Board -202 3-Mtg -02 1
Minutes

Gavi Alliance Board Meeting
26 -27 June 2023
Global Health Campus, Geneva, Switzerland

1. Chair’s report

1.1 Noting that the meeting had been duly convened and finding a quorum of
members present, the meeting commenced at 14 .05 Geneva time on
26 June 202 3. Prof Jos é Manuel Barroso, Board Chair, chaired the meeting.

1.2 The Chair welcomed new Board members and Alternate members attending
for the first time, namely: Eduardo Retes of Honduras , Greg Widmyer of the Bill
& Melinda Gates Foundation and Me llissa Hisko of Canada .

1.3 The Chair welcomed a number of high -level observers from Brazil, Saudi
Arabia , South Africa and Spain . He also welcomed Kenneth Lay, International
Finance Facility for Immunisation (IFFIm ) Board Chair , and other directors of
the IFFIm Board , as well as representatives from Nestor Advisors , the external
firm which is undertaking the ongoing Board and Board Committee evaluation.

1.4 He provided a brief summary on a number of preparatory meetings that took
place on the eve of the Board meeting , including the meeting of the
Implementing Country Caucus and the All Chairs Group (ACG) .

1.5 The Chair highlighted the Gavi Mid -Term Review (MTR) event that had taken
place on 13 -15 June 2023 in Madrid at the invitation of the Government of
Spain , whom he thanked for their commitment to global health. He underlined
the importance of the MTR in reviewing the progress of Gavi ’s objectives and
commended the Alliance for reaching the milestone of 1 billion children
vaccinated since Gavi’s inception in 2000.

1.6 The Chair noted that during the closed session earlier that day he had informed
the Board of a critical development related to the CEO position. Dr Muhamm ad
Pate , who was expected to assume his role as the new Gavi CEO on
3 August 2023 had informed Prof Barroso on the eve of the Board meeting that
he will not be able to join Gavi as he has accepted a request to return and
contribute to his home country , Nigeria . The Chair explained that in view of this
the Board had agreed to appoint the Chief Operating Officer (COO) David
Marlow, as interim CEO (and therefore a non -voting Board member) until a new
CEO has been recruited . He noted that the Board had also received an update
from Mr Marlow on the Operational Excellence initiative during the closed
session .

1.7 Standing declarations of interest were tabled to the Board (Doc 01a in the Board
pack).

1


Board -2023 -Mtg -02 -Doc 01c

Report to the Board
26 -27 June 2023

Subject No -Objection Consent Decisions
Agenda item 01 c
Category For Information


Since the December 2022 Board meeting, four decisions have been circulated
electronically for approval by no -objection consent in line with Section 11 of the Board
and Board Committee Operating Procedures.
1) On 10 February 2023 , Board Members were invited to consider approv al of the
appointment of Board and Committee Members .

No objections were received prior to the end of 22 February 2023 and the following
decision was therefore entered into the record:

In accordance with Section 11.3 of the Board and Board Committee Operating
Procedures, on a no -objection basis, the Gavi All iance Board:

a) ?Appointed Bruce Aylward as Board Member representing WHO in the seat
currently held by Zsuzsanna Jakab, effective immediately and until his
successor is appointed

b) ?Appointed Greg Widmyer as Alternate Board Member representing the Bill &
Mel inda Gates Foundation in the seat currently held by Alaa Murabit effective
immediately and until his successor is appointed

c) Appointed the following to the Market -Sensitive Decisions Committee effective
immediately:
? Greg Widmyer (Alternate Board Member) un til 31 December 2023

d) Appoint ed the following to the Governance Committee effective immediately:
? Kate O?Brien (Alternate Board Member) until 31 December 2023

2) On 28 March 2023 , Board Members were invited to consider approv al of the
appointment of an Audit and Finance Committee and an Evaluation Advisory
Committee Member .

No objections were received prior to the end of 11 April 2023 and the following
decision was therefore entered into the record:


In accordance with Section 11.3 of the Board and Board Committee Operating
Procedures, on a no -objection basis, the Gavi Alliance Board:

1

Board -2022 -Mtg -03 -Doc 10 -Annex A
Report to the Board
7-8 December 2022
Annex A: Impact Modelling
In order to inform Gavi governance deliberations on potential future support for
COVID -19 vaccination in 2024 -2025, the Gavi Secretariat commissioned Imperial
College, London , to generate estimates of the potential impact of COVID -19
vaccination over 2024 -2025 based on several different epidemiological and
programmatic scenarios. As such, this annex leads with their analyses and initial
estimates. We were subsequently able to bring in outputs generated by t he Institute
for Disease Modelling (IDM) from the Bill & Melin da Gates Foundation as a partial
comparator in part to address model uncertainty (noting that their work is based on a
set of similar scenarios and assumptions to Imperial?s, but not an exact match) .
The primary outputs sought from these modelling efforts included cases,
hospitalisations, deaths, years of life lost (YLL) averted as well as cost -effectiveness.
Given th at much of the disease burden is in the elderly, it would be beneficial to
compare DALYs for C OVID -19 vaccines versus other vaccines. Unfortunately , this
was unable to be done given the uncertainties. Instead, YLL was used, which
constitutes the largest po rtion of the DALY s los t. For more details on the specific
scenarios, assumptions and limitations across both Imperial and IDM?s work, technical
summaries have been made available as appendices on Board Effect.
Topline summary based on modelled outputs from Imperial and IDM
Initia l results from both Imperial and IDM suggest the following:
? Modelled estimates from both Imperial and IDM broadly support the proposed
COVID -19 programme in 2024 -2025 being brought for discussion to the Gavi PPC
and Board (yearly boosting of high/highest p riority groups) as laid out in Doc 10 .
Continuing COVID -19 vaccination in 2024 -2025 has benefits, but the overall
expected health impact is lower than that seen earlier in the pandemic.

? Initial projections for the proposed 2024 -2025 programme show deaths averted
ranges comparable to the current Gavi core routine immuni sation portfolio (albeit
on the lower end). However, after incorporating costs , the proposed programme
appears to compare relatively less favourabl y from a value -for -money perspective
than Gavi core supported vaccine programmes.

? While expanding the vaccination programme to include broader population groups
such as all adults, adolescents and children results in greater total health impacts,
it is less efficient in tha t the expected cases and deaths averted per fully vaccinated
person declines when including younger age groups in the program.

? Results are highly sensitiv e across several key uncertainties including:
- Epidemiological evolution
- Assumptions around waning i mmunity and affinity maturation
- Vaccine efficacy assumptions across different vaccine products
- Coverage levels assumed at end of 2023 and for 2024 and 2025
- Cost (both procurement and delivery)