3 questions to Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance

Interview with Dr. Sania Nishtar, CEO of Gavi, the Vaccine Alliance

Focus 2030 : Together with the African Union and Gavi, France will co-host the Global Forum for Vaccine Sovereignty and Innovation in Paris on June 20. On this occasion, Gavi will launch its investment opportunity for the years 2026-2030 and present its funding requirements. What are the objectives of this Forum? Who will be taking part?

Dr Sania Nishtar:The event will mark the launch of Gavi’s 2026–2030 Investment Opportunity (IO), which will outline the projected impact of the Alliance’s next five years of work, clarify the funding required to support this effort, and make the case to donors to invest in the future of immunisation.

Since its founding in 2000, Gavi has vaccinated over a billion children, saved more than 17 million lives and helped halve child mortality in 78 countries. But with five years remaining until the deadline of the Sustainable Development Goals, more needs to be done. 1.5 million children still die every year from vaccine preventable diseases.

To do that, we need to keep our existing programmes running and continue to evolve to meet countries needs. We want to be more ambitious than ever, because that’s what is required to meet countries’ needs and challenges such as climate change and fragility.

Gavi’s new strategy will offer the widest portfolio of vaccines in its history, preventing against 20+ diseases, up from just six in 2000. We’ll aim to protect more people faster than ever before. We will also continue to play a key role in global health security, by providing the largest ever set of emergency stockpiles in response to rising outbreaks of deadly diseases like cholera, Ebola, meningitis and yellow fever. A $2.5bn Day Zero Financing Facility backed by innovative finance will form part of world’s emergency response toolkit for the next pandemic.

We are making the case that in a complex world, investing in immunisation is a must-have, not a nice-to-have. Climate Change is creating the conditions for vaccine preventable diseases to spread in lower-income countries, whilst the rising use of antibiotics is causing record cases of AMR – 50% of the vaccines in Gavi’s portfolio help countries adapt and respond to these twin threats.

And of course, partnerships are at the heart of Gavi. Working alongside other actors in global health, Gavi will help countries strengthen health systems and unlock wider benefits. Combining vaccines with nutrition programs will reduce food insecurity. Empowering local actors and a gender-focused approach to immunisation will target hard-to-reach communities. By 2030, we will look to reach more people and families, more often with immunisation and primary health care.

The event will also be the launch of the African Vaccine Manufacturing Accelerator (AVMA), a unique US$1 billion innovative financing mechanism designed by Gavi in close collaboration with the African Union, Africa Centres for Disease Control and Prevention (Africa CDC), G7 and G20, to support a sustainable vaccine manufacturing ecosystem on the African continent.

And we will be doing this in the presence of several Heads of State and Ministers, including from Africa, who will join President Macron, AUC Chair Moussa Faki, and our Board Chair, former EU President and former Prime Minister of Portugal, Professor Jose Manuel Barroso, in Paris. The event will also be attended by leaders from international organisations such as WHO and UNICEF as well as from civil society, industry, government, and the private sector. In other words, a full representation of our Vaccine Alliance.

Focus 2030 : Gavi’s next funding cycle will end in 2030, the target date for achieving the Sustainable Development Goals (SDGs). A recent WHO-led study revealed that vaccination has saved at least 154 million lives over the last fifty years. To what extent could an ambitious replenishment of the organization you lead help to make up for the setbacks in global health since the Covid-19 pandemic? Which vaccines could make the difference in delivering on the 2030 Agenda?

Dr Sania Nishtar:Vaccines have indeed saved at least 1 life every 6 seconds for the past half century. I say at least, because that WHO study only looked at 11 vaccines, and Gavi’s current portfolio offers vaccines against 20 infectious diseases – and this will expand in the next strategic period. Vaccines truly are one of humanity’s greatest achievements, and one of the most cost-effective and impactful health and development interventions we have available to us today. They are a critical tool to make progress against the sustainable development goals.

Building on more than two decades of progress that has seen child deaths in the countries we work go down by a remarkable 70%, in our next strategic period, our goal is to accelerate that progress: reach more people, with more vaccines, faster than ever before.

We will vaccinate hundreds of millions of children by 2030, saving millions more lives in the world’s poorest countries.

The core of Gavi’s new strategy will remain the introduction and scale up of vaccines. This period will offer the widest portfolio in Gavi’s history, increasing coverage of traditional childhood vaccines whilst also expanding access to the most impactful tools and latest breakthroughs and innovations.

For example, more young women and girls than ever will be protected from cervical cancer with the HPV vaccine, and millions more children will receive the new malaria vaccine once it is rolled out at scale. This is a game changing new tool against an age-old disease which can help reduce overall child mortality by up to 13%.

Gavi’s traditional vaccine programmes play a foundational role in global health security. Immunisation systems are a first line of defence to stop dangerous pathogens from crossing borders, and we’ll continue to make investments that strengthen health systems’ ability to detect, respond and remain resilient in the face of threats. We’ll also be making our largest ever investments into emergency stockpiles that will help countries respond to rising numbers of deadly disease outbreaks like cholera, Ebola and yellow fever. Further, around half of the vaccines in Gavi’s portfolio will protect people from the twin-threats of climate change and antimicrobial resistance, and support countries to adapt to this new reality.

By 2030 Gavi will facilitate more than a billion touchpoints between families and health services. This will require integrating immunisation more deeply into primary healthcare – working tirelessly alongside new and existing partners in new ways to strengthen health systems, reach more women and zero dose children and unlock wider benefits, including for health security.

And through it all, Gavi donors and implementing countries will continue to enjoy the unparalleled return on investment of vaccines, supported by Gavi’s unique innovative, efficient, and sustainable funding model. We’ll be using our market shaping skills to lower vaccine prices, and implementing countries will continue to contribute to the cost of immunisation programmes – supporting the overall push towards sustainability.

Focus 2030 : The African Vaccine Manufacturing Accelerator (AVMA) will be launched on this occasion. Drawing on the lessons of the Covid-19 pandemic, this innovative mechanism will provide financial support for regional vaccine production and contribute to the African continent’s vaccine sovereignty. To what extent will the AVMA be a game-changer? How will it be financed and implemented?

Dr Sania Nishtar:Following more than 18 months of close collaboration between Gavi, the African Union and Africa CDC, our Board in December 2023 approved the establishment of the African Vaccine Manufacturing Accelerator (AVMA). AVMA is an innovative financing mechanism that has been designed to provide a pathway to a sustainable African vaccine manufacturing sector, while improving the region’s resilience in the face of pandemics, outbreaks and other health emergencies, all the while being careful not to compromise the health of vaccine markets globally.

AVMA aims to make up to US$ 1 billion available to manufacturers, by offering a “pull” incentive at the end of the vaccine value chain – via subsidies – for vaccine candidates that progress through critical stages of development. This offers assurance to manufacturers who reach this stage that they can offset some of the high initial investments that must be made in vaccine production – and sends a powerful market signal to other actors to invest in earlier stages of research and development. AVMA’s design is based on evidence and extensive consultation and collaboration across a broad spectrum of stakeholders, including partners, donors, industry and civil society organisations.

By predominantly directing subsidy support towards vaccines whose drug substance is manufactured in Africa, with initial consideration also given for “fill & finish only” projects using imported drug substance, AVMA’s objective is to help nurture an ecosystem that encompasses the entire vaccine value chain. These subsidies will apply to the full Gavi portfolio of supported vaccines, with “priority vaccines” and vaccines produced on pandemic-appropriate drug substance platforms eligible for a higher rate of subsidy, as well as for a lump sum award on attainment of WHO prequalification for the product.

Building a sustainable manufacturing sector in Africa will take time and political commitment from the region’s leaders. AVMA’s aim is to catalyse this, and in so doing help set the AU’s vision of producing 60% of its vaccine needs by 2040 on a positive pathway, setting in process the establishment of an enabling environment – encompassing areas such as regulatory frameworks, infrastructure, human capital development, trade policy, and assured demand from African countries for African-made products.

NB: The opinions expressed in this interview do not necessarily reflect the ideas of Focus 2030.