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Board -2021 -Mtg -3-Doc 04 b-Annex A
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Board -2021 -Mtg -3-Doc 04 b-Annex A
Classified as Internal

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Board -2021 -Mtg -3-Doc 04a
Classified as Internal

Section A: Executive Summary
Context
At its June 2021 meeting, the Gavi Alliance Board approved : a) the continued
administration of the COVAX Facility by Gavi in 2022 ; b) the propos ed future
participation model for Self -Financing Participants (SFPs) ; and c) Gavi taking an
active role in the provision of fast, responsive and flexible funding through the
creation of a COVID -19 Delivery Support (CDS) envelop e and cross -cutting
delivery element s. These decisions were taken in the context of growing inequities
in access to COVID -19 vaccines and affirmed the COVAX Facility ?s continued
central role in the global vaccine response .
To date, COVAX Pillar partners ha ve supplied a total of 261 million doses , of which
204 million have gone to AMC countries (including 10 million for India) and 58
million to Self -Financing Participants (SFPs ). It is the main or only source of
vaccine for an estimated 57 countries. In the face of supply challenges , the COVAX
Facility has worked hard to adapt and build resilienc e, including through the
establishment of a dose sharing programme that has supplied 110 million donated
doses (of over 660 million th at have been pledged to date ) and through portfolio
diversification across vaccines platforms, geographies and manufacturers. Based
on the latest COVAX Facility Supply Forecast most likely supply scenario, close to
1 billion doses will be available for supply between now and the end of 2021, and
the 2 billion mark will be met before the end of Q1 2022 . For AMC Participants, the
COVAX Facility can provide access to ~2.5 billion doses through donor funds and
vaccine donations , enough to fully vaccinate ~37% of the AMC population 1.
In light of the WHO COVID -19 Global Vaccination Strategic Vision , the ongoing
COVAX Pillar Strategy effort , and a continuously evolving external environment ,
the Facility is updating its strategy for 2022 and beyond, while maintaining focus
on core operations and working across Gavi and Alliance partners and countries
to prepare for the significant increase s in deliver ies over the coming quarter.
Questions this paper addresses
W hat should the COVAX Facility contribution to global vaccin e supply in 2022 be ?
How is the delivery of COVAX vaccine s progressing and what should Gavi?s role
in COVID -19 vaccine delivery in 2022 for AMC92 be ?
1 Average excludes India, who gets 20% of COVAX APA doses
SUBJECT: COVAX : KEY STRATEGIC ISSUES
Agenda item: 04a
Category: For Guidance
Report to the Board
28 September 2021

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Re port to the Board

Board -2021 -Mtg -3-Doc 04a -Annex B

Annex B: Further updates : Allocation, Humanitarian Buffer and Contingency
provision
Update on Allocation
1.0 The Allocation mechanism was established in a period when countries had
not introduced COVID -19 vaccination, when we had little idea of whether
countries would be successful in negotiating bilateral deals - or be part of
multilateral deals - when the exten t of dose donations was unknown, and
that products were all considered equal, and supply plans were considered
to be relatively fixed.
1.1 We have learned lessons across the course of implementation of the first
Phase as we have untaken to address the large di sparities in coverage
levels and vol atility of supply , and at the same time accommodate vaccine
preferences for a variety of reasons , not least due to the emergence of
variants.
1.2 Given what has been learned and what has changed contextually, several
changes to the allocation mechanism are proposed for Q4 allocation and
beyond Phase 1. These include :
? Taking into account participants? total population coverage in order to
serve participants mainly or solely dependent on COVAX for C OVID -19
vaccines.
? Factoring in absorptive capacity in collaboration with participants to
avoid reallocation s, redistributions and redeployments of excess doses ,
to lower the likelihood of wastage and to allow participants with high
absorptive capacity to set ambitious allocation targets.
? Taking need into account in the sequence of dose shipping within a
Round.
1.3 Use of epidemiological consideration s in allocation. The Facility
includes epidemiological considerations in determining a priority sequence
for shipments of allocated doses. This takes into account both case and
mortality trends, as well as vaccination coverage levels, to prioritise
shipmen ts. This approach is also used to determine recipients of reallocated
doses as well as dose donations. The absorptive capacity of participants is
also considered in the shipping sequence, to avoid wastage and refused
doses.
Update on Humanitarian Buffer
1.4 In March 2021, the Board approved the financing of the COVAX Buffer by
reserving 5% of COVAX AMC Funding. The Board also approved
delegating decision making on Humanitarian Buffer dose allocation to the
Inter Agency Standing Committee ( IASC) Emergency Directors Group ,
following which , applications for the Humanitarian Buffer opened in May
2021.

September 2021Update to the Gavi Board | Annex ACOVAX Pillar Strategy
for 2022 and beyondDRAFT
CONTENT PENDING FURTHER CONSULTATION
Doc 04a - Annex A
2Context and objectives for
COVAX Pillar Strategy
ObjectivesContext
Since the first articulation of the COVAX strategic
vision in mid - 2020, the global context has
significantly changed as new players have
emerged, successful vaccine products are deployed
around the world, and the epidemiology has
continued to evolve.
In light of these changes and building on WHO?s
COVID - 19 Global Vaccination Strategic Vision
exercise, it is important that the COVAX Pillar ,
consisting of core partners WHO, CEPI, Gavi, and
UNICEF, revisits its Strategy and updates it for
2022 and beyond, reaffirming its commitment to
work together to address the greatest crisis in a
generation. A successful 2022 Strategy for COVAX will:
? Clarify the Pillar?s objectives, role, and value
proposition
? Help delineate the role of each of the partners
? Provide a cohesive foundation upon which each
partner organisation can plan and structure
The Strategy will both support internal Pillar
coordination and effectiveness, but will also define
externally what COVAX stands for and what
COVAX seeks to offer to the world. DRAFT | CONTENT PENDING FURTHER CONSULTATION
Doc 04a - Annex A
Doc 04a - Annex A

Board -2021 -Mtg -3-Doc 03 1
Report to the Board
28 September 20 21

















SUBJECT: STRATEGY, PROGRAMMES AND PARTNERSHIPS:
PROGRESS, RISKS AND CHALLENGES
Agenda item: 03
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Board -2021 -Mtg -3-Doc 02

Report to the Board
28 September 202 1


21 September 202 1

Dear Board members ,

As we head into our additional Board meeting, I wanted to provide some thoughts
on the key issues up for discussion. My usual report will come in December,
touching on the breadth and richness of the important work underway in the
Secretariat, but for now I will stay focused. It is hard to believe that we are now a
year and half into the COVID -19 pandemic and nearing the end of the first year of
Gavi 5.0. Even before the pandemic hit, we were expecting this past year to be a
busy one as we worked with count ries, forged new partnerships, and focused our
resources and attention on zero -dose and missed communities. Against a
backdrop of high performance, we were prepared to be ambitious. But 2021, like
2020, proved to be a difficult year, the repercussions of w hich are still unfolding.

The 2020 WHO/UNICEF Estimates of National Immunization Coverage (WUENIC)
data released in July provided us with critical insights into how Gavi -supported
countries are faring in the pandemic, and the resiliency of their immunisat ion
systems. Throughout Gavi 4.0, with the exception of last year, we saw positive
progress and were on track to achieve most of our strategic goals ? particularly in
ten Tier 1 countries that we prioritised under the partners? engagement framework
(PEF) where the Alliance has had more deliberate and focused engagement ,
including high -level country m issions. These countries showed a 6 percentage
point increase in coverage, surpassing our target.

The COVID -19 pandemic, however, has set back progress and resulted in a
4 percentage point decrease in DPT3 coverage across Gavi -supported countries
in 2020. While it is hard to see our gains eroded, this loss is less severe than what
we had initially feared . The resumption of routine immunisation services and catch -
up of missed children in many countries over the second half of 2020 speaks to
the resilience of Gavi implementing countries and the strength of the health
systems in which we have invested. These same systems are supporting the
COVID -19 response, speaking to the importance of our investments in health
systems as a component of global pa ndemic preparedness and response.

Report of the Chief Executive Officer

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Board -2021 -Mtg -3-Doc 02 FR

Rapport au Conseil d?administration
28 septembre 202 1


Le 21 septembre 202 1

Chers membres du Conseil d?administration,

? l?approche de notre nouvelle r?union du Conseil d'administration, je tenais ?
vous faire part de quelques r?flexions sur les principa ux points dont nous aurons
? d?battre. Mon rapport ordinaire sera publi? en d?cembre et traitera en d?tail des
activit?s importantes men?es par le Secr?tariat, c?est pourquoi je ne vais pas m?y
attarder . Nous avons du mal ? r?aliser que la pand?mie de COVID -19 a d?but? il
y a un an et demi et que nous approchons d?j? de la fin de la premi?re ann?e de
Gavi 5.0. Avant m?me le d?but de la pand?mie, nou s nous attendions ? avoir une
ann?e 2020 tr?s charg?e, car nous devions travaill er avec les pays, forg er de
nouveaux partenariats et concentr er nos ressources et notre attention sur les
communaut?s ? z?ro dose ? qui ?chap paie nt ? la vaccination . Compte ten u de
notre niveau de performance, nous pouvions nous montrer ambitieux . Mais 202 0
s'est av?r?e une ann?e difficile dont les retomb?es se font encore sentir ? et 2021
l?est tout autant .

Les estimations 2020 de l'OMS et de l'UNICEF sur la couverture vaccinale
(WUENIC) publi?es en juillet dernier nous fourni ssent des informations cruciales
sur la fa?on dont les pays soutenus par Gavi font face ? la pand?mie, et sur la
r?silience de leurs sy st?mes de vaccination. ? l'exception de l'ann?e derni?re ,
nous avons constat? des progr?s notables tout au long de la p?riode Gavi 4.0
(2016 -2020) , et nous ?tions en bonne voie d?atteindre la plupart de nos objectifs
strat?giques, en particulier dans dix p ays de niveau 1 auxquels nous av ions
accord? la priorit? en ce qui concerne le Cadre d'engagement avec les partenaires
(PEF), et aupr?s desquels l?Alliance s??tait engag?e de fa?on plus pr?cise et plus
cibl? e, notamment pour des missions nationales de haut niveau. Avec une
augmentation de 6 points de pourcentage de l eur couverture vaccinale , ces pays
ont d?pass? l?objectif fix?.

La pand?mie de COVID -19 a toutefois frein? ces progr?s et entra?n? en 2020 une
perte de 4 points de pourcentage de couverture avec le DTC3 dans les pays
soutenus par Gavi. Il est difficile de voir nos acquis s'?roder, mais cette baisse est
moins forte que nous l? avions craint initialement . Les services de vaccination
syst?matique ont repris et, dans de nombreux pays, les enfants qui avaient
R ap port du Directeur ex?cutif