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Report of the
GAVI Alliance Board
12 -13 June 2012

Board -2012 -Mtg -2-Doc 15
Subject : Programme update : Accelerated Vaccine Introduction
Report of: Seth Berkley, Chief Executive Officer
Authored by: Jon Pearman, Senior Technical Advisor, Vaccines
Agenda item : 15
Category: For Information
Strategic goal : SG1 - Vaccines & SG4 - Market shaping
Section A: Overview
1 Purpose of the report
1.1 The purpose of this report is to provide a summary on the progress of new
vaccine rollout supported by the Accelerated Vaccine Introduction (AVI)
initiative and progress toward building a platform for future introductions.
2 Recommendations
2.1 For information only.
3 Executive Summary
3.1 Pneumococcal and rotavirus vaccines :
(a) In 2012, the GAVI Alliance marked the first simultaneous introduction of
both pneumococcal and rotavirus vaccines in Ghana in April. Nine
additional countries are expected to launch pneumococcal vaccines
(bringing the total to 10) and another seven are planned to introduce
rotavirus vaccines (bring ing the total to 8) this year. As reported to the
Board in Dhaka, however, unprecedented levels of demand for the two
vaccines that exceeds available supply will lead to delays in a number of
countries, at this point in time anticipated to affect mainly 2013.
(b) The supply situation remains dynamic. For example, since AVI?s recent
update to the Programme and Policy Committee (PPC) in April, one
manufacturer has confirmed the availability of additional quantities of
pneumococcal vaccines (PCV). Furthermore, the WHO has approved the
expanded use of the novel two dose PCV presentation with special
requirements. Both of these developments could ease supply constraints
for pneumococcal vaccines in 2012 and 2013 (see Annex 1 for details).

Jon Pearman

Programme update:
Accelerated Vaccine Introduction (AVI)


GAVI Alliance Board Meeting
Washington DC, USA, 12 -13 June 2012
GAVI Alliance Board Meeting
Washington DC, 13 -14 June 2012
AVI update
Rotavirus & Pneumococcal vaccines - status of roll
out & supply

1
AVI TAC

Aur?lia Nguyen
Vaccine introduction grants and
operational support for campaigns
GAVI Alliance Board meeting
Washington, DC, USA, 12 -13 June 2012
GAVI Alliance Board meeting
12 -13 June 2012
Background: Vaccine introduction grants
1
? Until March 2012, GAVI had disbursed ~ 150 vaccine
introduction grants (US$ 28.6m total).

2001 2007 2011 ?12
US$ 100,000 lump
sum for all countries
Revised policy : US$ 100,000 or
US$ 0.30/child in birth cohort
Policy under review to better
serve newer vaccines
e.g. Kiribati Bangladesh
$ $
$
$

?
Newer vaccines: pneumococcal,
rotavirus, HPV , rubella
campaigns
e.g. Kiribati Bangladesh

Nina Schwalbe
Continued funding for special
studies
GAVI Alliance Board meeting
Washington, DC, USA, 12 -13 June 2012
GAVI Alliance Board meeting
12 -13 June 2012
Special studies background
? Funding for special studies provided under the ADIPs:
? Pneumo (US$ 30m) focused on evidence
generation and disease advocacy
? Rota (US$ 50m) included significant phase IV
investment for data to support SAGE
recommendation
? Hib Initiative (US$ 30m) designed to promote Hib
disease burden awareness and conduct studies
including phase IV, impact, etc
? AVI TAC Special Studies ? (US$ 11m) for additional
studies required for pneumococcal and rotavirus
vaccine roll -out

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Report to the
GAVI Alliance Board

Board -2012 -Mtg -2-Doc 14
12 -13 June 2012
Subject : Continued f unding for special s tudies
Report of: Nina Schwalbe, Managing Director, Policy & Performance
Authored by: Ciara Goldstein , Analyst, Policy and Performance and
Peter Hansen, Director, Monitoring & Evaluation
Agenda item : 14
Category: For Decision
Strategic goal : SG1 - Vaccines & SG2 - Health systems

Section A: Overview

1. Purpose of the repor t

1.1 This paper outlines a request for urgent funding for continui ng research studies
submitted by the Accelerated Vaccine Introduction Initiative Technical
Assistance Consortium (AVI -TAC).

2. Recommendations

2.1 The PPC reviewed four urgent special studies proposals from AVI -TAC and
recommended that the GAVI Alliance Board:

? Approve an amount of up to US$ 9.3 million for AVI -TAC to continue two
urgent pneumococcal studies and conduct two urgent rotavirus stud ies
over a three year period, through 2015 .

2.2 In connection with these four urgent studies, the PPC noted that consideration
should be given to the impact of the recent SAGE recommendation to loosen
the age restrictions for the delivery of rotavirus vaccines. To enable an
assessment of this impact , in parallel with the four urgent studies , and
following the PPC, the Secretariat recommends that the Board:

Approve , subject to the Secretariat receiving satisfactory peer review
reports, an amount of US$ 1.8 million for AVI -TAC to conduct a study to
monit or the impact of the SAGE recommendation on widening age
restrictions related to rotavirus vaccine delivery.

3. Executive summary

3.1 The AVI -TAC Special Studies sub -team has identified urgent priority needs
and submitted four study proposals to GAVI in February 2012. Because of the
imperative to address these mission critical questions in a timely manner,

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Report to the
GAVI Alliance Board

Board -2012 -Mtg -2-Doc B
12 -13 June 2012
Subject : Programme update: country programmes
Report of: Paul Kelly, Director, Country Support , and
Bakhuti Shengelia, Director, Technical Coordination
Authored by: Paul Kelly and Bakhuti Shengelia
Agenda item : B
Category: For Information
Strategic goal : SG1, SG2, SG3


Section A: Overview

1. Purpose of the repor t

1.1 To update on implementation of GAVI country programmes since reporting to
the Board in November 2011.

2. Recommendations

2.1 This report is for information.

3. Executive summary

3.1 Good progress is being made in India and Nigeria. Pentavalent vaccine has
now been introduced in two states in December 2011 in India and in January
2012 GAVI received a request to scale -up to an additional six states. Nigeria?s
National Vaccine Summit in April has focused high level atte ntion on the
phase -in of pentavalent and pneumococcal vaccines. This will be supported
by reprogramming of GAVI HSS and ISS funds (up to $ 60m in total ) and
targeting of potential new funding (to the tune of US$ 40 million) until the
country graduates .

3.2 Alliance partners are working closely with DRC, Ethiopia and Pakistan to
support them to manage significant implementation challenges related t o
introducing and sustaining new vaccine s. DRC paid its 2010 co -financing
arrears in May 2012 and intends to pay the 2011 amount by June 201 2.

3.3 In February 2012, WHO, UNICEF and the Secretariat reviewed progress on
development of Alliance action plans to support countries achieve and
maintain DTP3 coverage above 70%. WHO will prioritise work in Chad , DRC
and Uganda and finalise plans in Q3 of 2012 .

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Report to the
GAVI Alliance Board

Board -2012 -Mtg -2-Doc 02
12 -13 June 2012
Report of the Chief Executive Officer


5 June 2012
Dear Board Members,
Our Board meeting next week in Washington DC will occur around the
UNICEF/USAID Child Survival Call to Action . As you may recall, this special event
started out as an immunisation meeting around the one year anniversary of the GAVI
pledging conference, but now is much broader. We will of course attempt to use the
opportunity to highlight the important role of i mmunisation in preventing child illness
and deaths and have joined with the UN Foundation to hold a side event to celebrate
the anniversary of the pledging conference and all of the work that has gone on since
then.
Immediately after our productive Board retreat in Oslo, Dagfinn joined the
celebrations in Haiti of World Immunisation Week, and I visited Ghana for the
simultaneous launch of pneumococcal and rotavirus vaccines. Dagfinn was struck by
the intensification of a vaccination campaign against meas les, rubella and polio by
Haiti?s Ministry of Health as they also prepare for the roll out of pentavalent vaccine
later this year. For me, the excitement of people in Ghana was palpable; there?s
strong national commitment to achieve high and equitable cov erage. It was also
great to see so many members of the Alliance represented, all playing their part in
supporting Ghana in taking a giant step for its children. We will be carefully
evaluating the simultaneous introduction to see what we can learn, inclu ding whether
simultaneous introductions should be more widely encouraged.
This month, we also saw the adoption of the Global Vaccine Action Plan of the
Decade of Vaccines by the World Health Assembly. Discussion emphasised the
centrality of immunisation in publ ic health and health systems, and t he importance of
using existing mechanisms was highlighted by several member states, as was their
support for GAVI. The resolution called for progress to be assessed annually by the
WHO regional committees and th e WHA, which provides a useful opportunity to keep
vaccines as a top priority on the global health agenda.
Achieving our mission
The GAVI Progress Report for 2011 sets out what we achieved together in the first
year of the strategy period including a fu ller data picture than ever before. It shows
that we are generally on track to meet our ambitious goals ? although we will have to
work hard to overcome some of the vaccine cap acity issues discussed below.
Regardless, I think the report is a clear messag e of our shared obligation to deliver on
our existing commitments under the 2011 -2015 strategy ? our first priority. The
report has been sent to you and an animated electronic version will soon be available
on the website.

Report to the
GAVI Alliance Board


Board-2011-Mtg -3-Doc 03a
16 -17 November 2011
Subject: Accelerated Vaccine Introduction ? progress report
Report of: Nina Schwalbe, MD, Policy and Performance
Authored by: Jon Pearman, Director AVI, Policy and Performance,
Johanna Fihman, with input from AVI management team
Agenda item: 03a
Category: For Guidance/Discussion
Strategic goal: SG1 - Vaccines & SG4 - Market shaping


Section A: Overview
1. Purpose of the r eport

1.1 The purpose of this report is to provide a summary on the progress of the
Accelerated Vaccine Introduction (AVI) initiative and review ongoing
challenges to building a successful platform for future new vaccine introduction
going forward.

2. Recommendations

2.1 For information only.

3. Executive Summary

3.1 With regard to pneumococcal vaccines, five countries have introduced s ince
the AVI Board update in July, making a total of 16 countries forecasted to have
introduced by year end. T he demand for pneumo vaccines has increased with
the approval of an addit ional 18 countries by the Executive Committee in
September . In spite of new supply agreements signed under the AMC, vaccine
supply has become even tighter in 2012 and 2013.

3.2 With regard to rotavirus vaccines, in July Sudan became the first country
outside Latin America to launch. The demand for rota vaccines has increased
with approval of an additional 14 countries by the Executive Committee in
September and there are forecast to be 30 countries introduc ing in 2012 - 13
time -frame . Award notification has been issued for longer term contracts for
rota. There is sufficient supply over the long -term to meet demand, with the
exception of 2013 where there will be supply constraints.

3.3 The GAVI Secretariat , with support from the AVI partners , worked on the
development of implementation plans for new vaccines ( agenda item 5 ).

Report to the
GAVI Alliance Board

Board -2011 -Mtg -3-Doc 12 1
16 -17 November 2011
Subject: Vaccine supply and procurement strategy for the
period 2011 -2015
Report of: Nina Schwalbe, MD, Policy and Performance
Authored by: Aurelia Nguyen and Eliane Furrer, Policy and Performance
Agenda item: 12
Category: For Decision
Strategic goal: SG4 - Shape vaccine markets


Section A: Overview

1. Purpose of the report

1.1 The pu rpose of this paper is to seek approval by the GAVI Alliance Board of
GAVI?s new Vaccine Supply and Procurement Strategy. The strategy focuses
on the period defined by GAVI?s five -year strategic plan (2011 -2015), although
the recommendations do consider and impact the period beyond.

1.2 The strategy does not address vaccine -related supplies (e.g. autodisable
syringes, safety boxes), the selection of GAVI?s procurement partners 1 or
downstream (in -country) supply -chain and efficiency. 2

2. Recommendations

2.1 The Programme and Policy Committee (PPC) recommends that the GAVI
Alliance Board approve the proposed revised Vaccine Supply and
Procurement Strategy for the period 2011 -2015 as presented in detail in
Annex 2.

3. Executive summary

3.1 GAVI?s Vaccine Supply and Procurement Strategy aims to support the
achievement of GAVI?s mission to save children?s lives and protect people?s
health by ensuring adequate and secure supply of quality vaccines to meet
demand, minimising the costs of vaccine s to GAVI and countries and fostering
development of appropriate and innovative vaccines . This requires timely,
transparent and accurate market information.

1 GAVI has a series of Memoranda of Understanding (MOUs) with the procurement partners, which run
through to the end of 2012 for some vaccines and beyond for pneumococcal vaccines.
2 In-country supply chain and delivery issues are addressed through other areas of the work of the GAVI
Secretariat and of the GAVI Alliance.

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Report to the
GAVI Alliance Board

Board -2011 -Mtg -3-Doc 02
16 -17 November 2011
Report of the Chief Executive Officer


9 November 2011
Dear Board Members,

It is a great pleasure to provide you with this report, which combined with my board
presentation, provide my perspective on the first GAVI Board meeting I will attend as
CEO, as well as my first 100 days on the job.
I am grateful to the Government of Ba ngladesh for hosting this Board meeting.
Around the meeting we will have the opportunity to see some of the Government?s
achievements in improving the health of the people of Bangladesh. I would
particularly like to highlight and thank Faruque Ahmed as a former Board member
and Director of the Health Program me of the Bangladesh Rural Advancement
Committee (BRAC) which represents one of the best examples of the power of civil
socie ty in development in Bangladesh and around the world.
It is five months sinc e GAVI?s last Board meeting, and three months since I became
CEO. Some of the papers that have been provided for the Board and the decisions
that the Board will be invited to take are the result of processes that began many
months before I became CEO, an d so the perspective I offer here and at the Board
meeting is in some respects still one of an outsider. Of course, I am fully engaged
and so this is really the last time I will be able to say this?
GAVI has a strong business model, with a relatively smal l secretariat, and a large
well -functioning Alliance, drawing on the strengths of each of the partners. Our
model allows us to pool vaccine demand from countries and funding from donors, to
create a significant market for vaccines appropriate for people l iving in the poorest
countries.
This model has achieved some powerful results. Since GAVI?s inception in 2000,
WHO now estimates that the Alliance has helped countries prevent more than 5.5
million future deaths by immunizing 326 million additional chil dren against hepatitis B,
Haemophilus influenza type b (Hib), measles, pertussis, pneumococcal disease,
polio, rotavirus diarrhoea and yellow fever.
I am particularly grateful to WHO fo r providing these figures. W e are also working
with our partners to strengthen the methodology behind them and the way we report
results. An additional important challenge will be to capture our collective impact on
morbidity. For many vaccines, Meningococcal A , Polio, and Rubella being good
examples, the largest effects will be in reducing morbidity. We all know we are
making a big difference in this area but we do not have an agreed way of measuring
it.