Akhona Tshangela on Shaping the Agenda of Gavi’s New CEO

What are the most pressing challenges facing Gavi as it embarks on its next strategic period, known as “Gavi 6.0”?

I see three key issues ahead for Gavi. First, Gavi will need to play a role in supporting a diverse procurement base to prevent future bottlenecks, especially during future pandemics. The COVID-19 pandemic laid bare the shortcomings of global vaccine supply chains, which led to shortages and inequitable access across Africa. Gavi’s efforts will have especially big implications for the global vaccine market given its large procurement volumes.

Second, and building on the above, Gavi will need to work with a wide range of manufacturers to operationalize an equitable distribution of producers. Therefore, it would be imperative to spread the geographical scope of their procurement to other regions, including Africa. Building a resilient vaccine manufacturing ecosystem will require strengthening nascent manufacturers to help set them up for effective and sustainable production in a competitive global vaccine market.

Finally, as the manufacturing ecosystem expands, Gavi will need to ensure inclusivity across the vaccine value chain to support women’s economic empowerment. Gavi should identify and address the challenges preventing women and women-owned business from accessing and participating in vaccine production and procurement.

What priority actions should be at the top of the new CEO’s agenda to ensure Gavi can deliver on its mission in Gavi 6.0 and beyond?

Dr. Nishtar’s leadership is needed in three key areas to equip Gavi to facilitate equitable immunization access in the upcoming strategic period. First, Gavi must help advance regional vaccine manufacturing initiatives, especially to ensure supply chain diversity. Gavi’s recently approved African Vaccine Manufacturing Accelerator (AVMA), which is set to launch in June 2024, is an important step in incentivizing local production of vaccines in Africa and making progress towards the African Union’s goal of producing 60 percent of vaccines on the continent by 2040. Dr. Nishtar must ensure Gavi builds on this momentum to effectively operationalize AVMA and, in parallel, modify Gavi’s procurement arrangements to ensure they are inclusive of new suppliers, including those from Africa

Second, Dr. Nishtar should support Gavi in ensuring another element of vaccine supply diversity by promoting gender equity. Gavi can contribute meaningfully to women’s empowerment by seeking opportunities to integrate women-owned businesses into the vaccine value chain. Increasing women’s involvement across the supply chain will contribute to expanding economic opportunities for women as well as building up women’s leadership in the field of immunization

Third, Dr. Nishtar should leverage Gavi’s market shaping capabilities to ensure access to critical vaccines—including for diseases with high burdens in low- and middle-income countries that are not currently produced in adequate quantities, such as cholera. Scaling up production and delivery of relevant vaccines will help overcome shortages in lower-income settings and maximize the impact of existing vaccine technologies.

What does success look like for Gavi’s new CEO?

Success for Dr. Nishtar’s tenure as Gavi’s CEO will be measured by progress made in advancing equitable access to vaccines. A critical component of this overarching objective will be addressing women’s health issues, including expanding access to the human papillomavirus (HPV) vaccine. For example, Dr. Nishtar should lead Gavi in testing new approaches to address gender-related barriers, such as making HPV vaccine available for boys, as well as girls, to alleviate fears in regions that only vaccinate girls at present. Lastly, success also includes having more African manufacturers as part of the supply chain of vaccines procured through Gavi, thus ensuring equitable distribution of vaccines.