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Board -2021 -Mtg -2-Doc 03
Report to the Board
23 -24 June 202 1

Section A: Executive Summary
This report provides an update on progress in implementing the Gavi 4.0
strategy and associated risks 1. The final report on progress on the achievement
of Gavi 4.0 strateg ic goals will be presented at the next Board meeting, after the
WUENIC (WHO and UNICEF Estimates of National Immunization Coverage)
estimates become available. This paper focuses mostly on Gavi?s strategic
performance and risks in light of the pandemic , as well as on providing an update
on the operationalisation of the zero -dose agenda as part of Gavi 5.0 .
While C OVID -19 sharply impacted immunisation services , there were clear
signs of restoration in the second half of 2020. Vaccine introductions have
slowly started to resume . Notably, country performance on co -financing remains
strong despite the fiscal constraints caused by the pandemic.
However, the risk of new disruption during 2021 remains real . Countries are
focus ed on mitigating the impact of second and third waves of infection and the
spread of new var iants of SARS -CoV -2, while also shifting attention to the delivery
of C OVID -19 vaccines . The pandemic will also continue to affect the macro -
economic and fiscal stability of Gavi -supported countries.
Maintaining, restoring and building back more resilient, equitable and
integrated routine immuni sation systems has become the main focus of the
Alliance?s broader support to countries, besides laying the foundation to reach
more zero -dose children and missed communities during Gavi 5.0.
To reflect the increase of Gavi?s overall risk profile in the context of Gavi 5.0, the
COVID -19 pandemic and the COVAX Facility, the Board is requested to approve
the updated Risk Appetite Statement .
The Programme and Policy Committee (P PC ) also recommended an
adjustment to the structure of the Partners? Engagement Framework (PEF)
at global and regional level and asked the Secretariat to address a number of open
questions before requesting Board approval . Working closely with the
Partnerships? Tea m the Secretariat has started to engage in extensive
consultations with countries, partners and civil society organisations ( CSOs ) and
will revert to the PPC and Board in due course , as appropriate .

1 Associated risks refer to the top risks described in the 2020 Risk & Assurance Report (see
https://www.gavi.org/news/document -library/gavi -risk -and -assurance -report -2020 ). A mid -year
update on the top risks to the AFC is included in Appendix 6.
SUBJECT : STRATEGY, PROGRAMMES AND PARTNERSHIPS:
PROGRESS, RISK S & CHALLENGES
Agenda item: 03
Category: For Decision

Report to the Board
Board -2021 -Mtg -2-Doc 04a -Annex A
Annex A: Implications / Anticipated Impact
Impact on countries
Approval of the Financial Forecast enable s funding to be allotted to programmes
in accordance wit h the Programme Funding Policy.
Risk implication and mitigation, including information on the risks of inaction
Determination of Gavi?s financial capacity to approve the recommended
decisions relies on the Financial Forecast.
Risks that may impact the reliability of the financial forecast are described below,
as well as the mitigation strategies in place to address these ris ks. These risks
are currently elevated by the continued uncertainty from the impact of the
COVID -19 pandemic and COVAX deployment on existing vaccine
programmes and new introductions .
One of those risks arises from exposure to foreign currency ex change rate
fluctuations. In the forecast, non -US $ pledges are valued at their US $
equivalents using the Bloomberg spot exchange rates when compiling the
forecast (consistent with the approach agreed with donors ) or, where hedged,
at the hedge rate. Pledge s are hedged progressively .
Gavi?s Cash and Investments Reserve provides a cushion for adverse
fluctuations in resources and expenditures. Gavi can also decline or defer
funding requests based on resource availability.
Risks associated with the financial forecast and mitigation
Factors that may impact the expenditure forecast include:
Demand volumes can vary significantly based on small changes in country
introduction assumptions. While the introduction assumptions made in the
current forecast leverage the information readily available, there remains an
inherent high degree of uncertain ty on these assumptions. In addition, the
assumptions on introduction timing are often dependent on projections of when
a country will no longer be eligible for new Gavi support. This forecast represents
the application of the current Board approved Eligib ility and Transition Policy.
Changes or exceptions to this policy could vary demand significantly.
Price forecasts reflect expected market dynamics specific to each vaccine. The
forecast represents a moderate most likely scenario estimate among a range of
possible estimates and reflects information available at the time of preparation.
The forecast includes assumptions for supply availability as currently
anticipated.
Expenditure reductions may also be achieved through future vaccine price
reductions bey ond what has already been incorporated into the price forecast
and more efficient stock management at country level that cannot yet be
reflected in the forecast.

Report to the Board
Board -2021 -Mtg -2-Doc 04a -Annex B
Classified as Internal
Annex B: Terminology Used in the Financial Forecast
Terms used in this paper have the meanings described below, and are relevant to
Gavi?s Programme Funding Policy:
a) Assured Resources comprise:
? Cash and investments of Gavi, in the amount that exceeds the Cash and
Investments Reserve (see (g) below)
? Exp ected proceeds from IFFIm, based on existing donor pledges
? Expected AMC and any other contributions that are contingent on
programmatic expenditure included in the expenditure forecast
? Confirmed direct contributions to Gavi that are pledged under already -signed
agreements or otherwise confirmed in writing
? Projected investment income
b) Allowance for Further Direct Contributions (for the purpose of approving funding
decisions): An allowance for further expected direct contributions from existing
donors w ho have not confirmed their pledges for each year, based on current
overall contribution levels. The allowance is mandated by the Programme
Funding Policy and is important towards enabling programme funding decisions
to be made while pledges have yet to be completed for particular years. The
allowance assumes that in years where currently confirmed direct contributions
total less than the current level, further contributions will bring the total to that
level. The Allowance for Further Direct Contributions currently included within the
Financial Forecast is nil as it is reported as an opportunity.
c) Qualifying Resources : The sum of Assured Resources and the Allowance for
Further Direct Contributions (i.e. (a) plus (b) above).
d) Existing Programmes : Countr y programmes (for vaccine and cash -based
programmes and investment cases) that have already been approved for support
by Gavi, the Partners? Engagement Framework and the Secretariat budget.
e) New Requests : Projected demand from country applications that are currently
being recommended by the Independent Review Committee for approval.
f) Expected Future Requests: Projected demand from countries expected to
request Gavi support in the future for the current ly approved portfolio of vaccines
and cash -based programmes. It does not include any additional vaccines that
Gavi may consider for support in the future.
g) Cash and Investments Reserve : The reserve required by the Programme
Funding Policy to be maintain ed at a minimum equalling eight months of
expected annual expenditures.

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Board -2021 -Mtg -2-Doc 04a


Section A: Executive Summary
Context
At its December 2020 meeting, the Gavi Alliance Board reviewed and approved
the Financial Forecast s for the Strategic Periods 2016 -2020 (Gavi 4.0) and 2021 -
2025 (Gavi 5.0) which reflected ; (a) the impact o f COVID -19 including Gavi?s
immediate response to the pandemic ; (b) the outcome of the Global Vaccine
Summit ; and (c) the financial impact of the additional investment decisions made
by the Board after the successful replenishment.
As the Gavi 4.0 Strategic Period is now complete, this paper presents a summary
of the financial results for 2016 -2020 period , as well as the updated Financial
Forecast for Gavi 5.0 . The updated Financial Forecast reflect s the final results for
the previou s strategic period a s well as updated Available Resources and Forecast
Expenditures , including the impact of the additional investment priorities presented
for decision at this Board meeting .
The Financial Forecast presented excludes COVAX which is considered
separately under Agenda Item 4b. Specifically , the Programme and Policy
Committee ( PPC ) agreed to recommend to the Board it approve the design and
associated funding envelope of the COVID -19 Delivery and System Strengthening.
As there is no proposed change to the Gavi ?core? funding envelope of
US$ 150 million and any additional expense will be fund ed from COVAX AMC
delivery resources , the re is no financial impact of this decision on the Financial
Forecast presented in t his paper. Effective from the next forecast cycle, the
Secretariat will include COVAX in the Financial Forecast and a consolidated view
will be presented to the Board from Decembe r 2021.
Except to reflect the actual expenditures of Gavi 4.0 and the financial impact o f the
investment decisions being considered at this Board meeting, there are no material
changes to the Financial Forecast approved by the Board in December 2020. The
Audit and Finance Committee (AFC ) considered and recommended to the Board
for approval this updated Financial Forecast at its meeting on 7 June 2021 and
concluded , in line with the Program me Funding Policy, that sufficient resources
were available for the Board to approve the investment decisions being considered
at this meeting . After reflecting t he fina ncial impact of the se investment decisions ,
the amount available for future investments is US$ 224 million.
SUBJECT : FINANCIAL UPDATE , INCLUDING FORECAST
Agenda item: 04a
Category: For Decision
Report to the Board
23 -24 June 2021

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Board -2021 -Mtg -2-Doc 04b


Section A: Executive Summary
This report presents to the Gavi Alliance Board the COVAX Financial Forecast
(?Forecast?) for the Gavi COVAX Advance Market Commitment ( COVA X AMC )
economies for the period 2020 to 2022, including both procurement and delivery
of COVID -19 Va ccines. Focused only on the AMC, it does not provide a forecast
for Self -Financing Participants (SFPs ) resources and expenditure .

The Forecast is currently presented separately to the Board (Doc 04a). Effective
from the next forecast cycle, the Secretariat will include the COVAX Facility in the
regular forecast process and present a consolidated view.

The Board is requested to note the financial implications of the recommendations
from the Programme and Policy Committee ( PPC ) and conclude that these
recommendations could be approved by the Board in accordance with the
Programme Funding Policy. The Board is also requested to approve the
2021 -2022 COVAX AMC Financial Forecast.

Section B: COVAX AMC Financial Forecast

Context

1.1 The forecast presente d includes the results of the COVAX AMC Summit
?One World Protected? event which exceeded its US$ 2 billion fundraising
target in June 2021 , achieving US$ 2. 5 billion in new pledges. The funds
raised will enable COVAX to secure approximately 2 billion doses of
COVID -19 vaccines for lower -income countries participating in the COVAX
AMC . A further US$ 925 million of funding has been mobilised for in -country
delivery (US$ 775 million of donor funds and US$ 150 million approved by
the Board from Gavi Core resources ) that means that the total COVAX AMC
resource forecast is US$ 10. 6 billion.

1.2 In addition to cash resources pledged, donors have also committe d to
donate doses to the Facility primarily to the COVAX AMC , totalling more
than 500 million doses . W e have also started accepting and distributing
doses from France and New Zealand, with many more to come. Belgium,
Denmark, Germany, Italy, Spain, Sweden, other member countries of the
EU, Canada, Japan and Norway have announced plans to donate doses
throu gh COVAX. The United States of America committed 80 million in dose
SUBJECT : COVAX AMC FINANCIAL FORECAST
Agenda item: 04b
Category: For Decision
Report to the Board
23 -24 June 2021

1Goal framework
2022 goals development 1
1. Indi cati ve fram ework as other countri es have achi eved sam e goal s wi th di fferent com binations (e.g., Chi na); 2. M aps to SPRP 2021 "Suppress
transm i ssi on" strategi c goal ; 3. M aps to SPRP 2021 strategi c goal s of ?Protecti ng the vul nerable? and ?Reducing m ortality and M orbidity from all causes?Goals (global and countries) to be revisited as the pandemic unfolds and new epi data/information
becomes availableReduce COVID -
19 mortality and
protect health
workers 3Reduce COVID -
19 disease
burden and limit
health system
impactReduce viral
transmission 2
Low erHigherHe a lth goal aspiration level 2021 Goa l
3
Ne x t
1-2
ye a rs El i m i nation ?
Socio - e conomic goal a spiration levelLow er HigherResumed economic and social activityPHSM de creasing stringe ncyStringent PHSM
leading to lockdown Softer PHSM, some
limitations to socio -
economic activity and
travel TTIQ and travel
restrictions only TTIQ only, fully
resumed economic
and social activityIncreasing vaccination target with priority
group defined per SAGE Roadmap
Ultimately, countries have a
continuum of socio e conomic and
he alth goals they can pursue (non -
exhaustive). Each will require a
different level of vaccination ambition,
different by country archetype
T he increasing level of vaccination
(low, medium, ...) is allocate d am ong
diffe rent risk groups according to
the SAGE roadm ap
T he framework must be considered
within the broade r Strategic
Pre paredness Re sponse Plan
Primarily a conservative ? direct
protection? strategy; indirect protection
as ? buffer? against VOCs, lifting
PHSM, supply delays, hesitancyLow Medium
High Very highSource: W HO; W ork - in - progress as of June 8, 2021
Doc 06 - Annex A

1
Report to the Board
Board -2021 -Mtg -2-Doc 01f -Annex C
Annex C: Gavi 5.0 Strategy Indicators Dashboard
 

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Board -2021 -Mtg -2-Doc 01f REVISED AS AT 22 JUNE 2021
Report to the Board
23-24 June 2021

Section A: Introduction
Seven recommendations are being presented to the Board under the Consent
Agenda for consideration. Detailed information on the item s can be found in the
relevant Committee paper in a dedicated folder on BoardEffect at :
https://gavi.boardeffect.co.uk/workrooms/6459/resources/127300
Section B: Actions requested of the Board
The Gavi Alliance Board is requested to consider the following recommendation s
from the Gavi Alliance Governance Committee , Audit and Finance Committee and
Programme and Policy Committee.
Decision One ? Board and Committee Member Appointments
The Gavi Alliance Governance Committee recommend s to the Gavi Alliance
Board that it:
a) Appoint Awa Marie Coll Seck as an Unaffiliated Bo ard member in the seat
currently held by Stephen Zinser effective 1 July 2021 and until 30 June 2024
b) ?Appoint Naguib Kheraj as an Unaffiliated Board member in the seat currently
held by William Roedy effective 1 August 2021 and until 31 July 2024
c) Appoint Bounfeng Phoummalaysith of Lao PDR as Alternate Board Member
representing the implementing country constituency in the seat formerly held
by Bounkong Syhavong of Lao PDR, effective immediately and until 31
December 2023
d) Appoint the following to the Governa nce Committee effective 1 August 2021:
? An Vermeersch (Alternate Board Member) until 31 December 2021
e) ?Appoint the following to the Audit and Finance Committee effective
1 August 2021:
? Naguib Kheraj (Board Member) until 31 December 2021

SUBJECT: CONSENT AGENDA ? REVISED AS AT 22 JUNE 2021
Agenda item: 01 f
Category: For Decision

Report to the Board

Board -2021 -Mtg -2-Doc 01f -Annex D
0

Gavi Alliance
Market Shaping Strategy 2021 -20 25

Structure

Executive summary ????????????????????????? ? ? ? 1
1. Context influencing the Market Shaping Strategy 5.0 ?????????? ? ? 3
2. Market Shaping model for 5.0 ???????????? ??????????. 5
3. Strategic priorities 2021 -2025
3.1. Foster a sustainably competitive future supplier base ???????? ?. . 11
3.2. Support healthy demand ????????????????????... .... 14
3.3. Establish an enabling environment for transformational i nnovation ??... .... 19
4. Monitoring and evaluation framework and next steps to operationalise ???? 24
Annexes ???????????????????????????????? ? 26

Annex A: Detailed theor y of change by strategic priority ??????????... ..... 26
Annex B: Strategic enablers
1. Implement an optimised market shaping p artnership plan ????????? . 29
2. Support regulatory efficiencies that contribute to enabling vaccine access ?? . 34
3. Implement updated strategic tools & processes ????????????? .. 36
? Healthy Markets Framework and strategy development process
? Demand Health toolkit, including demand shaping intervention guidelines
? Product Portfolio Management
? Financial tools
Annex C: Demand health case studies ??????????????????? ? 50
Annex D: Detailed M&E framework ?.???????????????????? 54
Annex E: Preliminary resourcing analysis ???????????????????.. 59
Annex F: List of authors and contributors ???????????????????? 60
Annex G: Acronyms and abbreviations ??????????????????? ? 62

Classified as Internal #
Gavi Alliance Board Workplan
Gavi Board Paper Type Sept Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec Mar/Apr June Nov/Dec
A. Strategy/Performance/Risk/MEL
CEO's Report CEO's Report Discussion
2021-2025 Strategy 2021-2025 Strategy, Partnerships and Programmes Discussion
Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion Discussion
2021-2025 Strategy Gavi 5.0 Decision
Measurement Framework (Targets & Indicators) Measurement Framework Decision Decision
Funding Policies* Gavi 5.0: Operationalisation Decision Decision
Innovation (including private sector partnerships) Gavi Innovation Strategy Decision Decision
Middle Income Countries (MICs) TBD Decision Decision
Civil Society and Community Engagement Approach Civil Society and Community Engagement Approach Decision Decision
Partners' Engagement Framework TBD Decision
Disease Surveillance and Diagnostics in Gavi 5.0 TBD Decision Decision
Risk and Asurance Report Risk and Assurance Report Decision Decision Decision Decision Decision Decision
2026-2030 Strategy TBD Decision
Measurement Framework (Targets & Indicators) TBD Decision Guidance Decision
B. Vaccines & Sustainablity
Typhoid TBD Information Information
Pneumococcal AMC (Advance Market Commitment) TBD Information
Inactivated Polio Vaccine (IPV) co-financing approach TBD TBD
TBD
Malaria TBD Decision Decision
Update on vaccines for epidemic preparedness and response TBD Discussion Discussion
Vaccine Investment Strategy TBD Decision Decision Decision Decision
COVAX COVAX Decision
Discussion Decision Decision Decision
C. Policy
Fragility, Emergencies, Refugees Policy TBD Decision Decision
Transparency and Accountability Policy Decision Decision
D. Country Programmes
Nigeria TBD Information Information Information Information Information Information
PNG TBD Information Information
Strategic Partnership with India Strategic Partnerships with India Decision Decision
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
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
Audit & Investigations Report Audit & Investigations Report Information Information Information Information Information Information
F. Governance
Board Chair Appointment Board Chair Appointment Decision
Board Vice Chair Appointment Consent Agenda Decision Decision Decision Decision
Committee Chair Appointments Consent Agenda Decision 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
Amendments to Governance Documents (Statutes, By-Laws, Committee Charters) Consent Agenda Decision
IRC Terms of Reference TBD Decision
Audit & Investigations Terms of Reference TBD Decision
G. Reporting
Committee 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 TBD Discussion
HR Report Closed Session Information Information Information Information Information Information
Annual Report on Implementation of the Gender Policy TBD 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. Pre-Board Technical Briefing Sessions Discussion Discussion
Malaria vaccine programme investment case
TBC
*Includes Eligiblity & Transition Policy, Co-Financing Policy, HSIS Support Framework, CCEOP Last updated - 9 June 2021
Next Board Meetings
:
28 September 2021, Virtual
1-2 December 2021, Geneva 2022 2023 2024 2025
Board-2021-Mtg-2-Doc 01g

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Board -2021 -Mtg -2-Doc 02 FR

Rapport au Conseil
d?administration
23-24 juin 202 1


Le 16 juin 202 1

Chers memb re s du Conseil d?administration,

Cela fait maintenant 16 mois que nous vivons en pleine pand?mie , avec ce que
cela comporte d?incertitudes et de risque s omni pr?sent s dans le monde entier .
Dans la plupart des pays, les syst?mes de sant? sont confront?s ? la double t?che
du maintien ou de la remise en route des programmes de vaccination
syst?matique, et de la riposte ? la COVID -19. Dans le m?me temps, certains pays
? revenu ?lev? commencent ? c?l?brer le retour ? la normale, gr?ce ? des taux de
vaccination ?lev?s. Comme l'a vait fait r emarquer le pr?sident Jos? Manuel Barroso
lors du lancement de l?offre d'investissement pour la garantie de march? (AMC)
COVAX de Gavi , ? dans un monde globalis?, toutes les ?conomies sont
interd?pendantes. Nous ne pouvons pas nous dire les uns aux autres : " Le bateau
est en train de couler de votre c?t? ?. ? L'?conomie mondiale ne pourra reprendre
que lorsque tout le monde sera prot?g? et pourra retourner travailler , et la menace
de nouve aux variants demeure ra tant que les populations ne s er ont pas toutes
prot?g?es.

Quand nous reviendrons sur ce qui s?est pass?, il y a d?j? beaucoup de choses
que nous, la communaut? mondiale, pourrons largement applaudir ? mais il y aura
?galement beaucoup de choses pour lesquelles nous aurons ? redire, que nous
au rions d? faire diff?remment. Le rythme de la recherche et du d?veloppement des
vaccins a ?t? remarquable. Seize vaccins contre la COVID -19 sont d?j?
mondialement utilis?s ; sur la m?me p?riode, nous avons pu envoyer sept fois plus
de doses de vaccins , ? qu atre fois plus de pays ? faible revenu , et deux fois et
demie plus rapidement que pour la pand?mie de grippe d?origine porcine. La
collaboration entre les diff?rents partenaires a atteint un niveau sans pr?c?dent :
nous, l?Alliance , nous nous sommes mobilis?s rapidement pour offrir aux pays la
souplesse de financement dont ils avaient besoin et nous avons r?ussi , avec eux,
? maintenir ou ? r?tablir la vaccination syst?matique en d?pit des mesures de
confinement et de la surcharge des syst?mes de sant?. Malgr? une concurrence
accrue pour les mati?res premi?res et l es capacit? s de production des fabricants ,
nous n'avons pas connu de p?nurie dans notre approvisionnement en vaccins de
routine , parce que l 'Alliance avait d?velopp? une base de fournisseurs solide au
cours des 21 derni?res ann?es.

Rapport du D irecteur ex?cutif

Bo ard -2021-Mtg -2-Do c 00a




G avi Alliance Board Meeting
23-24 June 202 1 - Virtual Meeting

Wednesday 23 June : 13.30 -18.30 Geneva Time
Thursday 24 June : 13.30 -18. 30 Geneva Time
Quorum: 14

Document list

No. Document
00a Document list
00b Agenda
01a Declarations of interest
01b Minutes f rom 29 -30 September 2020
01c Minutes f rom 15 -17 December 2020
01d Minutes f rom 22 March 2021
01 e No Objection Consent Decisions
01f Consent Agenda
01g Workplan
02 CEO?s Report ? To follow
03 Strategy, Programmes and Partnerships: Prog ress, Risks and Challenges
04a Financial Upda te, including f orecast
04b COVAX AMC f inancial f orecast ? To follow
05 Committee Chair and IFFIm Board reports ? To follow
06 COVAX Update
07 Fiduciary Risk As surance and Financial Management Capacity Build ing
08 Civil Society and Community Engagement Approach
09 Strategic Partnerships with India
10 Review of decisions ? No paper
11 Closing remarks ? No paper
No. Ad ditional Doc uments f or Informa tion (on Boa rdEffect )
A Board and Committee minutes (For i nformation only)
B CEPI 2020 Annual Progress Report
C Audit and Investigations Report