1 Board-2023-Mtg-02-IFFIm Chair Report
Report to the Gavi Board
26-27 June 2023
Subject IFFIm Chair Report
Category For Information
Overview
?This report provides the Board with an overview of the activities of IFFIm?s
support to date for Gavi?s 2021- 2025 strategic period and expected future
capacity .
? IFFIm remains central to donors? participation in Gavi programmes. We are
pleased that Canada has finalised its pledge to IFFIm becoming IFFIm? s 11
th
s

overeign donor.
? As part of continued efforts to maximise IFFIm's strategic value for Gavi, the
Gavi Secretariat , The World Bank (as IFFIm?s Treasury Manager), donors and
the IFFIm Board are coordinating to establish a Contingent Financing
M echanism to support Gavi?s Pandemic Preparedness and Response (PPR)
work .
? IFFIm has reviewed administrative aspects of its operations including a
transition of its listing to the Euro MTF exchange and a transition in external
legal counsel. Additionally, IFFIm plans to recruit a board member in the coming
months.
? The IFFIm Chair report is attached in the form of a presentation as Annex A,
which will be presented and discussed during the forthcoming Gavi Board
meeting.
Annex es
Annex A: IFFIm Chair Report

1


Board -2023 -Mtg -02-Programme and Policy Committee Chair Report

Report to the Board
26 -27 June 2023

Subject Programme and Policy Committee Chair Report
Category For Information
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 2022 .
? On 16 -17 May 2023 , the PPC held an in -person meeting . 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 26 -
27 June 2023 meeting for consideration.
? The PPC Chair report is attached in the for m 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 : 16 -17 May 2023 recommendations to Gavi Alliance Board

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Board -2023 -Mtg -02-Doc 09
Report to the Board
26 -27 June 202 3

Subject Vaccine Investment Strategy 2024: longlist and evaluation
frameworks
Agenda item 09
Category For Decision
Section A : Executive Summary
Context
The Vaccine Investment Strategy (VIS) is Gavi?s prioriti sation process to evaluate
vaccines and immunisation products for inclusion into the portfolio. Every 5 years,
through this rigorous, consultative and transparent process, the Secretariat review s
evidence and carries out impact modelling to identify and assess new and /or under -
used vaccines of high public health relevance for Gavi -eligible countries . The VIS
facilitates strategic decision -making and provides predictability to countries,
manufacturers, and donors for their own planning and future decision -making. It is a
fundamental tool in fulfil ling Gavi?s aim of shorten ing the time between life -saving
vaccines being available in high -income countries to them being rolled out in lower
income countries.
Th is paper seek s Board approval on the first step in the VIS 2024 process: vaccine
candidate longlist and evaluation frameworks to assess them against . Th ere will be
two more governance decision points related to the VIS : a) Board Dec ember 2023
will consider a shortlist of vaccines ; and b) Board Jun e 2024 1 will make f inal decision s
on investment cases into new r outine / preventive vaccination programme s, s tockpiles,
or l earning agendas for implementation in Gavi 6.0, subject to a successful
replenishment cycle.
The VIS draws on the expertise of Alliance partners and other stakeholders to reflect
multidisciplinary perspectives . An independent VIS Steering Committee 2 has been
convened to provide technical and scientific guidance to the Secretariat in advance of
governance decis ion points , and country input was sought during this first phase
through a non -representative survey that received 111 responses from 36 Gavi
countries .3
As part of the VIS 2024 , the Secretariat proposes to evaluate the potential of providing
support to develop, strengthen and deliver vaccines at new touchpoints for specific
target populations (i.e. health workers and pregnant people), building upon lessons
learned related to the relaunch of HPV, introduction of malaria and delivery of
COVID - 19 vaccines, which required additional support to ensure sustainability and
1 VIS 2024 is in close alignment with the development of the Gavi 6.0 strategy to ensure that the outcomes of VIS
2024 respond to and inform the strategic priorities defined in Gavi 6.0, which will also be reviewed by the Board in
June 2024. 2 Steering Comm ittee members and summaries from meetings (Dec 2022, Apr 2023) in Appendix 1. 3 The survey took place in March 2023 and targeted government officials (Ministry of Health, EPI managers, and
other ministries) and in -country Gavi Alliance partners. Result su mmary in Appendix 2.

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Board -2023 -Mtg -02 -Doc 10

Report to the Board
26 -27 June 202 3

Subject Committee Chair a nd IFFIm Board reports
Agenda item 10
To follow

1


Board -2023 -Mtg -02 -Doc 11

Report to the Board
26 -27 June 202 3

Subject Review of decisions
Agenda item 11
No paper

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Board -2023 -Mtg -02 -Doc 12

Report to the Board
26 -27 June 202 3

Subject Closing remarks
Agenda item 12
No paper

1


Board-2023-Mtg- 02-Audit and Finance Committee Chair Report

Report to the Board
26-27 June 202 3

Subject Audit & Finance Committee Chair Report
Category For information

Section A : Introduction
? This report provides the Board with an overview of the activities of the Audit
and Finance Committee (AFC) since the Committee Chair last reported to the
Board in December 202 2.

? Since the last Board meeting, the AFC met three times (14 February, 11 May
and 8 June ) to consider Gavi recurring matters in accordance with the standard
workplan for Gavi 5.0 and the Office of the COVAX Facility .

? In addition, the Committee Chair held several technical sessions in relation to
financial ri sk management with IFFIm and the Secretariat Treasury team .

? The C hief Operating Officer briefed the Committee at each meeting on progress
with the work on Operational Excellence.

? Subjects reviewed are noted under Section B and matters to be reviewed in
upcoming meetings are presented under Section C.

? AFC recommendations to the Board are attached as Annex A.

Section B : Subject s reviewed
1. Financial Update
Management reporting ? The AFC was presented with the Balanced Scorecard, December 2022 and Q1
2023 Mana gement reporting. The AFC acknowledged the excellent work
performed by the Secretariat to bring transparency on data in response to
stakeholder expectations.
2022 Annual Financial Report (AFR)
? The AFC reviewed the draft AFR and the report of the external auditor (Deloitte)
for the year ended 31 December 2022 at its meetings in May and June.

? The accounts for the 2022 Fiscal Year continue to reflect the complexities
associated with COVAX activities as well as the impact of a significant increase
in interest rates . As a result, the c ommittee chair held several sessions with the
S ecretariat and the external auditors to ensure financials reflect the appropriate

 

Board -2023 -Mtg -02-Doc 07 -Annex A 1
Report to the Board
26 -27 June 202 3
Annex A: COVAX Reporting Fram ework
Section A: Update on Gavi?s COVAX Facility and COVAX AMC Monitoring, Evaluation
and Learning (MEL) strategy

The table below provides some of the key highlights and updates on progress against the core
elements of Gavi?s COVAX Facility and COVAX AMC MEL Strategy since the December 2022
Gavi Board.

MEL strategy
component
Key activity Highlights / update (May 2023)
Cross -cutting COVAX Theory
of Change
COVAX Facility and AMC theory of change for
2023 drafted, mapping against the objectives and
goals as presented to the Gavi Board in December
2022.
Monitoring COVAX
Reporting
Framework
Reporting against COVAX Reporting Framework
made available for PPC and Board. The 2023
Reporting Framework is further streamlined and
accompanied by short qualitative updates for some
key 2023 objectives (see below).
Complementary
monitoring to
COVAX
Reporting
Framework
COVAX Facility, Gavi Secretariat teams and core
COVAX partners continue to monitor aspects of the
Facility and AMC to a much greater extent beyond
the metrics currently captured in the topline
Reporting Framework. Examples includ e:
? COVID19 Vaccination Insights Reports
generated by WHO covering a range of
disaggregated analyses on uptake, supply
received and external delivery financing;
? Monitoring of progress across subgrants
funded through COVID19 Delivery Support;
? Other operational metrics and analyses across
supply, allocation, deliveries and in -country
implementation gathered internally.
Core country
monitoring and
reporting on
COVID -19 /
COVAX
COVAX continues to utilize data reported via the
WHO -UNICEF electr onic Joint Reporting Form
COVID -19 module and WHO regional COVID -19
vaccination dashboards to gather core reporting
from COVAX participants. Gavi recently co -
convened a Global Meeting with WHO, UNICEF
and CoVDP to set forth a pathway for revisions to
the c ore minimum dataset and reporting on COVID -
19 vaccination going forward.
Recipients of COVID19 Delivery Support funds are
expected to report back on a six -monthly basis to
Gavi.
Evaluation Multi -stage
independent
Itad ( www.itad.com ) was selected as the
independent evaluator for the first stages

 

gavi.orgG a v i ' s R o l e i n a F u t u r e C O V I D - 1 9 V a c c i n e P r o g r a m m e
Annex B ? COVID - 19
Vaccine Investment
Assessment
Gavi Alliance Board
26 - 27 June 2023 Doc 07 - Annex B
Disease context and uncertainties
Latest vaccine policy and strategy
Health and economic impact assessment
Demand assessment
Delivery strategy
Financial implications
Risks and potential mitigation
Detailed C19 Vaccine Investment Assessment
Appendix
2 Available vaccinesTable of contents Doc 07 - Annex B

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Board -2023 -Mtg -02-Doc 07
Report to the Board
26 -27 June 202 3

Subject COVAX update and Gavi?s Role in a future COVID -19 Vaccine
programme
Agenda item 07
Category For Decision

Section A : Executive Summary
Context
2023 is a critical year for the COVAX Facility. With the lifting of the Public Health
Emergency of International Concern (PHEIC) designation for COVID -19 on
5 May 2023 and recognition that the pandemic is now at a different phase, we continue
to operate in the World Health Organization -designated ?base -case? scenario for
COVID - 19 1, and we anticipate the approach to COVID -19 vaccination will continue to
evolve. Guidance from the WHO Strategic Advisory Group of Experts on Immunization
(SAGE) was u pdated in March 2023 2 recommending a more streamlined approach for
continued COVID -19 vaccination in 2023 focusing on the high priority user group.
In June 2022, the Gavi Board approved Gavi's continued hosting of the COVAX
Facility through the end of 2023. For the remainder of 2023, Gavi will continue to
integrate relevant COVAX processes into Secretariat and Alliance partner core
processes to enable a smooth transition to the proposed 2024 -2025 COVID -19
vaccine programme, pending Board approval. This paper provides an outlook for
COVAX in 2023 and seeks Board approval for a future Gavi -supported COVID -19
programme in 2024 -2025.
Questions this paper addresses

? What progress has COVAX made supporting Advance Market Commitment (AMC)
participants reach their COVID -19 vaccination goals, and what are the objectives
of a Gavi -supported COVID -19 programme in 2024 -2025?
? What is the state of supply and demand, and what is the supply strategy for
transitioning from COVAX to a future COV ID -19 vaccine programme?
? How is COVAX adjusting in preparation for the shift from an emergency response
to a potential future COVID -19 vaccine programme that utilises existing Alliance
processes?
? What are the financial implications of a 2024 -2025 COVID -19 vaccine programme
for Gavi?

1 Strategic preparedness, readiness and response plan to end the global COVID -19 emergency in 2022, WHO 2 https:/ /www.wh o.int/publications/i/item/WHO -2019 -nCoV -Vaccines -SAGE -Roadmap

Board -2023 -Mtg -02-Doc 08 -Annex A 1
Report to t he Board
26 -27 June 202 3
Annex A: Gavi?s Day Zero Pandemic Financing Facility for Vaccines
Overview
As the global community advances discussions to define an ecosystem to enhance
equitable access to medical countermeasures (MCM) during health emergencies, the
issue of financing remains unresolved. It is also important to note that not all financing
has t he same requirements. It is particularly complicated in the context of vaccines,
which require heavy up -front, at -risk investments at the onset of a crisis.
The Secretariat is exploring options to solve this problem by leveraging Gavi?s
existing suite of innovative financing tools to create a Day Zero Pandemic
Financing Facility for Vaccines. This could potentially see US$ 2 billion rapidly
mobilised as additional surge and contingent financing at the onset of a global
pandemic . Building on Gavi?s 20 years of experience in innovative financing, our core
proposition is to leverage the systems already built to support COVAX AMC, to avoid
the need for ne w complex structures or bodies to provide this surge funding capacity.
Pre -agreed considerations, such as a WHO declaration of a Public Health Emergency
of International Concern as well as geographic scope of concern and Gavi Board
processes, are examples of what would be considered in an expedited process to
realise liquid resources. While the total cost of a global vaccine response would likely
require much more than US $ 2 billion, based on the COVAX experience a figure of
approximately US $ 2 billion is a n initial needs estimate for early deals and preparation
for equitable delivery. This funding could enable Gavi to enter into advance purchase
agreements on a competitive timeline while we define a more complete picture of
expected funding needs spanning v accine procurement and delivery - buying time to
mobilize resources for a comprehensive response.
The Day Zero facility would comprise multiple financing windows and contingent
arrangements that offer donors different ways to contribute ? and could limit th e impact
of commitments on national balance sheets until they are activated.
Our proposed approach includes:
? Contingent financing ? funding that is only unlocked once certain predefined events
occu r. An example of a tool being developed to provide rapid access to contingent
donor financing in this way is the IFFIm Contingent Financing Mechanism.
? Surge funding includes two types of tools:
o Standby funds that can be deployed immediately ( e.g. a future iteration of a
Pandemic Vaccine Pool).
o Frontloading tools that accelerate the availability of funds once new pledges or
grants are made. Funding through frontloading tools would typically take longer
to become available than contingent financing but be faster than a traditional
new grant agreement. Examples of these types of tools are the European
Investment Bank frontloading facility and the US Development Finance

Board -2023 -Mtg -02-Doc 08 -Annex B 1
Report to the B oard
26 -27 June 202 3
Annex B: Design considerations for an Advance Market Commitment to support
sustainable vaccine manufacturing capacity
The Secretariat is currently exploring different options for the following AMC design
considerations:
1. AMC objectives
2. Value chain focus
3. Incentive structure
4. Antigen specificity
5. Procurement pathway and manufacturer eligibility
6. Financing, governance and operationalisation
Given the number of interested stakeholders and range of mode l options , the
Secretariat is facilitating a transparent and evidence -based treatment of these design
options to facilitate constructive open debate. These analys es reflect substantial
learning from the PCV AMC and explore the implications of multiple design choices
on operationalisation and impact. Further analysis and expert validation are being
conducted over Q3/4 2023 before any recommendations are made.
1. AMC objectives
To strengthen regional manufacturing of vaccines the Gavi Board approved three
underpinning objectives in December 2022 . The AMC mechanism is expected to
adhere to these as ?boundary conditions?:
Gavi board -
approved
objectives
Description
Support healthy
global markets
Minimize market distortions and help to sustain low global
prices and resilient supply for priority vaccines
Drive efficient
market outcomes
Provide a signal to guide and align new manufacturers and
investors behind resilient, sustainable business propositions
Reduce barriers to
investment
Carefully structuring the level of incentive to help offset
initial costs of market entry whilst aligning support with other
providers of capital for greater overall impact
These have been t ranslated into two clear overarching AMC objectives , that both
meet Gavi?s objectives and match the requirements of external stakeholders voiced
during the Secretariat?s consultations ( in order of priority below ). Drafting theories
of change for these AMC objectives has already begun. These will form the
foundation of a holistic monitoring, evaluation and learning strategy to accompany
the AMC as well as the broader four -pillar regional manufacturing strategy. Gavi is
also embracing learnings generated from other AMCs as part of this design
process .