1



Board -2021 -Mtg -2-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 December 2020 .
? The PPC convened by videoconference on 2 February 2021 for an informal
disc ussion on two topics: (i) the COVAX Buffer for high -risk groups in
humanitarian situations , and (ii) on changes to the Partners? Engagement
Framework (PEF) approach for Gavi 5.0. The PPC comments from the
informal meeting help ed shape the work on the COVAX Buffer that came
back to the PPC for decision at a virtual meeting on 1 March 2021 .
? The PPC met virtually on 19 -20 May 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
June meeting for consideration.
? 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
23 -24 June 2021

Gavi

1



Board -2021 -Mtg -2-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 December 2020 Board meeting .
? The GC met virtually on 11 February 2021, 16 March 2021 and 12 May
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) the Governance Risk Matrix ;
(ii) Best Practice Guidelines for Virtual Meetings for the Gavi Board and its
Committees ; (iii) the EAC Chair Recruitment process; and (vi) the
Governance Subcommittee for High -Level HR Issues .
? In addition, a number of nomination s 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 10 February 2021, 16 March 2021 and 28 May 2021 .
? The GC will meet on 17 June 2021 and it is expected that further
recommendations will be put forward to the Board on the consent agenda
at its June meeting in relation to Board and Committee appointments and
Committee Chair appointments .
? The GC Chair report is attached in the form of a presentation as Annex A .
Annexes
Annex A : Governance Committee Chair report
Annex B: Best Practice Guidelines for Virtual Meetings for the Gavi Board and its
Committees
SUBJECT : GOVERNANCE COMMITTEE CHAIR REPORT
Category: For Information
Report to the Board
23 -24 June 2021

1



Bo ard -2021 -Mtg -2-In vestmen t Co mmittee Ch air Rep o rt


Section A: Introducti on
? This report provides the Gavi Alliance Board with an overview of the
investment portf olio perf ormance, the changes in the portf olio related to the
ongoing f oc us on sustainability and the ac tiv ities of the Inv estm en t
Committee since the Committee Chair last reported to the Gavi Allianc e
Board 15 -17 December 2020.
? The total portf olio value is US$ 1.5 billion of which US$ 1,1 25 million is
invested in the long -term portf olio with an additional US$ 101 million
pending inv estm ent as of 31 M ay 2021 . The remaining US$ 236 million in
the short -term portf olio represents donor contributions which are invested
in very liquid, risk -f ree strategies such as money market f unds. This was
down f rom US$ 394 million at the end of December 2020. In Q 1 2021 the
Investments team transf erred US$150 million in cash to su pport Gavi
programmes which required the liquidation of US$ 110 million of long -ter m
portf olio proceeds and US$ 40 million f rom the termination of one manager
in the short -term portf olio.
? The Committee met twice in 1H 2021. In addition to the activities of
monitoring markets, risks and investment perf ormance, the Committee also
covered two topics whose prof ile has increased with the advent of the
COVID -19 pandemic: ESG and Sustainability and Diversity, Equity and
Inclusion.
? Estimated y ear -to-date p ortf olio perf ormance results have been compiled
as of 31 May 2021 . The long -term portf olio delivered year -to-date return s of
3.3 %. A component of the policy index is not yet available so a comparison
to the policy index cannot be of f ered as of this writing. However , as of 30
April the long -term portf olio return of +2.2% exceeded the policy index
return of +2.0%.
? In 2020 , equities and f ixed income enjoyed recoveries based on
accommodative monetary policy and large f iscal stimulus programs,
propelled f urther by expect ant and actual news on COVID -19 vaccine
successes. However, perf ormance diverged in 2021; equities remained
buoyant while the f ixed income f altered as f ears increased on the potential
f or interest rate hikes. Sovereign bond prices with long duration experi enced
the most damage (yields and prices have an inverse relationship). For
example, Bloomberg?s Long Treasury index, which measures long duration
US Treasury perf ormance, suf f ered a -13.5% drop in Q 1 2021 bef ore
enjoying a modest recovery in the months of April and May. The Fixed
SUBJECT : INVEST MENT COMMIT TEE CHAIR REPORT
Category: For Inf ormation
Report to the Board
23 -24 June 2021

1



Board - 202 1 - Mtg - 2 - IFFIm Chair Report

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?s financing model has proven well - suited to the current environment ,
which calls for flexibility and the means to provide surge financing.
? IFFIm is a valuable tool for Gavi to f inance both COVAX AMC activities and
Gavi?s core programmes .
? IFFIm executed a US$ 750 million bond in April 2021 that was well received
by the capital markets.
? Investor interest in IFFIm continues to grow, especially among those looking
to invest in social or sustainable sectors.
? The IFFIm Board is actively recruiting new members and expects to appoint
at least three new board members before the end of the year.
? The IFFIm Chair report is attached in the form of a presentation as Annex
A .
Annexes
Annex A : IFFIm Chair report SUBJECT : IFFIM CHAIR REPORT
Category: For Information Report to the Gavi Board
23 - 24 June 2021

1
Report to the Board
Board -2021 -Mtg -2-Doc 07 -Annex A
Annex A : Overview of capacity building interventions
Increasing the use of government systems as proposed will require significant
effort for both the Secretariat and the countries and close coordination with
other donors and partners . As an example, successfully shifting to the use of
government systems in Tanzania in Gavi 4.0 required significant effort on behalf of the
country and the Secretariat and took over two years. See Figu re 4 below. Gavi used
interventions such as developing IT systems and leveraging embedded technical
assistance (TA) to build capacity and develop a level of trust and cooperation from the
government and other partners, which required an investment of over US$ 500,000.


Figure 1
Capacity building and the use of innovative technologies will be a core
component of the new approach . The Alliance has already successfully supported
a number of countries with such interventions:
i. Implemen ting mobile money in Liberia. The country had a low absorption rate
of funds and a high amount of questioned expenditures , with an excessive
reliance on cash at sub -national level. In 2019, with TA support, the first pilot was
conducted with mobile payments to vaccinators for outreach and campaigns
facilitation and supervision support . The MoH has since scaled up the use of
mobile payments across the country .
ii. Using Financial Management Agents in Uga nda to build financial
management processes whilst managing risks. Uganda?s EPI programme
had a history of fiduciary problems and poor audits . Gavi engaged a local partner
as Financial Management Agent to provide assurance over fiduciary risk and to
build capacities . The partner supported the Expanded Programme on
Immunization ( EPI ) on financial systems training, IT configuration and improved
tools and guidance. This has allowed a ll funds, except for large procurements, to
remain within the government syste ms.

1
Report to the Board
Board -2021 -Mtg -2-Doc 07 -Annex B
Annex B: Proposed new strategic approach
1. Gavi?s new strategic approach
1.1 Responding to these challenges, the Secretariat has developed a new
strategic approach for Fiduciary Risk Assurance and Financial
Management of cash grants for Gavi 5.0. It is anchored in three objectives :
promoting timely and efficient funding of immunisation activities ; building
ownership and capacity; and ensuring fiduciary risk assurance and mitigation.
As previously discussed, these objectives are at times in conflict and the right
trade -offs have to be made for each country.

Figure 1
1.2 Gavi has developed a strategic decision -making framework and applied it
across its portf olio to guide the trade -offs between the three objectives
for each country. For each country, the framework has been used to
systematically assess whether the country conditions are favourable to using
government systems, the required level of effort as we ll as the strategic
importance of shifting to the use of government systems. Favourable country
conditions include political will and sufficiently strong public financial
management systems with adequate capacity. Based on this, the ambition for
using gove rnment systems and financial management capacity building in each
country for Gavi 5.0 has been defined. When defining its ambition, Gavi has
looked beyond the relatively narrow definition of using government accounts as
a proxy for using government system s and has identified seven components
that it will attempt to integrate as they become strong and mature (see Annex
A). As part of the approach, Gavi will also further focus on opportunities for
alignment and coordination with other donors on using governm ent systems
and jointly building capacity in countries.

1 1



Board -2021 -Mtg -2-Doc 07
Report to the Board
23 -24 June 2021

Section A: Summary
During Gavi 4.0, less than a third of cas h grants were cha nnelled through
government systems compared to over two -thirds during Gavi 3.0 , due to a greater
focus on fiduciary risk management and assurance. This led to challenges in
balancing fiduciary risk appetite with other priorities such as efficient funding of
immunisation activities and the strategic principle of building country capacity ,
sustainability , and ownership, which is at the heart of Gavi?s model. Hence, w hile
the Alliance has already made some progress in reversing this trend and
channelling an increased share of grants through government systems in recent
years , a more strategic approach towards the financial management of Gavi?s
grants is required for Gavi 5.0.
The Secretariat has developed a proposed systematic approach for the financial
management of cash grants for Gavi 5.0 , applying a strategic decision -making
framework across its portfolio. This will be essential to ensur e timely and efficient
funding of immunisation activities in line with the Gavi Board?s risk appetite . It
would result in 55% of funds being channelled through government systems
by 2025, almost double the current share, and 65% of countries at least
partially using government systems for channelling Gavi grants by the end
of Gavi 5.0 . In order to implement this approach, Gavi is requesting
US $ 164 m illion for 202 1-2025 of which US$ 25 million bridge funding has already
been approved by the Board for 2021 .
At its 19 -20 May 202 1 meeting the Programme and P olicy Committee ( PPC )
expressed its support for the proposed approach and recommended it for approval
by the Gavi Board , recognising the critical importan ce of effective fiduciary risk
mitigation and financial management capacity building in countries .
Section B: Content
1. Background and context
1.1 Financial management and fiduciary risk assurance are crucial in
achieving Gavi?s 5.0 mission to leave no one behind with
immunisation . Cash grants tota lled US $ 1.8 billio n during Gavi 4.0 and are
estimated at US $ 2.3 billio n for the Gavi 5.0 strategic period 1. They need to
be channelled in a timely, efficient, and equitable manner to catalyse the
desired programmatic impact while also building country capacity and

1 Does not include the C OVID -19 Delivery and System Strengthening Fund (CDSS ) (see Doc 06 )
SUBJECT : FIDUCIARY RISK ASSURANCE AND FINANCIAL
MANAGEMENT CAPACITY BUILDING
Agenda item: 07
Category: For Decision

Report to the Board
1
Board -2021 -Mtg -2-Doc 08 -Annex A
Annex A: Gavi Civil Society and Community Engagement Approach

1. Gavi Civil Society and Community Engagement Vision and Strategic
Framework for Gavi 5.0
1.1 Effective civil society and community engagement will contribute significantly to
reaching all four Gavi 5.0 goals in line with the strategy?s guiding principles,
particularly advancing gender equity , and being collaborative , differentiated,
innovative and prioritis ing missed communities .
1.2 Working closely with the CSO Steering Committee and through consultations with
other Alliance stakeholders, a strategic framework was developed for the CSCE
approach, constructed from a detailed Theory of Change (see Annex B) . Thr ee
Strategic Priorities are envisaged, as well as a crosscutting set of Strategic
Enablers in order to achieve them , as illustrated in Figure 1.
Figure 1 : Strategic Framework for Gavi?s Civil Society and Community Engagement


2. Operationalisation of Gavi CSCE Approach
In order to ensure the success of the CSCE approach, a number of operational
shifts are required to create the necessary enabling environment for more effective
CSO engagement . These are grouped into the three areas of managing effectively ,
enhancing capacity, and funding efficiently (See Figure 2) . Drawing on our
Theory of Change, this section describes the operational shifts already underway
within the Secretariat and outlines a proposal for a new Civil Society and
Community Engagement Strategic Ini tiative (CSCE SI) to enhance civil society
capacity for successful implementation of the approach.

Community
based, including
faith based
organisations,
particularly
working in the
most vulnerable
and marginalised
communities
National/regional
CSOs engaged in
service delivery,
demand, advocacy
and accountability
International
NGOs for technical
and capacity
building, direct
implementation
and advocacy
Regional civil
society network
platforms
to support
coordination,
capacity
enhancement,
cross-country
learning, solidarity
and political
influence
Local non-
governmental
research, academic
and knowledge
institutions
Local professional
associations
including
influential
networks of
pediatricians,
medics, nurses and
journalists
Global not-for-
profit advocacy
and accountability
organisations
Civil Society
perspectives and
voice reflected in
Gavi governance
processes and
decision making
CSO engagement
in national and
subnational
immunisation
planning processes
CSOs actively
engaged in building
political will for
immunisation
financing
and holding
governments
to account for
equitable service
delivery
Increased capacity
and funding to
conduct community
level activities for
demand generation
and tackling gender
related and other
social barriers
Increased capacity
and funding for
immunisation
service delivery and
identification of
missed communities
Outputs / Int. Outcomes Impact CSO areas of expertise Gavi inputs
Prioritise missed communities Gender focusedCountry led, sustainable
Collaborative, accountable
Differentiated Innovative
Integrated Guiding Principles from Gavi 5.0
Activities Outcomes
Strategic Priority 1
CSOs build social &
political will, advocate
for immunisation
commitments at
global, regional,
national and sub-
national levels, &
ensure visibility and
accountability
Strategic Priority 3
CSOs complement
public sector
immunisation service
delivery and extend
services to areas
where government
programmes have
limited access or are
not effectively utilised.
Strategic Priority 2
CSOs build trust,
confidence, and
active demand for
immunisation and
primary health care.
To save lives and protect people?s health by increasing equitable and sustainable use of vaccines
GOALIntroduce
and scale up
vaccines 1
GOAL Strengthen
health systems
to increase
equity in
immunisation
GOALImprove
sustainability of
immunisation
programmes
GOALEnsure healthy
markets for
vaccines and
related
products
2
3
4
Increased
political
and public
commitment to
immunisation
Routine
immunisation
systems are
maintained,
restored and
strengthened
during and
beyond the
C-19 pandemic
Increased and
sustained
demand for
immunization
and broader
primary health
care
Immunisation
services reach
zero dose
and under-
immunised
children
and missed
communities,
including in
fragile settings
and hard to
reach areas
High levels of
demand for
and uptake
of Covax-
supported
vaccines
Regional/multi-country
Global Level Advocacy for CSO engagement in
health & immunisation through
Gavi processes and global level
initiatives
Country Level
Provision of TA and capacity
building to strengthen CSO
advocacy & accountability role
Strengthened hosting
arrangement for CSO networking,
coordination and communication
across Gavi?s CSO Constituency
Harnessing regional platforms to
aid coordination and networking,
provide TA & facilitate cross
country learning
Building understanding of the
value of CSO engagement for
improved immunisation and
health outcomes
Supporting CSOs to build
capacity of government & local
partners in gender, demand,
community monitoring and social
accountability for equitable health
& immunisation services
Financial support & TA to
strengthen CSO capacity for,
& implementation of, service
delivery & demand generation
Catalytic funding for testing,
learning & scaling of innovative
CSO led approaches
TA & capacity building to CSOs for
engaging in Gavi specific country
planning processes
Strategic
Initiative for effective and
sustainable CSO engagement
Building
capacity
Funding
efficiently
Managing
effectively Ensuring
representation, voice & accountability
FUNDING DESIGN
PEFCatalytic
Funding
PEF
TCA
HSIS
EAF
NVS(VIG/OPS)
PSP
SECRETARIAT PROCESS LEVERS
HR
capacity
Monitoring
& Learning Application kit
Guidance
Differenti-
ated
approach
Doc 08 - Annex B

1



Board -2021 -Mtg -2-Doc 08


Section A: Executive Summary
Context
If countries are to make equitable and sustainable progress towards reaching
their immunisation and broader health commitments, civil society and communities
must be actively and meaningfully engaged in national immunisation efforts.
Given the equity -driven Gavi 5.0 Strategy , Immuni sation Agenda (IA) 2030 and
COVAX goals , a new approach is needed to provide a step change in the way that
Gavi engages and partners with civil society organisations (CSOs) . Beyond their
comparative advantage in reaching zero -dose children and missed
commun ities , CSOs have key roles to play in helping to ensure immunisation is
maintained, restored and strengthened in the context of COVID -19 , and that
COVID -19 vaccines are introduced in an equitable way .
Questions this paper addresses
? How can the Alliance bet ter harness the expertise and comparative
advantages of civil society and communities to deliver on Gavi 5.0 and
COVAX goals ?
? How can Gavi build on evidence and learning to overcome existing barriers and
operationalise and fund civil society and community engagement ?
? What are the key learning agenda questions needed to measure
effectiveness of the new approach , and to ensure ongoing monitoring ,
learning , transparency and m utual accountability during implementation ?

Conclusions
In May 2021 , the Programme and Policy Committee ( PPC ) recommended for Board
approval a new Alliance approach for Civil Society and Community
Engagement (CSCE) (see Annex A ). Co-created through a n 18 -month consultative
process in partnership with the CSO Constituency , the approach provides a clear
vision for Gavi?s engagement with CSOs and communities , and is designed to
include a wide spectrum of civil society actors operating at different levels in
different country contexts . It acknowledges the complexit y of successful civil
society engagement , the need for flexibility and country differentiation , and the
importance of setting realistic ambitions of what is feasible to be achieved with in
this strategic period , particularly if we are to achieve equity and sustainability .
The PPC pointed to the need to reflect the new CSCE approach in key areas of
Gavi ?s work including equity and zero -dose, COVAX delivery , partnership s and
SUBJECT : CIVIL SOCIETY AND COMMUNITY ENGAGEMENT
APPROACH
Agenda item: 08
Category: For Decision
Report to the Board
23 -24 June 2021

1



Board -2021 -Mtg -2-Doc 09
Report to the Board
23 -24 June 2021


Section A: Executive Summary
Gavi?s current strategic partnership with India provides US$ 500 million of vaccine
and cash grant support for the period 2017 to 2021. India is currently scheduled to
transition out of Alliance support at the end of 2021 despite remaining gaps and
the unp recedented health and economic impacts of COVID -19.
Based on consultations with the Government of India, Alliance Partners and the
Programme and Policy Committee ( PPC ), it is proposed to renew Gavi?s
strategic partnership with India for another five years with an investment of
~US$ 250 million in 2022 -2026 (of which ~US$ 200 million would be implemented
during Gavi 5.0) .
Section B: Content
Achievements of Gavi?s strategic partnership with India
1.1 India has significantly improved immunisation services and heal th
outcomes over the past two decades. Between 2000 and 2017, under -
five mortality from vaccine -preventable diseases (VPDs) decreased by
73%, against 61% for all causes. The number of under -immunised and
zero -dose children plummeted by 80% between 2000 and 2019 , while full
immunisation coverage (FIC) 1, a key objective of India?s Uni versal
Immunisation Programme (UIP) has increased from 42% to 87%.
1.2 These improvements have been driven by i ncreasing domestic health
expenditure and strong poli tical will and leadership on immunisation .
Massive immunisation campaigns under ? Mission Indradhanush? and
?Intensified Mission Indradhanush? have been launched to vaccinate
unreached children and pregnant women . Government health expenditure
increased by more than 50% from 2013 to 2018 and is set to increase
further. This has allowed Gavi to engage meaningfully and help
accelerate progress through catalytic vaccine and cash grants. From
2002 to 2020, India received US$ 954 million in Alliance support , amou nting
to less than a quarter of the average support per child across Gavi -68

1 The Indian government defines a fully immunised child is one who at 12 -23 months of age has
received one dose of BCG, 3 doses of Penta or DTP vaccine, 3 doses of oral polio vaccine (OPV)
and one dose of measles -containing vaccine (MoHFW: Roadmap for achie ving 90% full
immunisation coverage in India)
SUBJECT : STRATEGIC PARTNERSHIP S WITH INDIA
Agenda item: 09
Category: For Guidance