021 to allow EAC members to join Evaluation Steering

Board -2023 -Mtg -02-Doc 08 -Annex B 1
Report to the B oard
26 -27 June 202 3
Annex B: Design considerations for an Advance Market Commitment to support
sustainable vaccine manufacturing capacity
The Secretariat is currently exploring different options for the following AMC design
considerations:
1. AMC objectives
2. Value chain focus
3. Incentive structure
4. Antigen specificity
5. Procurement pathway and manufacturer eligibility
6. Financing, governance and operationalisation
Given the number of interested stakeholders and range of mode l options , the
Secretariat is facilitating a transparent and evidence -based treatment of these design
options to facilitate constructive open debate. These analys es reflect substantial
learning from the PCV AMC and explore the implications of multiple design choices
on operationalisation and impact. Further analysis and expert validation are being
conducted over Q3/4 2023 before any recommendations are made.
1. AMC objectives
To strengthen regional manufacturing of vaccines the Gavi Board approved three
underpinning objectives in December 2022 . The AMC mechanism is expected to
adhere to these as ?boundary conditions?:
Gavi board -
approved
objectives
Description
Support healthy
global markets
Minimize market distortions and help to sustain low global
prices and resilient supply for priority vaccines
Drive efficient
market outcomes
Provide a signal to guide and align new manufacturers and
investors behind resilient, sustainable business propositions
Reduce barriers to
investment
Carefully structuring the level of incentive to help offset
initial costs of market entry whilst aligning support with other
providers of capital for greater overall impact
These have been t ranslated into two clear overarching AMC objectives , that both
meet Gavi?s objectives and match the requirements of external stakeholders voiced
during the Secretariat?s consultations ( in order of priority below ). Drafting theories
of change for these AMC objectives has already begun. These will form the
foundation of a holistic monitoring, evaluation and learning strategy to accompany
the AMC as well as the broader four -pillar regional manufacturing strategy. Gavi is
also embracing learnings generated from other AMCs as part of this design
process .

 

Board -2023 -Mtg -02-Doc 07 -Annex A 1
Report to the Board
26 -27 June 202 3
Annex A: COVAX Reporting Fram ework
Section A: Update on Gavi?s COVAX Facility and COVAX AMC Monitoring, Evaluation
and Learning (MEL) strategy

The table below provides some of the key highlights and updates on progress against the core
elements of Gavi?s COVAX Facility and COVAX AMC MEL Strategy since the December 2022
Gavi Board.

MEL strategy
component
Key activity Highlights / update (May 2023)
Cross -cutting COVAX Theory
of Change
COVAX Facility and AMC theory of change for
2023 drafted, mapping against the objectives and
goals as presented to the Gavi Board in December
2022.
Monitoring COVAX
Reporting
Framework
Reporting against COVAX Reporting Framework
made available for PPC and Board. The 2023
Reporting Framework is further streamlined and
accompanied by short qualitative updates for some
key 2023 objectives (see 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. Examples includ e:
? COVID19 Vaccination Insights Reports
generated by WHO covering a range of
disaggregated analyses on uptake, supply
received and external delivery financing;
? Monitoring of progress across subgrants
funded through COVID19 Delivery Support;
? Other operational metrics and analyses across
supply, allocation, deliveries and in -country
implementation gathered internally.
Core country
monitoring and
reporting on
COVID -19 /
COVAX
COVAX continues to utilize data reported via the
WHO -UNICEF electr onic Joint Reporting Form
COVID -19 module and WHO regional COVID -19
vaccination dashboards to gather core reporting
from COVAX participants. Gavi recently co -
convened a Global Meeting with WHO, UNICEF
and CoVDP to set forth a pathway for revisions to
the c ore minimum dataset and reporting on COVID -
19 vaccination going forward.
Recipients of COVID19 Delivery Support funds are
expected to report back on a six -monthly basis to
Gavi.
Evaluation Multi -stage
independent
Itad ( www.itad.com ) was selected as the
independent evaluator for the first stages

 

1


Board -2023 -Mtg -02-Doc 07
Report to the Board
26 -27 June 202 3

Subject COVAX update and Gavi?s Role in a future COVID -19 Vaccine
programme
Agenda item 07
Category For Decision

Section A : Executive Summary
Context
2023 is a critical year for the COVAX Facility. With the lifting of the Public Health
Emergency of International Concern (PHEIC) designation for COVID -19 on
5 May 2023 and recognition that the pandemic is now at a different phase, we continue
to operate in the World Health Organization -designated ?base -case? scenario for
COVID - 19 1, and we anticipate the approach to COVID -19 vaccination will continue to
evolve. Guidance from the WHO Strategic Advisory Group of Experts on Immunization
(SAGE) was u pdated in March 2023 2 recommending a more streamlined approach for
continued COVID -19 vaccination in 2023 focusing on the high priority user group.
In June 2022, the Gavi Board approved Gavi's continued hosting of the COVAX
Facility through the end of 2023. For the remainder of 2023, Gavi will continue to
integrate relevant COVAX processes into Secretariat and Alliance partner core
processes to enable a smooth transition to the proposed 2024 -2025 COVID -19
vaccine programme, pending Board approval. This paper provides an outlook for
COVAX in 2023 and seeks Board approval for a future Gavi -supported COVID -19
programme in 2024 -2025.
Questions this paper addresses

? What progress has COVAX made supporting Advance Market Commitment (AMC)
participants reach their COVID -19 vaccination goals, and what are the objectives
of a Gavi -supported COVID -19 programme in 2024 -2025?
? What is the state of supply and demand, and what is the supply strategy for
transitioning from COVAX to a future COV ID -19 vaccine programme?
? How is COVAX adjusting in preparation for the shift from an emergency response
to a potential future COVID -19 vaccine programme that utilises existing Alliance
processes?
? What are the financial implications of a 2024 -2025 COVID -19 vaccine programme
for Gavi?

1 Strategic preparedness, readiness and response plan to end the global COVID -19 emergency in 2022, WHO 2 https:/ /www.wh o.int/publications/i/item/WHO -2019 -nCoV -Vaccines -SAGE -Roadmap

Board -2023 -Mtg -02-Doc 08 -Annex A 1
Report to t he Board
26 -27 June 202 3
Annex A: Gavi?s Day Zero Pandemic Financing Facility for Vaccines
Overview
As the global community advances discussions to define an ecosystem to enhance
equitable access to medical countermeasures (MCM) during health emergencies, the
issue of financing remains unresolved. It is also important to note that not all financing
has t he same requirements. It is particularly complicated in the context of vaccines,
which require heavy up -front, at -risk investments at the onset of a crisis.
The Secretariat is exploring options to solve this problem by leveraging Gavi?s
existing suite of innovative financing tools to create a Day Zero Pandemic
Financing Facility for Vaccines. This could potentially see US$ 2 billion rapidly
mobilised as additional surge and contingent financing at the onset of a global
pandemic . Building on Gavi?s 20 years of experience in innovative financing, our core
proposition is to leverage the systems already built to support COVAX AMC, to avoid
the need for ne w complex structures or bodies to provide this surge funding capacity.
Pre -agreed considerations, such as a WHO declaration of a Public Health Emergency
of International Concern as well as geographic scope of concern and Gavi Board
processes, are examples of what would be considered in an expedited process to
realise liquid resources. While the total cost of a global vaccine response would likely
require much more than US $ 2 billion, based on the COVAX experience a figure of
approximately US $ 2 billion is a n initial needs estimate for early deals and preparation
for equitable delivery. This funding could enable Gavi to enter into advance purchase
agreements on a competitive timeline while we define a more complete picture of
expected funding needs spanning v accine procurement and delivery - buying time to
mobilize resources for a comprehensive response.
The Day Zero facility would comprise multiple financing windows and contingent
arrangements that offer donors different ways to contribute ? and could limit th e impact
of commitments on national balance sheets until they are activated.
Our proposed approach includes:
? Contingent financing ? funding that is only unlocked once certain predefined events
occu r. An example of a tool being developed to provide rapid access to contingent
donor financing in this way is the IFFIm Contingent Financing Mechanism.
? Surge funding includes two types of tools:
o Standby funds that can be deployed immediately ( e.g. a future iteration of a
Pandemic Vaccine Pool).
o Frontloading tools that accelerate the availability of funds once new pledges or
grants are made. Funding through frontloading tools would typically take longer
to become available than contingent financing but be faster than a traditional
new grant agreement. Examples of these types of tools are the European
Investment Bank frontloading facility and the US Development Finance

gavi.org
FINACIAL UPDATE, INCLUDING FINANCIAL FORECAST
BOARD MEETING
Assietou Diouf
26 -27 June 2023
Table of contents
COVAX AMC and COVID -19 forecast
F orecast risks and opportunities
Gavi Core 5.1 financial forecast 1
2
4
3
5
Gavi 6.0 forecast
Annex
Board Meeting, 26 -27 June 2023

Board -2023 -Mtg -02-Doc 02b -Annex C

1
Report to the Board
26 -27 June 202 3
Annex C: Gavi 5.0/5.1 dashboard and update on key metrics
This is a technical report providing definitions of and progress against Mission and
Strategy Goal indicators in the new Gavi 5.0 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 Goal M1, and Strategy
Goals S1.4, S3.1, 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 tar gets with the PPC/Board in May 2021; our assumption
was that coverage would return to 2019 coverage levels in 2021, with the exception of
India which would take until 2022. This was noted in a footnote in the PPC paper on
the 5.0 Measurement Framework at t he 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 thre e 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 t o reach the
10% reduction target by 2025 ? in 2021, Gavi
countries have achieved a 6% reduction from
baseline .

M.2: Number of future deaths averted with Gavi support ?
Updated Sept 2022

This indicator estimates the impact of Gavi -
supported vaccinations in terms of averting
future deaths from vaccine -preventable
diseases.
More than 1.2m future deaths were averted by
Gavi -supported vaccinations in 2021. The
cumulative number of deaths averted from 2000
through 2021 is more than 16.2m.
This indicator will be updated in Sept 2023.


59.2 57.5 55.7 Target: decrease by 10%
0
10
20
30
40
50
60
2019(Baseline) 2020 2021 2022 2023 2024 2025
1.2M
Target: 7 -8M
0M
2M
4M
6M
8M
2021 2022 2023 2024 2025

1


Board -2023 -Mtg -02-Doc 04
Report to the Board
26 -27 June 202 3

Subject COO and Financial Update, including forecast
Agenda item 04
Category For Decision
Section A: Executive Summary
Context
This paper presents the updated Financial Forecasts for Gavi 5.1 (2021 -2025), COVAX
AMC (2020 -2023) including COVID -19 immunisation programme (2024 -2025) to the
Board for approval based on the recommendation of the Audit and Finance Committee
(AFC).
The Gavi 5. 1 forecast confirms sufficient financial flexibility given the uncertain context
with US $ 109 million available for future investments. The forecast reflects a decrease
of US $ 161 million in resources and a decrease in programmatic expenditures of
US$ 12 5 million (before new items for decision).
? Changes to forecast: The decrease in forecast expenditure is driven by the
proposed rephasing of cash programmes into the next strategic period partly offset
by increased vaccine costs . W hile overall cash support to countries (Core and
COVAX COVID -19 Delivery Support (CDS) ) is forecast to remain at record levels
for the rest of the strategic period, the Gavi 5.1 H ealth Systems Integration and
Strengthening (HS IS) forecast s are US$ 268 million lower (US$ 15 0 million Health
Systems Strengthening (HSS) , US$ 14 0 m illion Equity Acce lerator Fund offset by
a US$ 23 million increase driven by Campaign Operational Costs ), reflect ing
absorptive capacity in certain co untries for HSS and to extend the time line into
2026/ 20 27 for countries to implement their EAF p rogrammes . These funds are now
forecast to be disbursed in the next strategic period but will remain available to
countries to utilise in Gavi 5.1 if absorption exceeds current forecasts (in which case
the forecast could be revised upwards again in a future cycle) . Therefore, the
resulting cash programme forecast reflects the current best estimate of
disbursement phasing and does not represent the active deferral of any underlying
programmatic activities . Increased vaccine procurement costs (US$ 151 million or
+3%) are driven primarily by increased demand for m easles & m easles -rubella
vaccines in response to coverage declines and increased outbreak risk. To balance
the rephasing of cash programmes into th e next strategic period, US$ 179 million
of IFFIm (International Finance Facility for Immunisation) proceeds will also be
deferred.
? Items for decision: the Board is asked to approve US$ 29 million expenditure in
the Gavi 5.1 forecast for the launch of the Hexavalent vaccine programme, noting
that the impact on Gavi 6.0 is forecast between US$ 357 ? US$ 430 million , as well
as a US$ 10 million time -limited envelope for a Global Virtual Pooled Inventory
(GVPI) for Ebola Sudan and Marburg candidate vaccines. As a result of countries?
EAF applications being delayed due to the pandemic, the Board is also requested
to approve the extension of the timeline to disburse the remaining EAF funds from

Gavi Alliance Board Workplan
2023
Gavi Board Paper Type Dec Apr June Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec
A.Strategy/Performance/Risk/MELCEO's Report CEO's Report Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion 2021-2025 Strategy Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion Discussion Discussion Discussion Discussion Discussion Discussion 2021-2025 Strategy Gavi 5.0 Decision Measurement Framework (Targets & Indicators) Strategy, Programmes and Partnerships: Progress, Risks and Challenges Decision Innovation TBD Information Information Information Private Sector Engagement TBD Information Information Information Information Civil Society and Community Engagement Approach TBD Information Information Partners' Engagement Framework Strategy, Programmes and Partnerships: Progress, Risks and Challenges Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Disease Surveillance and Diagnostics in Gavi 5.0 TBD Decision Discussion Risk and Asurance Report Risk and Assurance Report Decision Decision Decision Decision Decision Decision 2026-2030 Strategy TBD Decision Guidance Decision Discussion Discussion Discussion Discussion Funding Policy Review TBD Decision Guidance Decision Measurement Framework (Targets & Indicators) TBD Decision Guidance Decision B.Vaccines & SustainablityTyphoid TBD Information Pneumococcal AMC (Advance Market Commitment) TBD Information Malaria Co-financing TBD Decision Decision Vaccine Investment Strategy Vaccine Investment Strategy Decision Decision Decision COVID-19 Vaccine Programme Update COVAX/COVID-19 Vaccine Programme Decision Information Information Gavi's role in Pandemic Prevention, Preparedness and Response Gavi's role in Pandemic Prevention, Preparedness and Response Decision Decision Information Gavi's role in support to Regional and African manufacturing Gavi's role in Pandemic Prevention, Preparedness and Response Decision Decision C.PolicyTransparency and Accountability Policy Decision Decision D.Country ProgrammesNigeria TBD Information Information Information Information PNG TBD Information Information Strategic Partnership with India Strategic Partnerships with India Information 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 Middle-Income Countries approach TBD Information 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 Decision Decision Programme Funding Policy Consent Agenda Decision Treasury Governance Policy Consent Agenda Decision Treasury Risk Management Policy Consent Agenda Decision Independent Auditor Selection and Evaluation Policy Consent Agenda Decision Audit & Investigations Report Audit & Investigations Report Information Information Information Information Information Information F.GovernanceBoard Chair Appointment Consent Agenda Decision Decision Board Vice Chair Appointment Consent Agenda Decision Decision Decision Decision Committee Chair Appointments Consent Agenda Decision Decision Decision Decision Board and Committee Appointments Consent Agenda Decision 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 Consent Agenda Decision Audit & Investigations Terms of Reference Consent Agenda Decision Delegation of Authority Policy Consent Agenda Decision G.ReportingCommittee Chair Reports Committee Chair and IFFIm Board reports Information 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 Information Replenishment/Resource Mobilisaton Resource Mobilisation Update Discussion Discussion Discussion Discussion HR Report Closed Session Information Information Information Information Information Information Information Information Information Information Annual Report on Implementation of the Gender Policy Annex to Strategy paper Information 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 Information Board and Committee minutes Annex to Board pack/On BE as additional materials Information Information Information Information Information Information Information Information Information Information H. Technical Briefing Sessions/Deep DivesEvaluation Discussion Discussion Discussion Discussion Discussion
2026 2027
Last updated - 12 June 2023
Next Board Meetings: 6-7 December 202317-18 April 2024, Retreat26-27 June 20244-5 December 2024
2024 2025

Board -2022 -Mtg -03 1

Minutes


Gavi Alliance Board Meeting
7-8 December 20 22
Hilton Geneva Hotel and Conference Centre, Geneva, Switzerland

1. Chair?s report

1.1 Noting that the meeting had been duly convened and finding a quorum of
members present, the meeting commenced at 09.05 Geneva time on 7
December 2022. Prof Jos ? Manuel Barroso, Board Chair, chaired the meeting.

1.2 The Chair welcomed Deena Shiff, attending for the first time as a new
Unaffiliated Board Member. He also welcomed Kenneth Lay, IFFIm Board
Chair, and other directors of the IFFIm Board as well as David Sidwell, in his
capacity as member of the CEO Recruitment Search Committee .

1.3 He recognised two recent achievements of the CEO , firstly Dr Berkley?s
appointment as a member of the US National A cademy of Medicine and the
honorary degree bestowed on him by Makerere University in Uganda . He also
noted the awar d of the 2021 North -South prize of the Council of Europe to
COVAX.

1.4 The Chair presented a short summary of the All Chairs Group (ACG) meeting
held on 6 December 2022 during which the ACG had discussed the Board
agenda as well as outcomes of recent Board Committee meetings. He
highlighted the importance of the work by the Committees in bringing forward
recommendations to the Board and reminded Board members that they are
welcome to attend Committee meetings as observers .

1.5 He noted that the closed session of the Board held on the previous day had
included an update on the CEO search process, the annual human resources
update, and an update on CO VAX. He also noted that during that session, he
had stepped out to enable the Board to consider his re appointment, a dding that
he was humbled and honou red to be reappointed and to continue his service
to the Board.

1.6 The Chair reported on the panel he had facilitated on 6 December 2022 which
had discussed the global geopolitical, macroeconomic and financial context
and the implications of these uncertainties for health, and for Gavi. Attendees
heard how geopolitical frictions across multiple concurrent crises a re affecting
global consensus and cooperation and driving greater complexity in Gavi? s
operating environment. He noted the economic downturn would have
budgetary implications for both donor and supported countries.

1.7 Noting that the unfolding path of the COVID -19 pandemic remains uncertain,
the Chair commended the achievements of the AMC countries in delivering
4 billion vaccine doses as unprecedented , and evidence of the Alliance?s pivotal
role. He underscored the importance of reflecting on the number of lives saved