Dr. Endie Waziri, the chair of the Gavi CSO Steering Committee, welcomed participants and highlighted the vital role of civil society in shaping global health strategies and ensuring equitable access to life-saving vaccines. She emphasised the importance of the Vaccine Investment Strategy (VIS) in guiding Gavi’s support for new or underused vaccines through a rigorous process of evidence-based analysis and extensive consultations. The VIS aims to evaluate the impact, cost-effectiveness, and feasibility of vaccines, ensuring that Gavi’s vaccine support programs prioritise the most critical needs.

Gavi provided an update on the progress of the VIS analysis since the December 2023 board meeting. They explained the methodology, which includes both quantitative and qualitative review of evidence of vaccines against both endemic and epidemic diseases, health and economic impact modelling, and consultations with independent experts, constituencies, key stakeholders at regional and national level including EPI programmes. The VIS aims to facilitate strategic decision-making on which vaccines to invest in, provide predictability to manufacturers and countries, and inform Gavi’s strategy and resource mobilisation. The feasibility of implementing new vaccination programmes is considered and alongside the investment cases for vaccine programmes, proposals for research on operational questions are developed. Gavi highlighted the key governance steps, evidence gathering, and consultations conducted, including a country survey and a meeting with the independent steering committee.

Presentations were made on the investment options for routine/preventive vaccine programmes , including Shigella, Group B Streptococcus (GBS), Dengue, and Tuberculosis (TB). For Shigella, the potential impact on stunting and long-term sequelae was highlighted, but market and feasibility risks were noted due to the young vaccine pipeline and low awareness of the disease burden. For GBS, a maternal vaccine, the high direct impact on mortality and morbidity, equity considerations, and the need for substantial investment in health system strengthening were discussed. For Dengue, the potential to address the increasing global burden, particularly in middle-income countries, was presented, but challenges around data availability and implementation were noted. For TB, the high health impact, value for money, and country interest were emphasised, along with the high investment required, feasibility challenges, and the need for stakeholder engagement were highlighted.

The consultation discussed investment options for a potential time-limited COVID-19 program from 2026 onwards. Three options were presented: discontinuing the program, continuing with a routine programme under Gavi’s regular co-financing policies, or continuing the existing routine program with exceptionally high costs. The key benefits, challenges, strategic fit, value for money, market implications, and feasibility considerations were discussed. The guidance from the Gavi CSO Steering Committee was to discontinue the programme, as country demand is likely to decrease, and a stockpile was not recommended due to the large size required and lack of broadly protective vaccines.

The consultation covered investment options for vaccine stockpiles for outbreak response , specifically Hepatitis E and Monkeypox (Mpox). For Hepatitis E, a stockpile investment by Gavi was presented as aligned with partner activities, having a high impact on equity and mortality in vulnerable populations, and coming at a relatively low cost. The Gavi CSO Steering Committee supported an investment in a stockpile when a prequalified vaccine becomes available in 2029. For Mpox, the analysis showed that an investment could address key evidence gaps and ensure access to vaccines in low- and middle-income countries facing outbreaks. Three investment options were discussed: monitoring the situation, engaging with partners and manufacturers, and signalling the intention to procure a vaccine for a stockpile contingent on regulatory approvals.