Board -2024 -Mtg -02-Doc 06a -Annex D 1
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6-7 June 202 4
Annex D: Overview of potential indicators for decoupling cash from vaccine support

Board -2024 -Mtg -02-Doc 06a -Annex E 1
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6-7 June 202 4
Annex E: Preliminary lessons learnt from the implementation of the MICs Approach

Board -2024 -Mtg -02-Doc 05 -Annex E 1
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6-7 June 202 4
Annex E: Shortened versio n of the one -pager framework and comparison with Gavi 5.1

To provide flexibility while keeping essential information easily accessible, below is a shortened one -pager framework
(preliminary version) for certain communication purposes. Following the June Board meeting decision, the Gavi website would
be updated and feature a drop -down section that expands into the full version for each item described in the one -pager.
1


Board -2024 -Mtg -02-Doc 05 -Annex E 2
Report to the Board
6-7 June 202 4
In addition, below is a track -changes version of the one -pager, show ing the main changes from the 5.1 version to 6.0 (in blue):
Gavi 6.0 strategy one -pager (2026 –2030)
3
Leaving no one behind with immunisation
Enablers
Mission 2030
Blue: main evolution in Gavi 6.0 vs 5.1
Mission 2030 Tosavelivesandprotect people’s healthby increasing equitable and sustainable use of vaccines Mission indicators
•Reduction inzero-dosechildren •Children immunised •Economic benefits unlocked tbctbctbc tbctbctbctbc
•Under-five child mortality reduction •Future deaths averted(including disaggregated for climate -sensitive diseases) •Future DALYs averted •Country -led, sustainable: Bolster country leadership to sustainably finance and deliver immunisation•Community -owned, inclusive: Engage communities and civil society organisations in planning, implementation and oversight of immunisation •Zero-dose and missed communities, first priority: Prioritise children missing out on vaccination, including among migrants, displaced and other vulnerable populations •Gender -focused: Identify and address gender-related barriers to promote immunisation equity •Differentiated , fragility -responsive :Target andtailorsupport toregional , national andsubnational needs,including fragile, conflict and humanitarian contexts
•Integrated: Strengthen integration of immunisation and primary healthcaretoreach missed communities insupport of Universal Health Coverage •Adaptive, resilient: Helpcountries leverage immunisation toaddress the challenges of global health security,antimicrobial resistance andothermajor global issues •Climate -sensitive : Support countries to adapt to the consequences of climate change and mitigate the carbon footprint of the Alliance •Innovative: Identify and scale up innovative products, practices and services to support Gavi’s goals •Collaborative, accountable : Accelerate purposeful partnerships with regional and global health institutions to collectively and efficiently respond to countries’ needs
Principles
IMPROVE PROGRAMMATIC AND FINANCIAL SUSTAINABILITY OF IMMUNISATION PROGRAMMES ENSURE HEALTHY MARKETS FOR VACCINES ANDRELATED PRODUCTS INTRODUCE ANDSCALE UP VACCINES Goals 1 3 4 STRENGTHEN HEALTH SYSTEMS TO INCREASE EQUITY INIMMUNISATION 2 Goals
Objectives
Strengthen countries’ prioritisation and optimisation of vaccine programmes, appropriate to their contextSupport countries to introduce and scale up vaccines for prevention of endemic, epidemic and pandemic diseases including beyond infancy Ensure equitable and timely access to mechanisms to respond to outbreaks, epidemics, and pandemics
Strengthen regional , national and subnational political and social commitment to immunisation, including through increased domestic public resourcesEnsure sustainable transition through stronger capacity of eligible countries to maintain immunisation performanceEngage self -financing countries to maintain performance and catalyse critical vaccine introductions
Drive healthy vaccine markets for Gavi - supported and self -financing countries, including acceleration of access to new high - impact, affordable vaccines and delivery innovationsEnhance regional vaccine supply security, in support of regional manufacturing expansion ambitionsDevelop sustainable markets for vaccinesagainst outbreak, epidemic, and pandemic - prone diseases
Enable countries to extend immunisation to zero-dose children and missed communities, integrated withprimary health care , including through addressing gender -related barriers and building resilient demandEnsure all children are fully immunised by maintaining and strengthening routine immunisation with vaccines required through second year of life Support countries to adapt systems to routinely deliver vaccines to populations outside early childhood through targeted and catalytic interventions
Objectives
•Secure long-termpredictable funding forGavi programmes •Deliver as one Alliance with strengthened accountability mechanisms •Ensure global political commitment for immunisation and global health security •Ensure simple, efficient and agile Gavi operating model •Drive digitalisation (including artificial intelligence), improved data and evidence •Leverage the private sector and development finance institutions , including through innovative finance mechanisms Enablers
A
B
C
A
B
C
A
B
C
A
B
C

Board -2024 -Mtg -02-Doc 05 1
Report to the Board
6-7 June 2024

Subject Gavi 6.0 – The Alliance’s strategy 2026 -2030
Agenda item 05
Category For Decision

Executive Summary
This paper provides an overview and seeks approval of the Alliance’s 2026 -2030
strategy (‘Gavi 6.0’), grounded in its vision, mission, strategic goals, objectives,
operating principles and enablers. Led by the Board, the Gavi 6.0 design started in
March 2023, informed by a country -centr ic, consultative process. Gavi 6.0 will be an
ambitious yet realistic strategy that is based on Gavi’s core mandate, country needs
and capacity, fiscal context and the Alliance’s comparative advantage. Responding
to key contextual shifts in the world, sign ificant impact can be expected from Gavi
6.0 in line with the Alliance’s vision of ‘leaving no one behind with immunisation’:
• access to the widest, most innovative portfolio of critical life -saving vaccines
ever, vaccinating >500 million more children and adolescents, and saving 8 -9
million more lives;
• accelerating Gavi’s equity agenda, contributing to the Immunisation Agenda (IA)
2030’s ambition to reduce zero -dose children by 50%, integrated with primary
health care (PHC);
• enhancing Gavi’s eligibility, co -financing and transition model, ensuring it
protects Gavi’s investments and addresses inequities in access to vaccines in
middle income countries (MICs);
• stronger global health security building on the lessons from Gavi’s outbreak
response and COVAX. Ensuring that Gavi’s programmes make climate change
adaptation 1 and mitigation 2 part and parcel;
• streamlining the Secretariat operating model and revamping the Alliance model
for fragile, conflict, and humanitarian settings to better reach left behind children
with life -saving vaccines; and
• starting the next chapter in building new partnerships including with regional
organisations such as the African Union Commission and African Centres for
Disease Control and with other Global Health Institutions in line with the Lusaka
Agenda.
The document also presents the indicative strategic cost estimate for the new
strategy.

1 Climate change adaptation: The process of adjustment to actual or expected climate and its effects, in order to moderate harm or exploit beneficial opportunities. 2 Climate change mitigation: Human intervention to reduce emissions or enhance the sinks of greenhouse gases.

Board -2024 -Mtg -02-Doc 06a -Annex A 1
Report to the Board
6-7 June 2024
Annex A: Overview of the existing ELTRACO model and MICs approach, including
main challenges
The below consists of selected excerpts from the November 2023 Board briefing on
Eligibility, co -financing and transition model and MICs Deep -dive.
Figure 1: Overview of the current ELTRACO model and its three transition phases

Figure 2: Overview of the main elements of the ELTRACO



Board -2024 -Mtg -02-Doc 06a -Annex A 2
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6-7 June 2024
Figure 3: Gavi’s model has spurred country co -financing and domestic resource allocation for
immunisation

Figure 4: Gavi has already made a few amendments to the model to evolve with the need of countries

Board -2024 -Mtg -02 -Doc 05 -Annex B 1


Report to the Board
6-7 June 2024
Annex B: Narrative for Gavi 6.0, the Alliance’s 2026 – 2030 strategy
This document provides the strategic narrative for the Gavi 6.0 ‘one -pager
framework ’, providing more background for each of its key elements.

1. Vision: Gavi ’s vision of ‘leaving no one behind with immuni sation’
recognises the link to the SDG ambition and the critical contribution of
immunisation to it . The vision highlights the opportunity to reach all children
with immunisation by the end of the SDG era . It remains relevant for the 2026
– 2030 period, and in line with the Immunisation Agenda 2030 . It will therefore
remain unchanged.
2. Mission : In line with the vision, Gavi’s mission continue s to be ‘to save
lives and protect people’s health by increasing coverage and equitable
use of vaccines ’. Th is mission was revised for Gavi 5.0 and put s ‘equity’ at the
heart of the Alliance’s strategy. It recognises that the access and use of
vaccines protect s people at all stages of life ; preventing both the primary
causes of mortality in children (including diarrhoea and pneumonia) and
cancers later in life triggered by vaccine -preventable infections (such as
cervical cancer from HPV and liver cancer from hepatitis B) , and protecting
against epidemics and pandemics .
3. Principles : Most principles remain unchanged or see targeted updates
compared to Gavi 5.1 . A new principle on climate change has been added.
3.1 “Country -led, sustainable: bolster country leadership to sustainably finance
and deliver immunisation .” This principle , alongside the second one, has been
moved up to signal the importance of country led approaches and community
engagement in Gavi 6.0 , including in priority setting for immunisation .
3.2 “Community -owned, inclusive: engage communities and civil society
organisations in planning, implementation and oversight of immunisation .”
3.3 “Zero dose and missed communities, first priority: prioritise children
missing out on vaccination, including among migrants, displaced and other
vulnerable populations .” This principle signals Gavi’s core focus on the equity
agenda, further described under Strategic Goal 2 ( Section 5). It will remain
Gavi’s core programmatic priority.
3.4 “G ender -focused: identify and address gender -related barriers to promote
immunisation equity .” Building on the learnings from Gavi 5.1, the Alliance will
continuously enhance its approach to gender -responsive programming and
gender equity, benefits both vaccinees and vaccinators (see Section 5).
3.5 “D ifferentiated, fragility -responsive: target and tailor support to regional,
national and subnational needs, including fragile, conflict and humanitarian
contexts .” Gavi -eligible countries have a wide range of performance, with an
increasing share facing significant systemic challenges. The Alliance will further
support countries to differentiate their interventions, prioritising, targeting and

Board -2024 -Mtg -02-Doc 05 -Annex C 1
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6-7 June 202 4
Annex C: Gavi 6.0 - High level approach to operationalising the new strategy
1. Following Board consideration of Gavi 6.0 in June 2024, the Secretariat
will start operationalising the new strategy, with the aim to conclude by
December 2025. Gavi 5.1 execution will, however, remain the priority over the
next 18 months. The operationalisation will build on lessons learned from recent
external evaluations 1. Based on early planning, the operationalisation will be
structured around five workstreams and informed by the latest financial forecast
for Gavi 6.0. The operationalisation will build on lessons learned from recent
external evaluations. A strategic coordination mechanism will ensure alignment
and progress of the workstreams in the Secretariat.
i. Workstream 1: Development of a theory of change and measurement
framework . The Secretariat will translate the Gavi 6.0 ‘one -pager’ into a
Gavi 6.0 ‘theory of change’. The theory of change will provide the basis for
the Gavi 6.0 measurement framework, including the indicators (incl. final
mission indicators) and targets that wil l be brought to the Gavi Board for
approval in 2025.
ii. Workstream 2: Finalisation of key sub -strategies. These sub -strategies
or approaches will include (i) the Health Systems Strategy (with work
already ongoing since September 2023; see Doc 06b ); (ii) Gavi’s new
approach to Fragile, Conflict, and Humanitarian settings; and (iii) Gavi’s
Climate Change approach. These will be developed in the second half of
2024 and first half of 2025. Gavi’s market shaping strategy is also subject
to updates in 2 025.
iii. Workstream 3: Updates of Gavi’s programmatic policies . The updates
will include the review of the Eligibility and Transition Policies; the Co -
financing Policy and the Health Systems and Immunisation Strengthening
Policy to hardwire the evolution of Gavi’s support into its funding policies.
These will be brou ght to Board for approval in the second half of 2024 and
first half of 2025.
iv. Workstream 4: Evolution of the Alliance partnership approach. This
will involve enabling the Partner Engagement Framework (PEF) to support
a new partnership agenda, including the consolidation of global and
regional funding mechanisms for strengthened coordination, accountability,
and impact. New partnerships at loc al and regional level will be designed
and implemented to deliver on Gavi 6.0 priorities, such as those focusing
on PHC and engagement in Fragile, Conflict, and Humanitarian settings,
including w ith the private sector. Additionally, the Alliance will continue
efforts to drive collaboration with other global health initiatives, such as the
Global Fund to Fight AIDS, Tuberculosis and Malaria in line with the Lusaka
Agenda, and forge new innovative f inancing partnerships, e.g. with
multilateral development banks.
1 Available here: https://www.gavi.org/programmes -impact/our -impact/evaluation -studies

Classified as Internal
gavi.org
GAVI 6.0 ‘STRATEGIC COST ESTIMATE’
AUDIT AND FINANCE COMMITTEE MEETING
Ian MacTavish, Finance Director and Chief Accounting Officer
30May 2024, Virtual
Doc 05 - Annex D
Classified as Internal
Context & Objectives: AFC review of Gavi 6.0 Strategic Cost Estimate
•Board-led process to develop
Gav
i 6.0 strategy over past 12
months
• Gavi Secretariat completed a
str ategi

c cost estimate of Gavi
6.0 strategy to inform the
discussion
• As a result, Gav
i 6.0 One Pager*
will be put forward for approval to
June Board, supported by
strategic narrative and indicative
strategic cost estimate
*- see Annex for draft Gavi 6.0 “one pager”
Context Objectives of the AFC discussion
• AFC to review and provide guidance on key
assumptions and potential financial risks and
opportunities which could impact delivery of Gavi
6.0 strategy
• Secretariat to provi de
update on source of funds
status ahead of replenishment event
• Not in scope: (i
) review of Gavi 6.0 strategic
priorities (ii) financial impact of strategic choices
not selected at April 2024 Board retreat (iii)
replenishment ask to deliver the strategy
Next steps:
• Feedback to Board (via AFC Chair briefing)
• Operationalisation of Gavi 6.0 strategy, including detailed 6.0 Financial Forecast reflecting outcome of
replenishment (2025 May AFC)
Audit and Finance Committee, 30 May 2024 2
Doc 05 - Annex D

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Board -2024- Mtg-02-IFFIm Chair Report
Report to the Gavi Board
6-7 June 2024

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 has reviewed administrative aspects of is operations including the United
Kingdom’s annual rating of IFFIm as A+, Fitch’s revised outlook to stable, and
recruitment for the IFFIm Board.
• The IFFIm Board, in consultation with Gavi and the World Bank (IFFIm’s
Treasury Manager), are discussing the best approach to the replenishment for
the Gavi 6.0 strategic period.
• As part of continued efforts to maximise IFFIm's strategic value for Gavi, several
enhancements have been made to IFFIm in recent years. IFFIm continues to
be a valuable tool in Gavi’s financial toolkit, and its flexible model will be critical
in the Gavi 6.0 strategic period.
• Annexed hereto, is the IFFIm Chair Report to be presented and discussed
during the forthcoming Gavi Board meeting.
Annex
Annex: IFFIm Chair Report

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Board -2024 -Mtg -02-PPC Committee Chair Report
Report to the Board
6-7 June 2024

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 2023 .
• On 15 -16 May 2024, 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
6-7 June 2024 meeting for consideration.
• The PPC Chair report is attached in the form of a presentation as Annex A , the
PPC recommendations to the Board are attached as Annex B , and a set of
over view slides on Gavi ’s Eligibility, Tra nsition and Co -Financing (ELTRACO)
model that were used by the PPC in its last meeting are attached as Annex C.
Annexes
Annex A : PPC Chair report
Annex B : PPC recommendations to Gavi Alliance Board
Annex C : Overview slides on ELTRACO model

1


Board -2024 -Mtg -02-EAC Committee Chair Report
Report to the Board
6-7 June 2024

Subject Evaluation Advisory Committee Chair Report
Category For Information
Section A: Introduction
• This report provides the Board with an overview of the activities of , and
guidance provided by , the Evaluation Advisory Committee ( EAC ) since the
Committee Chair last reported to the Board in December 2023 .
• At the in -person EAC meeting on 20 -21 March 2024, the EAC provided
guidance on: (i) progress of the commissioned Gavi 5.1 centralised evaluations
including the proposed centralised evaluation on sustainability/post transition ;
ii) the Zero -Dose Evaluation; (ii i) the Mid -Term Evaluation (MTE) of Gavi’s
2021 -2025 Strategy ; (i v) the COVAX Evaluation; (v) centralised evaluation work
planning for Gavi 6.0 ; (vi) the Evaluation Function Review planned for 2024;
and (vii) EAC engagement in Gavi 5.1 evaluations.
Section B: Overarching issues and guidance

• The EAC continue d to consider its remit, voice and practice in supporting a Gavi
evaluation portfolio of optimal independence, credibility and utility . The on -
going MOPAN assessment and the forthcoming Evaluation Function Review
will offer useful inputs into this process.
• The EAC provided guidance on the development of the Gavi 6.0 Centralised
Evaluation Workplan (CEWP) . Regarding stakeholder consultation, the EAC
encouraged the Secretariat to : (i) consult stakeholders and relevant partners ;
and (ii) map against other evidence generation functions such as Learning
Hubs , audit s, decentralised evaluations . On the proposed principles for the
Gavi 6.0 CEWP , the EAC advised to : (i) clarify the purpose of the proposed
principles for work planning; (ii) revisit content ahead of September 2024
meeting to align with policy aims o f credibility, utility and independence ; and (iii)
include issues of country representation/evidence partnerships . The EAC
provided feedback on potential topics for discussion at the September 2024
meeting related to principles, approaches, methods and data issues with
implications for evaluation work planning for Gavi 6.0.
• Regarding the Evaluation Function Review , the EAC advised for arrangements
to be put in place to ensure independence and oversight of the review ,
including : bringing in key stakeholders across Gavi’s Board, Programme and
Policy Committee (PPC) and Senior Leadership Team, and keeping them
informed early and throughout the process . EAC members also noted that this
review should consider the implications of all relevant developmen t trends (e.g.
Leave No One Behind, localisation, subnational focus, Lusaka Agenda, and
partnership ) and advised that a survey be added to the methodology for the

1
Board - 2024 - Mtg - 02 - Governance Committee Chair Report Report to the Board
6 - 7 June 2024
Subject Governance Committee Chair Report
Category For Information
Section A: Introduction
• This report provides the Board with an overview of the activities of the
Governance Committee (GC) since the Committee Chair last reported to the
Board in December 2023 .
• The GC met virtually on 26 February 2024 , in person on 16 April 2024, and will
meet again in person on 5 June 2024.
• In addition to some regular business such as Board and Committee
nominations, the recruitment of Unaffiliated Board Members and the
governance risk matrix, Committee discussions focused on ( i) the CEO
transition and onboarding process; (ii) Operational Excellence and Human
Resources; (iii) Board and Board Committee Evaluation ; (iv) Protection from
Sexual Exploitation, Abuse and Harassment (PSEAH) Policy ; (v) Human
Resources Sub c ommittee T erms of Reference ; (vi) Collaboration with the
Global Fund to Fight AIDS, Tuberculosis and Malaria; and (vii) P roposal for
governance of the Africa n Vaccine Manufacturing Accelerator (AVMA).
• At its meeting on 5 June 2024 the Governance Committee will discuss
proposals for Strengthening Implementing Country Constituency ; review the
proposed AVMA and Day Zero Financial Facility First Response Fun d
Governance ; the Appointment of the Treasurer; and c ollaboration with o ther
global health o rgani s ations.
• The GC Chair report is attached in the form of a presentation as Annex A .
Annexes
Annex A : Governance Committee Chair report
Additio nal information available on B oard Effect
App endix 1: Protection from Sexual Exploitation, Abuse and Harassment (P SEAH)
P olicy
App endix 2 : Human Resources Subcommittee Terms of Refer enc e