Got vaccines? Got life!

Gavi’s 2016–2020 Mid-Term Review report

Got vaccines? Got life!

Published midway through the 2016–2020 reporting period, this 24-page report describes Gavi’s progress in delivering on the four main Investment Opportunity commitments made at the 2015 Berlin pledging conference.

It also assesses how the Alliance is adjusting to its remaining challenges and setting a vision for the future.


Goal 1: Immunising 300 million more children

Making progress: from 2016 to 2017, Gavi helped countries to reach an additional 127 million children – usually with more than one vaccine. This is helping to avert 2.5 million future deaths, which represents 42% of the 2020 target. Children are being reached with more vaccines than ever before; average coverage for the last dose of nine Gavi-funded vaccines has risen by 11 percentage points since 2015.

Adapting to challenges: while coverage in Gavi-supported countries has increased slightly, it has not progressed as fast as expected, especially in fragile countries. The Alliance has adopted a range of new responses. These include both targeting populations with disproportionately low coverage rates or the highest numbers of underimmunised children; and channelling most health system strengthening (HSS) grants into a number of strategic focus areas to improve coverage.

Immunise 300m additional children

Prevent 5–6m future deaths


Goal 2: Increasing co-financing and transition

Making progress: empowering countries to take ownership of their vaccination programmes is core to the Alliance’s business model. Gavi-supported countries are allocating an ever-greater proportion of domestic resources towards immunisation. Of 20 countries due to transition out of Alliance support by 2020, 16 are already fully self-financing their vaccine programmes. Eight of these have been fully funding their vaccines and maintaining coverage rates for over a year.

Adapting to challenges: despite maintaining high immunisation coverage rates, some transitioned countries face programmatic challenges, while several are transitioning without having introduced critical vaccines. Five countries – Angola, the Congo, Nigeria, Papua New Guinea and Timor-Leste – face more deep-rooted obstacles to increasing coverage. Alliance partners are addressing these challenges through more systematic post-transition engagement and tailored plans.

Transition 20 countries

All countries co-financing


Goal 3: Ensuring healthy vaccine markets

Making progress: building healthy vaccine markets is critical to Gavi’s long-term success. Market shaping activities have generated US$ 764 million in savings since 2016 by ensuring sufficient supply of quality vaccines at affordable prices, while the weighted average cost of fully immunising a child with three life-saving vaccines fell by 17%. Three vaccine markets are showing moderate or high healthy market dynamics – 50% of the 2020 target.

Adapting to challenges: supply issues for a few critical vaccines continue to jeopardise the Alliance’s ability to meet country demand, hampering some introductions. The exit of one manufacturer from the pentavalent market shows the risks of over-supply, high competition and decreasing prices. While this is an expected part of market development, it needs to be carefully and transparently managed.

Healthy vaccine markets

Vaccine price indicator


Goal 4: Immunisation’s wider impact on development

Vaccines have far-reaching benefits for global development. Healthy children can go to school and grow up to become productive adults while parents can work instead of looking after sick children, thus significantly boosting a country’s economy. Since 2016, Gavi-supported vaccinations have generated long-term economic benefits of over US$ 50 billion.

By reaching approximately 65 million children annually in Gavi-supported countries, vaccination also contributes to universal health coverage, which is part of the third SDG. Immunisation connects the vast majority of families with the primary health system up to five times in the first year of a child’s life – more than any other health intervention. It ranks among the most equitable interventions, disproportionately benefiting the most marginalised populations.

US$ 80–100bn in economic benefits