Dr. Joanne Liu 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”?

Gavi faces both internal and external challenges. In terms of internal challenges, Gavi will need to realign and redirect its focus towards routine immunization for children under five-years-old following the COVID-19 pandemic. COVID-19 propelled Gavi on the world stage and hijacked Gavi’s agenda, given Gavi’s role leading COVAX. Gavi will need to recenter staff on its core mission—and will need to work on selling its mission and its Gavi 6.0 strategy to donors, who are also fatigued by the pandemic.

In addition, Gavi will need to consider the proportions of its new strategic plan dedicated to its core business as well as new initiatives. This includes whether it will dive into adult vaccination as well as rethinking its role in the research and development of new vaccines for emerging infectious diseases. It must first determine its ambitions in these directions before discussing specifics, such as Gavi’s support for HPV vaccines going forward. These decisions will inform donors and shape Gavi’s investments.

A key challenge for Gavi, along with other vertical global health initiatives like the Global Fund, is determining its raison d'être and future trajectory. Many people—donors especially—are wondering whether these initiatives are at the end of their cycle, if they should merge in some way, and/or if they should be financed indefinitely. Gavi, under Dr. Nishtar’s leadership, will have to prove its added value and consider its role in the broader global health ecosystem.

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?

First, and in line with the above, Dr. Nishtar must lead the charge to “stabilize the house” following the COVID-19 pandemic. During the pandemic, Gavi’s leadership focused its attention on COVAX, moving some other programs, like routine immunization, out of the spotlight. Dr. Nishtar will need to restore a sense of belonging and ownership of Gavi’s core mission among Gavi’s staff in the post-COVID era.  

Médecins Sans Frontières experienced a similar dynamic during the Ebola outbreak from 2014 to 2016: MSF’s leadership was absorbed by Ebola, and regular programs were not given as much attention, which left some staff feeling less valued and disconnected from the central action. Learning from this experience, Dr. Nishtar should help ensure that Gavi’s staff and donors are mobilized around a powerful and clear mission following the COVID-19 pandemic.

The other priority is, of course the new fundraising cycle. It is going to be hard in the current context. Half of the planet is going into election cycles. Some of these countries may swing more conservative and may not prioritize immunization. Potential shifts in donor budgets and priorities need to be mitigated upstream.

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

Dr. Sania Nishtar has a very different profile from her predecessor, Dr. Seth Berkley, who served as Gavi’s CEO for 12 years. In the midst of transition, the proxy of success will be keeping the house together, especially in the first 18 months. It will be critical for Gavi's staff and partners to recognize Dr. Nishtar as the new leader and rally behind her.

Success will also mean making sure that the replenishment exercise strikes even, meaning that Gavi raises at least as much for its next five-year cycle as it did for its current period (2021–2025). Dr. Nishtar will need to ensure donors and partners continue to prioritize Gavi, knowing that it will be tough to navigate the challenges that lie ahead.