Gavi

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

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

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.

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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

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