Gavi, the Vaccine Alliance (Gavi), is an international organisation that was created in 2000 to improve access to new and underused vaccines for children living in the world’s poorest countries. Based in Geneva, the Alliance comprises major public and private stakeholders in immunization. It includes developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry in both industrialised and developing countries, research and technical agencies, civil society, the Bill & Melinda Gates Foundation and other philanthropists. Gavi aims to reach 300 million children between 2016 and 2020, preventing 5-6 million deaths over the long term.

Two key factors that sets Gavi apart from other global health actors is its public-private partnership model – allowing it to capitalize all stakeholders’ comparative advantages – and its business model.  Drawing on the individual strengths of the Alliance partners, Gavi pools demand for vaccines from the world’s poorest countries, guarantees long-term, predictable funding, and brings prices down. A cornerstone of this model is Gavi’s efforts to improve the health of markets for vaccines and other immunizations. In 2016, the Gavi Secretariat, UNICEF and the Bill & Melinda Gates Foundation jointly developed a “healthy markets framework.

Gavi also provides countries with health system strengthening support to sustainably improve equity in immunisation coverage, encouraging governments to engage civil society organizations in this work. It addresses health system bottlenecks primarily in four areas: supply chain; data availability, quality, and use; community engagement; and, in-country leadership, management, and coordination.

Eligibility for Gavi support is determined by a country’s Gross National Income (GNI) per capita according to World Bank data. When demand for support from Gavi-eligible countries is higher than available donor resources, Gavi applies a prioritization mechanism to country proposals based on criteria intended to maximize health impact and value for money, reinforce financial sustainability of immunization programmes, support countries with the greatest need, and promote equitable distribution of Gavi’s resources. 

From the beginning of Gavi support, governments are expected to co-finance vaccines by financing a fraction of the needed doses. Gradually, as national income levels grow, co-financing levels for governments increase. Once countries have surpassed Gavi’s eligibility threshold, they enter an accelerated transition process.