Bo ard -2020 -Mt g-5-Doc 0 1a




Gavi Alliance Board Meeting
29 -30 September 2020
Virtual Meeting
Quorum: 1 4
Declarations of Interest

Declarations
Section 5.5 of the Conflicts of Interest Policy for Governance Bodies states ?Members
involved in decisio n-makin g processes on b ehalf of Gavi must take appropriate action to
ensure disclosure of Interests and Conflicts of Inter est, and take the necessary action in
respect thereof.?
Section 6.2 of the Conflicts of Interest Policy for Governance Bodies further states , ?T he duty
to d isclo se [in 6.1 above] is a continuing obligation. This means that Members are obliged to
disclose any Interests and/or Conflict of Interest, whenever the Member comes to know the
relevant matter.?
The following declarations were made b y me mbers of the Boar d on their most recent annual
statements:
Board members:
Member Org anisational Interest s

Financial/Personal/Advisor Int /
Others
Ngozi Okonjo -Iweala , Chair None
Board Member, Twitter; Boar d
Member, Standard Chartered
Bank; Board Chair, African Risk
Capac ity ; Co -Chair, The Global
Commission on the Economy and
Climate; Co -Chair, Lumos; Fellow,
Harvard; Non -resident Fellow,
Brookings; Board Member,
Carnegie Endowment for
International Peace; 1 of the 4
Envoys, AU Special Envoy for
COVID -19; Board Member , The B-
Te am; Board Member, Asia
Infrastructure Investment Bank;
Board Member, International
Advisory Board ? Japan
International Cooperation Agency
(JICA); Board Chair, African
University of Sci ence and
Technology; Member, IMF
External Advisory Group; Mem ber,
Eco no mic Advisory Council for
South African President Cyril
Ramaphosa ; WHO Special Envoy,
Access to COVID -19 Tools (ACT)
Accelerator ;
Gavi -appointed special adviser

Report to Board
Board -2020 -Mtg -5-Doc 02 Annex A
Annex A: Zero -dose & equity approach to immunisation: best practices
Pakistan: Precise identification of zero -dose children supported by data integration
and triangulation
? Pakistan has the 4 th highest number of zero -dose children (0.8m) in Gavi
supported countries after Nigeria, India and Indonesia 1. Identifying where the
highest number of these missed children are located and knowing why they
have been missed is a key step in reaching these c hildren through Primary
Health Care (PHC) services. Sub -national data analyses including triangulation
of data to support identification of areas with higher immunity gap and/or with
immunisation services gap. In some specific context like in pivotal count ries or
during preparation of Full Portfolio Planning, identification steps could be more
granular. Triangulation of population data from polio line listing has started
to bear fruit. Most of the electronic immunization registries (EIR) are not suited
to i dentify zero -dose children as only children who have been at least once in
contact with immunisation services are registered. To address this issue,
Pakistan used Alliance support during polio campaigns in 2019 to identify
children who have never being vac cinated in routine immunisation, to line -list
them and integrate them into Zindagi Mehfooz (ZM), the EIR solution used in
Sindh province. This was designed to solve two problems: (1) identifying zero -
dose children missed by routine immunisation; and (2) un derstanding which
children are missed by polio campaign efforts. For the first use case, analyses
showed not only pockets of zero -dose children but also the underlying reasons
for non -vaccination (e.g. ZM captures data relating to vaccinator compliance
wh ich is critical to identifying supply -related issues in the Pakistan context).
? To demonstrate the second use case, in 2019, the line list of children lost to
follow -up for polio was compared to the registry of surviving infants captured by
ZM. As this ana lysis is quite complex and requires advanced data integration
skills (which are costly), a proof of concept focused on a single Union Council
was generated. Results showed that 11% of children lost to the polio
programme, had in fact been reached through r outine immunization activities.
While these approaches require significant investment, they demonstrate how
innovation can help identify children who are otherwise missed by traditional
data systems.
South Sudan: partnership with International Organisation for Migration (IOM) and
Health Pool Fund (HPF) to accelerate vaccination coverage and reach missed
communities
? Gavi entered a partnership with IOM South Sudan in October 2019, with an
aim to support RI through, (1) 20 high priority health facilities in a nd around
Protection of Civilian (POC) sites and (2) provision of immunisation services at
a few specific nutrition treatment centres where mothers regularly access
supplementary nutrition or therapeutic food. A pilot conducted in 5 counties of
former Unit y state (Rubkhona, Mayom, Leer, Mayendit & Panyijar) between
2016 and 2018 showed that almost 50% of children vaccinated with Penta3
received their vaccination from Outpatient Therapeutic Programme (OTP)
1 WUENIC (2020)

1



Board -2020 -Mtg -5-Doc 02


Section A: Executive Summary
Context
The COVID -19 pandemic ha s triggered an unprecedented crisis , calling for an
equally exceptional response . At the Global Vaccine Summit in June 2020, in a
remarkable show of solidarity, global leaders came together to support the Alliance
and its mission for 2021 -20 25. The successful replenishment provides Gavi with
an opportunity to bolster support for its ambitious equity agenda, mitigate the
impact of the COVID -19 pandemic on immunisation, sustain hard won gains and
scale up smart investments in improv ing the quality, efficiency, effectiveness and
sustainability of immunisation delivery systems. Given the profound, multi -
faceted impacts of COVID -19 and in light of the successful replenishment , it
is opportune for the Alliance to tak e stock and re -examin e the objectives for
Gavi 5.0.
Questions this paper addresses
? What key shifts in Gavi 5.0 priorit ies does the Alliance envisage in the
context of COVID -19 and the successful replenishment?
? What are the implications for Gavi?s programmatic focus ?
? What are the resource implications ?
Conclusions
While leaving no one behind with immunisation and Gavi?s strategic goals
and objectives for 2021 -20 25 are more relevant than ever , the following
recalibrated priorities will require urgent action :
1. Maintaining, restoring and strengthening immunisation services:
Given the COVID -19 pandemic has caused widespread disruption of
immunisation services in Gavi supported countries, a key priority of the
Alliance will now be to support countries in adapt ing services to operate
safely in the context of the pandemic , restor ing previous levels of
immunisation coverage and catch ing up on children missed due to the
breakdown of services . In doing so, there is an opportunity to ?build back
better ? with efficient, integrat ed and sustainable approaches.
2. Reaching zero -dose children and missed communities : Gavi ?s
ambitious equity agenda has become even more urgent as COVID -19
SUBJECT : RECALIBRATING GAVI 5.0 IN LIGHT OF COVID -19 AND
SUCCESSFUL REPLENISHMENT
Agenda item: 02
Category: For Decision
Report to the Board
29 -30 September 20 20

Board -2020 -Mt g-5-Doc 00 a




G avi Alliance Board Meeting
29-30 September 2020
Virtual Meeting

Tu esday 29 September : 13.45 -18. 00 Geneva Time
Wedne sday 30 September : 13.45 -17.00 Geneva Time
Quor um: 14

Document list

No. Document
00a Document list
00b Agenda
01a Declarations of interest
02 Recalibrating Gavi 5.0 in the light of COVID -19 and successful replenishment
03 COVAX Facility operationalisation and vaccine programme
04 Review of decisions ? No paper
05 Closing remarks ? No paper

Board -2020 -Mtg -3-Doc 00b








G avi Alliance Board Meeting
29-30 September 2 020
Virtual Meeting



Tuesday 29 September : 13.45 -18.00 Geneva Time
Wednesday 30 September : 13.45 -17.00 Geneva Time
Quorum: 14



Agenda








Next Board Meeting s: 16-17 December 2020, Virt ual
17 -18 Marc h 202 1, TBD (Board Retreat)
23 -24 June 202 1, Geneva
1-2 December 202 1, Geneva

---
Brenda Killen , Director, Governance and Secretary t o the Board, + 41 22 9 09 6 680, bkillen @gavi.org
Jo anne Goetz , Hea d, Govern ance, + 41 22 909 6544, jgoetz@gavi.org

Please note that the Board meeting will be recorded. This recording will be use d as an aid to minute the meeting .
A transcr iptio n of the full proceedings will not norma lly be ma de. Shou ld a transcription be made it wil l be us ed
only as an aid to minute the meeting .



Boar d-2020 -Mtg-5-Doc 00b 2

Board Meeting - DAY ONE ? Tuesday , 29 September 2020

Item Sub ject Action Schedule

Board mem bers dial into virtual meeting 13.45 -14.00
Closed s ession fo r Board members and Alternate Board
members only
14.00 -14.30
1 Chair?s report
? Declarations of interest
Ngozi Okonjo -Iweala, Board Chair
14.30 -14.45
2 Reca librating Gavi 5. 0 in the light of COVID -19 and
successful replenishment
Anuradha Gupta, Deputy C EO
DECISION 14.45 -18.00



Board Meeting ? DAY TWO ? Wednesda y, 30 September 20 20

Item Subject Action Schedule
Board mem bers dial into virtual meeti ng 13.4 5-14.00
3 COVAX Facility operationalisation and vaccine programme
Seth Berkley, Chief Exe cutive Officer
Includes covering the following:
? Funding arrangements
? Financia l operating model and financial risk exposure
? Governance
? AMC
? COVID -19 vaccine delivery in AMC countries
DECISION 14.00 -16.45
4 Review o f decis io ns
Brenda Killen , Director, Govern ance
16.45 -16.55
5 Closing remarks
Ngozi Okonjo -Iwea la, Board C hai r
16.55 -17.00

Phase 1 of the evaluation focused on the demand side barriers of immunisation coverage in Kampala City.