…Progress includes critical advances in the push to reach 86 million girls with vaccines against human papillomavirus (HPV)
…African Vaccine Manufacturing Accelerator and Day Zero Financing Facility parameters were also approved, along with expansion of Gavi’s portfolio to include tuberculosis, dengue fever, group B streptococcus, hepatitis-E, and mpox
MON JUNE 10 2024-theGBJournal|The Board of Gavi, the Vaccine Alliance has announced a series of decisions that provide a framework for an acceleration of global immunisation – including approval of “Gavi 6.0”, the Alliance’s 2026-2030 strategy, expansion of Gavi’s vaccine portfolio, and plans to support global health security and regional manufacturing through the African Vaccine Manufacturing Accelerator and a First Response Fund for use in future pandemics.
The decisions were taken during a two-day meeting convened in Geneva from 6-7 June.
“Vaccines are one of the most impactful and cost-effective health and development interventions available today,” said Professor José Manuel Barroso, Chair of the Gavi Board.
“As we look to 2030 and progress against the Sustainable Development Goals amidst climate change and other challenges, the message is clear: the world must continue to invest in the transformative impact of vaccines and their ability to save lives and ensure our collective security.”
To set the scene for two days of discussions on Gavi’s future direction, the Board first reviewed progress for the current strategic period, noting that the Alliance is largely on track across mission indicators despite the disruptions caused by the COVID-19 pandemic.
Progress includes critical advances in the push to reach 86 million girls with vaccines against human papillomavirus (HPV), with five new country launches since September 2023, and the new malaria vaccination programme, where 22 country applications have been approved and deeper collaboration with the broader set of malaria stakeholders, including the Global Fund, is underway.
While there has been a 12% reduction in the number of outbreaks requiring a response between 2022 and 2023, it continues to be an area of concern that this remains far above pre-pandemic averages, primarily driven by surges in cholera and measles outbreaks.
PRIORITIES FOR GLOBAL IMMUNISATION THROUGH 2030
The Board approved the Vaccine Alliance’s strategy for the period 2026-2030, known as “Gavi 6.0”. The 6.0 strategy will be the most ambitious in Gavi’s history: seeking to protect more people, against more diseases, faster than ever before.
This means a continued focus on Gavi’s core mission: To support new vaccine introductions
-Expand existing programmes
-Achieve equity through targeted efforts to reach and fully immunise missed “zero-dose” children and communities
-Scale up critical innovations
-Shape markets to ensure the availability of affordable and suitable vaccines for lower-income countries.
The new strategy will also make the Gavi model increasingly responsive to the evolving global context – from climate change to the increasing threat of outbreaks, antimicrobial resistance, and fragility and conflict – to continue meeting countries’ and communities’ needs.
Key elements to this approach include proposed adjustments to Gavi’s co-financing, eligibility and transition approach to ensure the continued sustainability of immunisation programmes; deeper partnerships with global and regional organisations, civil society and communities; differentiated, flexible and tailored support for fragile and humanitarian contexts; streamlining Gavi’s operating model; and enhanced support for climate-sensitive and outbreak, epidemic and pandemic-prone diseases.
The Alliance begin work on operational details, in preparation for implementation of the strategy beginning in 2026.
The projected impact of the next five years of work, as well as the total funding needs for the strategic period, will be announced on 20 June at the “Protecting Our Future: Global Forum for Vaccine Sovereignty and Innovation”, co-hosted by the African Union (AU), Africa Centres for Disease Control and Prevention (Africa CDC), Government of France and Gavi.
The event will see the launch of both Gavi’s Investment Opportunity for 2026-2030 as well as the African Vaccine Manufacturing Accelerator (AVMA), a first-of-its-kind US$ 1 billion financial instrument in support of sustainable vaccine manufacturing on the African Continent. Securing funding for the 2026-2030 period will be vital to ensuring the success of Gavi’s strategy.
EXPANDING GAVI’S VACCINE PORTFOLIO
A critical part of each five-year period is the approval of a new Vaccine Investment Strategy (VIS), which looks at the pipeline of promising vaccines and vaccine candidates and evaluates how best to expand the portfolio of vaccines Gavi offers.
The Board approved the 2024 VIS, which will include future vaccination programmes and learning agendas for tuberculosis (adolescent vaccines), group B streptococcus, and dengue fever (the latter investment conditional on availability of relevant data on the burden in Gavi-supported countries), as well as global stockpiles and learning agendas for vaccines against mpox and hepatitis E.
In-principle approvals via the Vaccine Investment Strategy allow Gavi to begin market signaling and preparedness activities in advance, which is a critical part of Gavi’s model to accelerate access to lower-income countries so new vaccines can be deployed as soon as they become available.
The Board also approved a learning agenda on vaccination against shigella, and, given the levels of coverage achieved, current epidemiology and country demand, recommended sunsetting of the routine COVID-19 vaccination programme at the end of 2025.
Potential COVID-19 needs for a “worst-case scenario” after 2025 will be addressed through Gavi’s emergency response mechanisms.
For mpox, the Board additionally approved that in the current strategic period, the Alliance would support the response to the on-going outbreak in the Democratic Republic of the Congo (DRC) and further potential outbreaks in surrounding countries – including leveraging COVID-19 experiences to coordinate dose donations.
CRITICAL SUPPORT FOR VACCINE SOVEREIGNTY AND HEALTH SECURITY
Following Board approval in 2023, decisions were made on the operational parameters for innovative vaccine sovereignty and health security mechanisms set up by Gavi in response to learnings from the COVID-19 pandemic.
The Board approved the final structure of the African Vaccine Manufacturing Accelerator, which will be launched on 20 June. In particular this includes the eligibility criteria designed to focus support on sustainable end-to-end vaccine manufacturing on the Continent.
The Board also endorsed AVMA’s governance mechanisms, which will involve the Gavi Board as well as partners including the AU, Africa CDC, UNICEF, WHO, manufacturers, and donors.
The finalisation of AVMA sends an immediate signal to investors regarding Gavi’s long-term commitment to support a sustainable African vaccine manufacturing base, and to improving African pandemic and outbreak vaccine supply resilience.
Another mechanism discussed was the Day Zero Financing Facility for Pandemics, a suite of instruments that will seek to make financing accessible in the first 100 days of a major public health emergency. The Board approved the parameters for the DZF’s new First Response Fund, which sets aside US$500 million for rapid response to emergencies.
Following the Board’s decision, the scope of the First Response Fund was confirmed as core Gavi-eligible countries, with potential for exceptions if needed, and targeted mainly to WHO Public Health Emergencies of International Concern without existing vaccine programmes.
The Board also agreed that the funds could be used to procure, alongside vaccines, syringes and ancillaries, personal protective equipment, cold chain, surge capacity, health system and community preparedness and response activities.
“The decisions taken today reflect our full Alliance of stakeholders aligning around a clear goal: ensuring Gavi’s model continues to best support the countries and communities who are our partners,” said Dr Sania Nishtar, CEO of Gavi. “In a complex and changing world, today’s decisions will help Gavi deliver systematic impact faster than ever before.”
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