PowerPoint Presentation

CEO Board updateImmunising children together

Seth Berkley, MD7th December 2016, Cte dIvoire

www.gavi.org

1

Gavi Board meeting7 December 2016

2Globallandscape

2Reporting back on Board decisions

1Health threats

3Alliance fitfor purpose

4

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

2

HPV support review

Yellow fever approach

Stockpile strategy

Cte dIvoire: road to recoveryHigh coverage before crisis: 85% in 2010 During crisis coverage dropped: 62% in 2011Rapid system recovery waived coverage requirement for pneumococcal and rotavirus vaccines in 2014Focus on routine improved coverage: pentavalent 83%, pneumococcal 72% in 2015HPV demonstration project: 98% coverage, preparation for national introductionNo Ebola cases despite bordering Guinea and Sierra Leone

Gavi Board meeting7 December 2016

Fragility policy

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

3

Cte dIvoire: issues remainYellow fever: campaign 2011-2012, no confirmed cases since but routine coverage just 49% Equity: focus on low-coverage districts and communitiesData quality: country-tailored approach has plan to improve quality and flow of data from service delivery to national levelSustainability: challenge to shift from preparatory to accelerated transition (expected by 2020)Gavi Board meeting7 December 2016

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

4

15Reporting back on Board decisions

Malaria vaccine pilotsJune Board approved up to US$ 27.5m for pilots, to be matched by other donorsFull funding now secured for first phase: Global Fund: US$ 15mUNITAID: US$ 9.6mWHO responded to Gavis review committee request to reduce budget: 8% reduction means pilots should go aheadHistoric partnership to tackle one of the biggest child killers

Gavi Board meeting7 December 2016

June 2016: Board approved funding for pilots

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

6

Measles-rubella strategyImplementation: 10 applications so far, implementation from 2017Joint appraisals: incidence, coverage, surveillanceOwnership: countries self-financing 1st dose from 2018Sustainability: long-term planning, focus on routine Enhanced analysis: changed Ethiopia targets, high potential for modelling to improve results

Gavi Board meeting7 December 2016Dec 2015: Board approved new strategyCredit: World Health OrganisationSource: Surveillance DEF file, 09 Nov 2016

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

7

Measles SIA in Ethiopia (non-Gavi supported) April 2016 (545 woredas)

>= 95%

< 95%

No campaign

Measles SIA in Ethiopia (non-Gavi supported) October 2015 (367 woredas)Ethiopia: targeted measles campaign2013 nationwide campaign: 98% administrative coverage, 90.6% surveyContinued outbreaks 2013-15Oct/Nov 2015, Apr 2016 campaignsApril 2016: 94% average survey coverage in targeted woredas (districts)Jan 2017 targeted campaign Adjusted after epidemiological analysis Targeting woredas not covered before or below 90% coveragePost-campaign coverage survey

Gavi Board meeting7 December 2016Note: all woredas could not be accurately mapped

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

8

2011-2015PentavalentMeasles & rubella Pneumococcal Rotavirus HPV IPVsome states

Gavi Board meeting7 December 2016Dec 2015: Board approved India strategy Expansion to additional states/union territories* Funded by the Government of IndiaIndia partnership strategy Acceleration in new vaccine introductions

201620172018Q1Q2Q3Q4Q1Q2Q3Q4Transition to domestic funding***tentative tentative*one stateall statesTransition to domestic funding

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

9

Cold chain equipment platformGavi Board meeting7 December 2016June 2015: Board approved US$ 50m initial investmentApplied

Approved

Recommended

Total recommended and approved: US$ 134 millionHaiti

Sierra Leone

Malawi

Togo

Cameroon

Uganda

Kenya

Madagascar

Pakistan

S. Sudan

Uzbekistan

Guinea

Liberia

DR Congo

Niger

Resubmission

Senegal

SolomonIslands

Ethiopia

Chad

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

10

Cold chain equipment platformChanged marketplace in first 11 months :15 new prequalified devices2 manufacturers: 10-year warranty for solar direct drive fridgesFirst 5-year warranty for ice-lined fridges Financial forecast for the strategy period includes price reductions from market shaping activitiesGavi Board meeting7 December 2016June 2015: Board approved US$ 50m initial investmentSolar fridge in Mbankana village, DRC

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

11

Risk managementPlan approved by Board in December 2014 largely implementedNew teams and processes operational, embedded in business as usualEnhanced understanding of risk at Alliance and country levelIncreased Board engagement: risk policy & risk appetite, April 2016 retreat This meeting: risk & assurance reportGavi Board meeting7 December 2016Dec 2014: Board approved the risk policy

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

12

Alliance top risks ranked against likelihood and impactCurrent risk exposure, taking into account existing mitigation

Gavi Board meeting7 December 2016VERY HIGH RISKCountry management capacityData qualityTransition readinessCountry performance post-transitionHIGH RISKOutbreaks disrupt immunisationVaccine confidenceMisuse by countriesDonor supportPartner capacityStrategic relevanceSupply shortagesFrequent or unplanned campaignsHSIS value for moneySecretariat disruptionForecasting variability

Programmatic risk

Corporate risk

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

13

Nigeria risk: critical need to get back on trackGavi Board meeting7 December 20167th lowest coverage among Gavi-supported countries - below eg Afghanistan, Mali, DRCAcute fragility, especially in northern statesEntering transition in 2017Misuse of fundsNo longer polio freeDTP3 immunisation coverage, 2005-2015

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

14

Nigeria: moving in the right directionGavi Board meeting7 December 2016Visit with Mark Dybul and President Buhari in July Replaced leadership of National Primary Healthcare Development AgencyCommitment to repay misused fundsPlan to improve country systemsPlan for Alliance-wide visit Q2 2017

Global landscapeReporting back on Board decisionsHealth security on the agendaAlliance fit for purpose

15

Inactivated polio vaccine (IPV)55 countries introducedContinued delays due to supply shortagesFurther delays scaling up production: