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Board -2018 -Mtg -1-Doc 02l


Section A: Introduction
? In line with the SAGE recommendation on p neumococcal conjugate vaccine
(PCV) catch -up vaccination, the Gavi Alliance Programme and Policy
Committee (PPC) recommends that the Gavi Alliance Board approve Gavi
support for countries that may choose to vaccinate children between 1 -5
years of age in the year of introduction of PCV . The additional funding for
this decision is expected to be up to approximately US$ 18.7 million during
the 2018 -2020 perio d. At its meeting on 26 April 2018, the Audit and Finance
Committee (AFC) confirmed, that under the Programe Funding P olicy, the
Board could approve the recommendations the PPC would be consider ing
at its meeting on 2 -3 May 2018 .
Section B: Background
1.1 Gavi currently supports Pneumococcal conjugate vaccine (PCV) routine
vaccination for the base cohort (up to 1 year of age) with a 3 dose schedule.
Countries pay vaccine co -financing as per Gavi?s Co-Financing Policy and
receive v accines, supplies, and a Vaccine Introduction Grant (VIG) up to
US$ 0.80 per live birth (depending on the transition phase) in the year of
introduction. 1
1.2 In October 2017, SAGE reviewed recommendations 2 on PCV catch -up
vaccination and recommended vaccinati on as part of PCV introduction in
children aged 1 to 5 years old, stating that a single dose can be used to
vaccinate this age group .3,4

1 Since 2009, Gavi has invested more than US$ 3.4 billion in support of pneumococcal disease
prevention by routine vaccination. 2 Executive summary of SAGE October 2017, Pneumococcal Conjugate Vaccine
Session: http://www.who.int/immunization/sage/meetings/20 17/october/1_Hosangadi_PCV_Execu
tiveSummary_SAGE_PCV_WG_Oct2017.pdf 3 For the group aged 12 -24m, either a single or two doses are equally recommended. After
consultation with SAGE and PCV experts, Gavi proposes to support single dose only, for simplicity
of implementation. 4 SAGE also recommended the use of catch -up vaccination to reduce the disease burden in
areas/communities where low vaccination coverage has permitted sustained vaccine serotype
pneumococcal transmission (or disease), especially those wit h coverage below 50%. The
Secretariat is further considering the programmatic, financial and feasibility aspects of this
recommendation while simultaneously engaging in o ngoing efforts to improve routine coverage for
PCV and other vaccines through efforts with partners and countries.
SUBJECT : CONSENT AGENDA: EXPANSION OF PCV SUPPORT TO
INCLUDE CATCH -UP DURING NEW INTRODUCTIONS
Agenda item: 02l
Category: For Decision
Report to the Board
6-7 June 201 8

Board -201 8-Mtg -1-Doc 00b







G avi Alliance Board Meeting
6-7 June 2018
Crowne Plaza Hotel, Geneva, Switzerland



Monday 4 and Tuesday 5 June : Pre -Board meetings
Wednesday 6 June : 0 9.00 -18.15 (Board meeting Day One)
Thursday 7 June : 0 9.00 -17.00 (Board meeting Day Two)
Quorum: 14



Agenda








Next Board Meeting s: 28 -29 November 2018, Geneva, Switzerland
3-4 April 2019, TBD (Board Retreat)
26 -27 June 2019, TBD
4-5 December 2019, TBD

---
Philip Armstrong , Director, Governance and Secretary to the Board, +41 22 909 6504, parmstrong@gavi.org
Joanne Goetz , Head, Governance, +41 22 909 6544, jgoetz@gavi.org
Please note that the Board meeting will be recorded. This recording will be used as an aid to minute the meeting
and prep are news releases. A transcription of the full proceedings will not be made.



Board -201 8-Mtg -1-Doc 00b 2
Pre -Board Meetings ? DAY ONE ? Monday, 4 June 201 8

Schedule Meeting Room

07.45 -13.00 ? IFFIm Board meeting Paris
13.00 -15.30 ? IFFIm Donors? meeting Copenhagen
14.00 -17.00 ? Audit and Finance Committee meeting Paris
16.00 -18.00 ? AMC Stakeholders? meeting Munich
17. 30 -20.00 ? Governance Committee meeting Copenhagen

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Board -2017 -Mtg -3-Doc 05
Report to the Board
29 -30 November 2017

Section A: Summary
? This report asks the Gavi Alliance Board (?Board?) to approve the update d
financial forecast of resources and expenditure for 2016 -2020 , and provides
an indicative expenditure forecast for 2021 -2025.
? The forecast includes the financial implications of previous funding
de cisions , highlights the financial implications of the decisions that have
been recommended to the Gavi Board for approval at this meeting and
indicates potential future investments yet to be considered .
? Compared to the previous forecast approved by the Board in December
2016, the estimated amount available for future investments, through 2020,
has increased by US$ 1 98 million (excluding the decisions to be considered
by the Board in November 2017 ). This is due to the estimated expenditure
for 2016 -2020 d ecreasing by US$ 452 million which is offset by a reduction
in the estimated qualifying resources of US$ 254 million (due to the
postponement of IFFIm proceeds).
? The reduction in the expenditure estimate for 2016 -2020 is largely due to
market shaping that has reduced vaccine prices (by US$ 0.6 billion), while
better management of vaccine stocks has reduced the volume of vaccines
required by countries . These savings have allowed the Board to approve
new programmes ? such as a new measles strategy, investmen ts in
CCEOP, enhanced support for yellow fever, and a new HPV strategy. The
scale -up of these new programmes has been less predictable than for the
more mature programmes (penta, rota and pneumococcal), with some
delays in implementation.
? The forecast indicates that sufficient resources are available such that all
the decisions recommended for approval can be made in accordance with
the Gavi Programme Funding Policy.
? The report provides an update on the evolution of the estimates of resources
and expenditure in 2017 and reports back on utilisation of the Board -
approved programme funding envelopes . It also includes an overview of
cash balances of Gavi -support held in countries , for information.
SUBJECT: FINANCIAL UPDATE , INCLUDING FORECAST
Agenda item: 05
Category: For Decision

1 Board -2017 -Mtg -3-Doc 04b
Report to the Gavi Board
27 -28 November 2017

Report of the Chief Executive Officer

22 November 2017

Dear Board members,
It is indeed an honour to have been reappointed by the Board as CEO of the
Alliance. I am excited by what our innovative model has achieved to date and
humbled by the challenges we still face to ensure that every child receives all the
vaccines they need. I am also delighted that we will continue to benefit from Dr.
Ngozi ?s leadership as we tackle these challenges, following her reappointment as
Chair by the Board.
My highest priority is to deliver on reaching every child ? both by continuing to roll
out new vaccines to deal with intra -country equity and improving coverage and
equity (C&E) ? and on ensuring the success of ou r sustainability model. Success
is critical both for the Alliance and the broader community. By extending routine
immunisation to reach the underserved, we are building a foundation for
universal health coverage (UHC) as I discuss further below. And by pio neering a
systematic approach to transitioning countries out of development assistance,
Gavi ?s sustainability model is a pathfinder for the broader community.
We continue to see strong progress on sustainability with countries co -financing
a record amount in 2017 and 17 countries due to have transitioned by the end of
the year. We will meet in Lao PDR which is an example of the success of the
model. Since 2000, it has raised coverage with three doses of DTP -containing
vaccine (referred to as DTP3 in the re st of the report) from 51% to 82% and has
introduced pentavalent, pneumococcal, inactivated polio, rubella and Japanese
Encephalitis vaccines, a second dose of measles and conducted a human
papillomavirus (HPV) demonstration project. This has averted over 25,000
deaths (from a population of less than seven million) and significantly contributed
to Lao PDR nearly halving child mortality since 2000. The country is on course to
transition successfully at the end of 2021 and has an ambitious agenda for the
futu re including introducing rotavirus and HPV vaccines nationwide in 2019,
increasing domestic investment in health and immunisation and improving health
service delivery. Nonetheless, it continues to face coverage and equity
challenges exacerbated by its geo graphy, language barriers and transport
infrastructure which limit access to health services for non -Lao ethnic groups, as
well as programme management capacity and human resources capacity. The
country has experienced outbreaks of vaccine -derived poliovir us, diphtheria,
pertussis and measles in recent years and the response, including ten polio

The official formal notification of the remaining AMC Offer Amount.

Summary information regarding pneumococcal conjugate vaccine (PCV) products based on a review of technical and programmatic evidence, that may help countries make PCV product choices.

Gavi has supported routine introductions with pneumococcal vaccine since 2009. Find out more about the pneumococcal vaccine market, and Gavi’s approach to shaping it, in the public summary of the vaccine roadmap.

Appendix 3 : Update on resources and expenditures in 2016 and 2017
1 Resources
1.1 The Total cash inflows in 2016 are predicted to be 1 02 % of the amount projected
in December 2015, the increase being due mainly to additional direct
contributions. In January through September , 7 7% of the projection for all of 2016
was realised, compared to 75 % over the similar period in 2015.
Resource projections for 2016 and 2017

2 Expenditure
2.1 Disbur sements for programme s in 2016 are predicted to be 86 % of the amount
projected in December 2015, to reflect the results of programme approvals and
endorsements in 20 16 and updated assumptions on disbursement timing. In
January through September , 52% of th e projection for all of 2016 was realised,
compared to 61 % over the similar period in 2015. A breakdown of disbursements
by Programme is included in Annex 2, Figure 2 of document AFC -2016 -Mtg -4-
Doc 02 .









Resources
US$ millions
Dec-2015
Boa rd
Proj ecti on
Actual:
YTD Sept-16
% of
Proj ecti on
for yea r
Dec-2016
Boa rd
Proj ecti on
Dec-2015
Boa rd
Proj ecti on
Dec-2016
Board
Projection
Direct contributions - confirmed 1,471 1,117 76% 1,460 1,427 1,442
Direct contributions for IPV 97 93 96% 93 79 77
IFFIm Proceeds 100 0 0% 100 300 150
AMC Proceeds 100 107 107% 131 47 89
Investment Income 36 56 156% 50 36 25
Other * 0 15 0
Total Inflows 1,804 1,388 77% 1,834 1,889 1,783
For Res ources , the Proj ected a mount i s per the l a tes t foreca s t pres ented to the Boa rd before the s ta rt of the yea r
* 'Other' compri s es unrea l i s ed FX ga i ns /(l os s es ) a nd ti mi ng a dj us tments
2017 2016