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Contents 1

Introduction 1

Where Gavi spends its money: Vaccines, and everything else 3

The structural path forward: Stabilization and transformation 5

Balancing the budget: Five areas for potential cost-cutting 7

1. Cut direct funding to non-Gavi MICs and offer alternate forms of high-leverage support ($200 million) 7

2. Scale back Secretariat expenses ($280 million) 7

3. Secure vaccine price reductions ($200 million) 8

4. Reduce funding for the African Vaccine Manufacturing Accelerator ($900 million) 8

5. Decrease overall country allocations with an incremental roll out by eligibility phase ($900 million) 8

Conclusion 10

Tables 4

TABLE 1. Gavi offers funding to countries and partners under a range of different windows and mechanisms [non-exhaustive] 4

TABLE 2. Illustrative reductions to cash-grant support 9

Figures 2

FIGURE 1. Gavi pledges by top historical donors in 5.0 (2021-2025) vs. 6.0 (2026-2030) 2

FIGURE 2. Total budget by phase (2011-2030) 3

FIGURE 3. Summary of proposed path forward for Gavi 6.0 10