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Reach every child UNICEF VIC – 21 October 2020 Dominic Hein Head, Market Shaping Gavi Alliance Update 2019 was a record year of performance, building further momentum on Gavi 4.0 2 3 SG4 indicator

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1 www.gavi.org Reach every child UNICEF VI
www.gavi.org Reach every child UNICEF VIC – 21 October 2020 Dominic Hein Head, Market Shaping Gavi Alliance Update 2019 was a record year of performance, building further momentum on Gavi 4.0 2 3 SG4 indicators: 2019 progress In 2020, Covid - 19 is setting us back amid unprecedented uncertainty 4 Reach zero - dose children Strengthen immunisation delivery & build back better • Adapt immunisation in the context of COVID - 19 • Catch - up missed children (e.g. through intensifi

2 ed routine immunisation) • Sustainably
ed routine immunisation) • Sustainably reach zero - dose children & missed communities • Catalyse delivery of other essential health services • Promoting innovation • Broadening partnerships • Improve the quality and efficiency of immunisation programmes • Scale up transformative innovations & engage communities • Re - imagining surveillance Maintain & restore immunisation Today 2025 Maintaining & restoring immunisation a priority; then roll out of catch - up activities

3 & COVID - 19 vaccines • Immediate supp
& COVID - 19 vaccines • Immediate support to respond to COVID - 19 Respond & protect Opportunity to rebuild better While Gavi 5.0 is more relevant than ever, a few priorities and baseline would shift 6 Gavi is bolstered to deliver on its (recalibrated) 5.0 mission thanks to a successful replenishment 7 Cumulative immunisation and future deaths prevented by 2025 (300 million more children vaccinated; 7 to 8 million more lives saved) World leaders and private sector donors make

4 US$8.8 billion worth of new commitment
US$8.8 billion worth of new commitments to provide equal access to vaccines for all Expectation is for decreased demand in the acute pandemic followed by increased demand Considerations • Delays to routine intros & campaigns Tracking and reflecting short - term delays to routine introductions and campaigns (mainly impacting 2020) - monitoring best internally available information • Disrupted coverage Estimating adverse impact to coverage through a variety of internal sourc

5 es / ongoing studies. Coverage levels a
es / ongoing studies. Coverage levels assumed to recover to pre - pandemic levels in the longer term. • Resumption of activities Expect programme adaption, resumption and additional support to follow public health priority and disease burden (i.e. vaccines for outbreak prone preventable disease may be prioritised for resource allocation) • Impact of a COVID - 19 vaccine A future COVID - 19 vaccine can have a material impact on existing programmes and VIS ( eg : effect on futur

6 e intros) • Economic impact Assessment
e intros) • Economic impact Assessment of the mid/long term impact of economic deterioration on country GNI – this can effect co - financing levels and 8 Uncertainties Information on Short - term delays to routine intros and campaigns is incomplete and still evolving Available information is largely qualitative and complex to translate into a quantitative impact. Assessment sources remain at a relatively early stage of development. WHO guidance on programme adaption / resu

7 mption / additional support is expected
mption / additional support is expected, and can alter assumptions COVID - 19 vaccine in early stages of lifecycle – impact to demand (and potentially supply) for existing programmes is not yet assessed Country GNI impact remains unclear – assessments are ongoing as situation develops Approach for new post - COVID base volume forecasts: Roll - out of VIS vaccines will be deferred until after the acute phase of the pandemic • OCV (preventive in endemic hotspots) • DTP

8 boosters • HepB birth - dose • Rabi
boosters • HepB birth - dose • Rabies PEP • Multivalent Meningococcal • RSV Implementation origin ally set to be implemented during beginning of Gavi 5 . 0 2 . Now likely to be delayed Set to be introduced later in Gavi 5 . 0 pending Board confirmation of suitable products . Possibly delayed if acute phase persists , condition al to i ) Licensure, ii) WHO PQ, iii) SAGE recommendation and iv) Board approved support window Learning agenda will continue in order to inform next VI

9 S, which will kick off in 2023 • P and
S, which will kick off in 2023 • P andemic influenza In June 2020, the Board agreed to defer and reassess 1 the VIS vaccines roll - out until after the acute phase of the COVID - 19 pandemic. 1 We intend to reassess the decision to pause the roll out VIS vaccines after the acute phase of the pandemic and determine the appropriateness of initiating programming for these vaccines based on the evolving impact of COVID - 19 on country capacities and priorities. If this delay con

10 tinues well into the Gavi5.0, we will ne
tinues well into the Gavi5.0, we will need to reassess the investment cases as part of the next VIS in 2023 along with other vaccines in the pipeline 2 Gavi 5.0 refers to Gavi’s next strategic period from 2021 - 2025 9 Gavi’s approach to MICs is also being adapted in the light of Covid - 19 • Comprehensive approach to MICs paused because of Covid - 19 • Former Gavi countries face increased risk of backsliding • Current post - transition engagement is until 2020 only, limit

11 ed to TA • Covax offers opportunity t
ed to TA • Covax offers opportunity to engage with never Gavi - eligible MICs and lay the foundation for broader engagement • Innovative Financing Facility for Procurement • Proposal will not be advanced before June 2022 10 Gavi’s Supply & Procurement Strategy is due for update to support market & 5.0 strategic shifts 11 Programme and Policy Committee 28 - 29 October 2020 ❑ Deep understanding ❑ Desired supplier base outcomes ❑ Principles, tools and processes for stak

12 eholder engagement Shape the dynamics o
eholder engagement Shape the dynamics of the future supplier base ❑ Define indicators ❑ Consolidate initiatives ❑ Clarify MS role on demand, and define a set of principles to guide potential interventions. Address demand health as relevant to SG4 ❑ Build on VIPS ❑ Create enabling environment for priority innovations ❑ Define MS role to mitigate predictable future market failures beyond Gavi 5.0 Accelerate and operationalise innovation ❑ Partnership optimisa

13 tion ❑ Review strategic tools ❖ Fina
tion ❑ Review strategic tools ❖ Financial ‘de - risk’ tools ❖ HMF, demand, cross - market, innov . ❖ Advanced technologies, demand uncertainty ❑ Contribute to regulatory challenges Optimise strategic enablers Four focus areas for 5.0 revision Innovating immunisation products, services and practices will be critical for Gavi 5.0 and beyond Microarray patches (MAPs) Barcodes on primary packaging Heat stable formulations, including CTC www.gavi.org THANK YOU Reach ever