Gavi Board approves measures to support sustainability of vaccine programmes and boost access in vulnerable communities

The Board of Gavi, the Vaccine Alliance today approved a series of decisions that will help countries to sustain their own immunization programs and close equity gaps in the most vulnerable communities. The decisions were taken amid global demand for vaccines from Gavi-implementing countries.  

The two-day meeting, which was hosted by the Indonesian government, saw members take stock of recent historic strides made across Gavi’s core programmatic priorities: In 2024, the Alliance supported the introduction of malaria vaccination programmes, exceeding the forecasted target of 15 countries. Furthermore, the Alliance witnessed an unprecedented scale-up of HPV vaccination campaigns in 2024, with more girls reached with Gavi support than in any other year in history.

At the same time, 2024 saw a rise in the number of zero-dose children in Gavi countries, largely driven by ongoing humanitarian and health crises, an increase in disease outbreaks driven partly by climate change and macroeconomic challenges in some Gavi supported countries, placing at risk their abilities to sustain immunisation programmes.   

“Countries increasingly recognise that immunisation is one of the most powerful tools for saving lives, protecting communities and fostering sustainable growth and development,” said Professor José Manuel Barroso, Chair of the Gavi Board. “Gavi is committed to helping countries improve access to vaccines, and to helping them strengthen their own capabilities so that immunisation becomes sustainable over the long term.”

“Against a backdrop of historic progress, decisions taken by our Board today reflect a collective commitment of our partners to strengthen immunisation systems, tackle health inequities and place countries firmly on the path to sustainable transition," said Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance. “As we prepare for  our next strategic period starting in 2026, we must continue to innovate to address the new challenges we face and achieve the goal of protecting people, communities and our world from preventable disease.”

Indonesia is a living example of the power of the Vaccine Alliance to improve health and development outcomes over the long term. As a recipient of Gavi support in 2002, it has doubled the number of vaccines in routine immunisation program, significantly reduced child mortality and transitioned through the various phases of support to the point where it now fully funds its own immunisation programmes, while maintaining high levels of coverage and benefiting from its partnership with Gavi through the alliance’s Middle-Income Countries (MICs) Approach.

Support for sustainability

Signaling its commitment to helping countries on their pathway towards transitioning away from Gavi support while acknowledging the macroeconomic headwinds many countries are facing, the Board approved changes to Gavi’s transition, eligibility and co-financing model. These changes will see Gavi implement targeted measures for countries in various  stages of transition related to co-financing, eligibility thresholds and access to Gavi support, as well as duration of support.

Building on lessons learned from the MICs approach that was first implemented in 2022, the Board also agreed that Gavi will integrate catalytic support for lower middle-income countries and International Development Association (IDA)-eligible countries into Gavi’s broader co-financing model. This support will facilitate the introduction of the following high impact vaccines: HPV, PCV and rotavirus, and potential support for dengue and TB vaccines – taking into account the burden and potential for public health impact in middle-income countries. 

Addressing fragility

Recognising the impact of conflict and climate change on immunisation, the Board approved additional flexibility to support fragile countries, including the possibility of multi-year co-financing waivers for countries grappling with long-term, large-scale conflict as well as a special package of support for Small-Island Developing States (SIDS). This latter package seeks to help build resilience against the challenges SIDS grapple with including climate change and an increasing number of natural disasters that lead to a heightened risk of outbreaks and costly emergency response.

Strengthening health systems

Health systems are critical for equitable provision of immunisation and other vital health services. In recognition of their importance, and the added complexity that comes with an expanded portfolio of vaccines, the Gavi Board approved changes to the health systems policy for its next strategic period, “Gavi 6.0” which begins in 2026. 

The revised policy will see consolidated cash grants allocated to countries and a new grant allocation formula that will help ensure that those with greatest need receive adequate support, while also safeguarding vulnerable populations living in fragile settings.?In alignment with the goals of the Lusaka agenda, these measures will enhance efficiency, foster greater country ownership of immunisation programmes, in addition to encouraging domestic investments in health systems and cold chain.

A framework for demand 

With Gavi-implementing countries aiming for a record number of new vaccine introductions for 2024 and 2025, alongside high demand for other types of Gavi support, the Board approved an evidence-informed framework to guide Gavi's resource allocation to countries to drive the most impact - to be used in the unlikely event that adjustments to currently planned activities are necessary. The unprecedented demand for vaccines further underlines the importance of Gavi’s replenishment process for Gavi 6.0 which was launched in June this year at the Global Forum for Vaccine Sovereignty and Innovation, co-hosted by France, the African Union with Team Europe and will culminate in a pledging event in early 2025 with a goal to raise at least US$9 billion from donors. 

Appointments and process updates 

• Ana de Pro Gonzales was appointed as an Unaffiliated Board Member and as a member of the Audit and Finance Committee
• Anna Sedgeley was appointed as an Unaffiliated Board Member and as a member of the Governance Committee:
• Anne Schuchat was reappointed as Chair of the Programme and Policy Committee  

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