FOR INFORMATION

The Programme and Policy Committee (PPC) of the GAVI Alliance Board has held
four meetings since the December 2009 board meeting. This paper provides a brief
summary of issues discussed.

The Board will be requested to approve the PPC?s recommendations with regard to
prioritisation, co-financing, health systems strengthening programme allocations,
and the advance market commitment.
Programme and Policy Committee Update
December 2009 ? June 2010

The Programme & Policy Committee (PPC) serv es as the principal advisory body to
the board on all GAVI programme areas and leads the development of new policies.
It is staffed by high-level technical experts from partner organisations and
constituencies, with knowle dge in areas such as epidemiology, public health,
research, health systems and financing. Over the course of the reporting period, the
chairing function of the committee passed from Sissel Hodne-Steen of Norway to
Gustavo Gonzalez-Canali from France. The committee held two face-to-face
meetings and two teleconferences since De cember 2009. Actions taken by the PPC
and key discussion items from all three meetings are summarised below.

Policies Endorsed for Board approval

Prioritisation policy: The PPC endorsed the scope of work and appointed a time-
limited task team to develop a policy on prioritisation in February 2010. The policy
was endorsed in May 2010 for presentation to the board in June 2010 (see Doc 09).

Co-financing: In February 2010, the PPC endor sed the scope of work and
appointed a time-limited task team to review the policy on co-financing and propose
revisions, if necessary. The work of the task team is divided into two phases ? the
first focusing on policy objectives and the sec ond in implementation. Objectives,
principles and a definition of ?financ ial sustainability? have been endorsed for
presentation to the June 2010 board (see Doc 07).

Supply strategy: In February 2010, the PPC endor sed the scope of work and
appointed a time-limited task team to re view and update GAVI?s vaccine supply
strategy looking specifically at innovativ e procurement strategies and how to achieve
the best value for money, while ensuring suffi cient supply. The work of this team
will commence in June 2010.

Advance market commitment (AMC): The PPC reviewed policy options to
address the impact of the November 2009 board decisions (eligibility, graduation and
funding pause) on the demand forecasts for pneumococcal vaccines that underlie
the AMC. An endor sed option is being presented to the June 2010 board (see Doc
08).

Health systems strengthening : The PPC recommend moving forward with the
platform, informing a board decision tak en in April 2010. Further, a system for

1


GAVI Alliance Governance Committee Meeting
15 June 2010
Geneva, Switzerland

FINAL Minutes

Finding a quorum of members present 1, the meeting commenc ed at 19.37 Geneva
time on 15 June 2010. Mary Robinson c haired the meeting. The Committee
reviewed the minutes from its meeting on 19 April 2010 (Doc #1 in the committee
pack).

DECISION
GAVI Alliance Governance Committee:
Approved the minutes of its meeting on 19 April 2010

1 Matters Arising ? Gender Guidelines
The Committee discussed the guidelines on the board gender balance
recommended to the Board on 17 March 2010 2 and how they would be interpreted
and implemented, particularly since the Governance Committee would consider an
exception at this meeting. The Commi ttee had agreed the new guidelines would not
come into force until the 2011 vacancie s were considered in December 2010.
2
Neither the current guidelines, nor the recommended guidelines mandate a complete
prohibition of male candidacies.
The Committee agreed further clarificat ions could be made when the Board
discussed the guidelines; and potentially at a future Governance Committee meeting
if required.
2 By-Laws ? Approving the Annual Accounts
Tim Nielander reviewed the Audit and Fi nance Committee?s recommendation to
allow the annual accounts to be approved by the Executive Committee or via no-
objection voting (Doc #2) since the Board does not normally meet during the time of
year the audited financial statements need to be approved. Discussion followed:
? The Swiss authorities signa lled that approval of the annual accounts is a core
responsibility of the Board, and th e Committee agreed. As such, the
Committee was not inclined to forward the recommendation that the Executive
Committee be deleg ated authority.

? The Governance Committee recognised t hat other organisations allow for no-
objection voting generally and that the Board?s current unanimous consent
clause
3 is difficult to exercise with a large number of board members.



1 Attendees are listed in Attachment A 2 Section 3 of the 17 March 2010 Governance Committee Minutes 3 See Section 2.7.3 of the By-Laws

GAVI Alliance Evaluation Advisory Committee Meeting, 2 June 2010 FINAL MINUTES


1

GAVI Alliance Evaluation Advisory Committee Meeting
2 June 2010
Teleconference

FINAL MINUTES

Finding a quorum of members present 1, the meeting commenced at 15.15 Geneva
time on 2 June 2010.

Given the length of the documents, the Chair of the Evaluati on Advisory Committee
(EAC) propose d that each committee member review the main report and the report
from one of the four strategic goals, along with their fellow committee member as
indicated.

? Strategic Goal 1: Sania Nishtar and Bernhard Schwartlander
? Strategic Goal 2: Stan Foster and Ken Hill
? Strategic Goal 3: George Wellde and Gonzalo Hernandez
? Strategic Goal 4: Minister Sezibera and Zenda Ofir

The Committee Chair suggested focusing on the following questions:
1. To what extent is there adequate descrip tion of the methods used in the
evaluation study?
2. To what extent is there adequate identification and assessment of the
limitations and potential sources of bias in the evaluation study?
3. To what extent do the reports adequately address the study?s defined
evaluation questions?
4. To what extent are the conclusions substantiated by the evaluation?s findings,
and supported through sound and transparent application of appropriate
evaluation methods?

Discussion followed:
1 IFFIm Evaluation

? It was noted that the report for Strategic Goal #3 contains an extensive
discussion of the IFFIm and AMC . The Secretariat is prepared to go to tender
with a Request for Proposals for an evaluation of the IFFIm once the steering
committee for this evaluation is convened and app roves the terms of
reference.

? Although the p reliminary draft report from the Second GAVI Evaluation is not
complete , the section on the IFFIm is almost final. W e could therefore
compare what is addressed in the Second GAVI Evaluation vis -a-vis IFFIm
wit h what we want to get out of the IFFIm evaluation as per the draft ToRs .
The EAC could then ask the IFFIm donors and other stakeholders whether we
have already learned what we wanted to learn about the IFFIm and, if not,
whether the best way to address ou tstanding questions related to the IFFIm is
1 Attendees are listed in Attachment A.

GAVI Alliance Audit and Finance Committee Meeting, 25 May 2010 FINAL MINUTES
1

GAVI Alliance Audit and Finance Committee Meeting
25 May 2010
Teleconference

FINAL Minutes

Finding a quorum of members present 1, the meeting commenced at 16.30 Geneva
time on 25 May 2010. The Committee reviewed the minutes from its meetings on 11
March 2010 and 14 April 2010 (Docs #1a and #1b in the committee pack).

DECISION
The GAVI Alliance Audit and Finance Committee:
Approved the minutes of its meetings on:
? 11 March 2010
? 14 April 2010
1 2009 -2010 Administration and Work Plan Budget
Tony Dutson, Senio r Director, Finance and CAO updated the Committee on
spending against the 2009 -2010 administrative and work plan budget and noted that
while 2009 expenses were underspent compared to budget, the 2010 administrative
budget is forecasted to be overspent by 6 %, exceeding the Secretariat?s 5%
overspend authorisation (Doc #2). Though the Secretariat was pursuing cost
savings, it requested the Committee to consider the possibility of reviewing a
supplemental budget.
? The Board noted in November 2009 that the Sec retariat may need to
request a supplemental budget to support staffing costs associated with
programmes coming online during 2010, such as the Health Systems
Funding Platform and the innovative finance function.
? Nevertheless, the Committee requested the Secretariat to find sufficient
savings within the standard 5% overage allowance given the climate of
austerity and the fact that the projected overrun was only 6%.

2 Prioritisation Policy
Gian Ghandi, Head of Policy Development, provided an overview of the draft
prioritisation policy recommended to the Board by the Programme and Policy
Committee (PPC) (Doc #3). The policy?s aim is to create a system to rank
Independent Review Committee (IRC) recommended country proposals for New
Vaccine Support (NVS) and c ash -based programmes and inform the prioritisation of
vaccines within GAVI?s portfolio. This policy, along with the programme funding
policy 2, would form the basis of GAVI?s programme approvals architecture.

1 Attendees are listed in Attachment A 2 See section 3 of these minutes

GAVI Alliance Programme and Policy Committee Meeting, 18 -19 May 2010 FINAL MINUTES


1

GAVI Alliance Programme and Policy Committee Meeting
18 -19 May 2010
Geneva, Switzerland

Final Minutes

Finding a quorum of members present 1, the meeting commenced at 9.12 Geneva
time. The Programme and Policy Committee Chair Gustavo Gonzalez -Canali
exp ressed his vision to integrate the Committee?s technical discussions with a
strategic perspective to ensure Committee deliberations continue to be evidence
based, but accessible to a wider cross section of people. He asked committee
members to reflect on this issue and that of roles and responsibilities of the
committee.

The Chair welcomed Anne Schuchat, board representative for Research and
Technical Health Institutes, to her first in -person Committee meeting.

The Committee reviewed the minutes of its meeting on 17 -18 February, 29 March
and 16 April 2010 (Doc #1 in the committee pack).


DECISION
The GAVI Alliance Programme and Policy Committee:
Approved the minutes from 17 -18 February, 29 March and 16 April
2010.

1 Update from the Secretariat
Nina S chwalbe , Managing Director, Policy and Performance provided a summary of
key activities completed since the prior meeting and updated the Committee on
priorities/plans for the rest of 2010. She detailed Board -level committee meetings,
upcoming events, ong oing evaluations, and other key events for the information of
the Committee. Discussion including the following :

? The Evaluation Advisory Committee is actively providing guidance, advice and
input to the GAVI Phase 2 evaluation team. They are also spearhe ading the
development of the Terms of Reference (TOR?s) for the IFFIm evaluation. It is
hoped that the evaluation team will include a partner from a developing country.

? New AMC agreements have been signed. Provisional agreements were made
with Pfizer and full agreements with GSK. 13 Applications have already been
approved and will be supported through the AMC.

1 Participants are listed in Attachment A.

The purpose of these case studies is to document experiences and lessons learned under the GAVI CSO grant, including the application and selection process, implementation to date, and monitoring and reporting.

GAVI Alliance Programme and Policy Committee Meeting, 16 April 2010 FINAL MINUTES

1



GAVI Alliance Programme and Policy Committee Meeting
16 April 2010
Teleconference

FINAL Minutes

The teleconference commenced 1 at 15:12 Geneva time on 16 April 2010. Seven
members participated in the call. The PPC Chair decided with the assent of the p resent
PPC members to proceed despite the lack of quorum since the teleconference was
convened for ?guidance? (as opposed to ?decision?). 2 Discussion followed:
1. Introduction to Prioritisation F ramework Elements

The Chair of the PPC provided a brief summary of t he prioritisation work to date and
indicated the three areas where the P rioritisation Task Team (PTT) requests PPC
guidance:
? Guidance on the principles of the prioritisation mechanism
? Guidance on the objectives of the prioritisation mechanism
? Guidan ce with regard to the criteria and indicators used for prioritisation , and
specifically on the means of measuring the health impact and cost -effectiveness

Th e PTT Chair presented background information, including the composition of the
PTT, the scope of its mandate, and on progress made thus far (Doc #1). Several points
were emphasised :

? Defining which priorities are funded requires definition of the funding constraint.
However, prioritisation should be considered separately from the approach or
decision s about defining the overall funding envelope.

? Data limitations and the short time frame might make it difficult to create an ideal
mechanism. Consequently the PTT is likely to recommend that a pilot
mechanism be developed in the short term, and then eval uated and
strengthened in 2011.
2. Proposed Principles and Objectives

? The mechanism should be a transparent, easily understood, and objective.
Ideally, the next iteration of the mechanism should incorporate experience and
feedback from countries to ensure t he mechanism was sufficiently participatory.
1 Attendees are listed in Attachment A 2 The session was ratified as evidenced by the approval of these minutes during a quoriate session of the Committee
on 18 -19 May 2010.

GAVI Alliance Audit and Finance Committee Meeting, 14 April 2010 FINAL MINUTES
1


GAVI Alliance Audit and Finance C ommittee M eeting
14 April 20 10
Teleconference

FINAL Minutes

Finding a quorum of members present 1, the meeting commenced at 16.03 Geneva
time on 1 4 April 2010 .

1 Programme Funding Plan ? Nepal HSS
Subject to the Board?s adoption of the health systems funding platform (HLSP) , the
Secretariat intended to request the Board to endorse a three -year HSS budget and a
near term financial commitment for Nepal (Doc #1 in the subcommittee pack).
Though the Board had decided in Nove mber 2009 that this programme , among
others , would be considered in the context of the prioritisation exercise, the
Secretariat in discussion with the Programme and Policy Committee had concluded
that Nepal would need to be considered in the near term in o rder for it to remain a
viable HLSP candidate. Discussion followed :
? The Committee acknowledged that approving the total budget (approximately
US$ 14 million) and near term financial requirement (approximately $4
million), would not meaningfully hinder the prioritisation exercise and that
GAVI could afford this programme.
? Of all the programmes that the October 2009 Independent Review Committee
(IRC) put forward for funding, only the Nepal programme was time sensitive.
However, the Programme and Policy Comm ittee will need to discuss the
potential equity concerns that accelerating the Nepal programme could raise .
? It was intended to use GAVI Alliance funds to pay for the programme rather
than IFFIm bond proceeds. If there are funds specifically set aside to h ealth
systems, these should be used. However, t hough the new donations to IFFIm
in support of health systems activities are on track, the agreements are not
yet fully in place .
? Though the costs of this programme are relatively small, the Committee noted
that it generally desired more financial information to understand in a
comprehensive sense the ultimate impact of funding decisions . It was
acknowledged that the Secretariat normally provides comprehensive
information ahead of time and that the data was b eing presented verbally .
However, having the charts in front of committee members is helpful.
? One committee member expressed some hesitancy with moving forward too
quickly with a programme before one of GAVI?s HSFP partners had formally
endorsed the platf orm. It was expected that this partner would take a decision
before the end of the month.

1 Attendees are listed in Attachment A.

GAVI Alliance Governance Committee Meeting , 19 April 2010 FINAL MINUTES
1



GAVI Alliance Governance Committee Meeting
19 April 2010
Teleconference

FINAL Minutes

Finding a quorum of members present 1

, the meeting commenced at 16.07 Geneva
time on 19 April 2010. Mary Robinson chaired the meeting. The Committee
reviewed the m inutes from its meeting on 17 March 201 0 (Doc #1 in the committee
pack).
DECISION
GAVI Alliance Governance Committee:
Approved

the minutes of its meeting on 17 March 2010 contingent
upon amending the language in Decision 3 to clarify that the
recommenda tions should be considered by the Board during its June
2010 meeting.
1 Nominations and Recruitment
Kevin Klock, Corporate Governance Officer and Assistant Secretary, presented
several candidates tabled by constituencies to serve as Alternate Board Members
(Doc #2). He also updated the Committee on the recruitment processes for the
developing country government and unaffiliated board member vacancies.
Discussion followed:

? It was noted that the tabled candidates would further progress in bringing the
Board into gender balance.
? The recruitment subgroup had identified a viable unaffiliated board member
candidate but preferred to cont inue its vetting process and present at least two
candidates for possible nomination in June.
? Mr Klock relayed that Minister Ri chard Sezibera felt strongly that the developing
country constituency should determine the process to name a new candidate. He
therefore provided two options for consideration by his African Ministerial
colleagues : The more expedient option is to select another candidate from the
2009 pool of nominees. The slower but more comprehensive option would be to
reopen the nomination window to accept nomination packages from all interested
ministers.
? The Minister expects to have the consensus opinion from his co lleagues shortly
and plans to report the preferred way forward to the Committee in due course.
? It was affirmed that there is no regulation in the Statutes or By -Laws that a
developing country government representative must rank at least at the vice
1 Attend ees are listed in Attachm ent A