On 24 April 2024, on a warm Wednesday morning in Antananarivo, Madagascar became one of the latest Gavi countries to formally commence the roll-out of the ‘Big Catch-Up’. How did we get here?
In the aftermath of the COVID-19 pandemic, Gavi faces an unprecedented situation. Billions of dollars that it raised back in 2022 for COVAX the global effort to provide COVID-19 vaccines to lower-income countries remain unspent. These resources are substantial, exceeding the entire annual budget of the World Health Organization (WHO) and are three times the amount allocated to the World Bank-managed Pandemic Fund. However, there is a lack of clarity about how much is remains unspent and a lack of transparency regarding the decision-making process and trade-offs associated with different options to spend this money.
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When Gavi’s board meets in Accra, Ghana, next week, advancing discussions on a new five-year strategic period, known as “Gavi 6.0,” will be a top agenda item. But conversations about Gavi’s future direction are also taking place against the backdrop of a leadership transition and a rapidly changing global landscape that is surfacing challenges for its existing model. As part of an ongoing CGD project on Gavi’s future, together with our colleagues, we’ve compiled a series of analyses and recommendations for Gavi’s board to consider in its upcoming strategy discussions.
Regulation plays a vital role in ensuring the quality, safety, and efficacy of vaccines and a strong regulatory system is key to successfully expanding vaccine manufacturing. The Gavi Secretariat is currently fine-tuning the design of a new Advance Market Commitment (AMC) a financial mechanism to subsidize African-made vaccines and provide the needed “pull” for a nascent, competitive industry.