Mercy Mwangangi on Shaping the Agenda of Gavi’s New CEO

Mercy Mwangangi
June 10, 2024
Janeen Madan Keller and Morgan Pincombe introduce this blog, which is part of CGD’s new virtual forum, “Shaping the Agenda of Gavi’s New CEO.” The forum features a series of expert perspectives, including the response below, and is part of CGD’s broader work on priorities and policy options for Gavi during its 2026–2030 strategic period.

Gavi’s new CEO, Dr. Sania Nishtar, took the helm earlier this year—at a critical time. Gavi is embarking on its new five-year strategy, known as “Gavi 6.0,” and preparing to launch its next replenishment campaign.

To help shape the new CEO’s agenda, CGD invited contributions from experts across governments, civil society organizations, global health initiatives, humanitarian organizations, industry, and academia. We asked these experts to weigh in on key challenges and opportunities for Dr. Nishtar’s leadership.

The response below is from Mercy Mwangangi, Director, Health Systems Strengthening, Amref Health Africa; Co-Chair, Future of Global Health Initiatives. This response has been edited for clarity and length.

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

The 6.0 strategy needs to be centered around the goals and imperatives of equity. It is important to center this discussion on what is happening right now in our ecosystem. The world is recovering from the aftershocks of the pandemic, including economic disruptions. At the same time, there is a high risk of another pandemic. We are also struggling with conflict and climate change. All of these factors tie into Gavi’s ability to meet its targets and goals.

Having served as the Deputy Minister of Health in Kenya and now as a public practitioner at Amref Health Africa, I am increasingly certain that we do need to continue investing in Gavi. But Gavi will need to consider shifting its approach, compared to the last five strategic periods. In this new strategic period, Gavi will need to adjust how it implements its programs, engages with countries, and mitigates risks.

It would be remiss of countries to hinge on a sunset clause as a way to improve efficiency in global health financing. Reflecting on my participation as co-chair of the Future of Global Health Initiatives process, I believe the risk of vulnerabilities and challenges will remain high—so we need to sustain this resource. I would encourage Gavi to consider feasible areas of collaboration and integration that can enable the efficiencies demanded of it. But beyond that, Gavi’s targeted support will still be necessary.

Gavi will also need to re-engineer its approach to get to unreached children, especially since some unreached children have been further displaced by economic disruptions and the climate crisis.

Being in the field right now, I see that certain communities in Ethiopia and Kenya, for example, have moved farther out of reach.

As we address challenges, it is also important to appreciate Gavi’s efforts and impact over the years through its investment in immunization, alongside other collaborative efforts delivered through the Alliance.

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 will be walking into different challenges than those experienced by past CEOs. But I think she will be able to lead Gavi through these challenges with collaboration and partnership with Alliance partners and the extended community.

A priority area for Dr. Nishtar will be the sustainability of immunization investments and systems. Dr. Nishtar will need to focus on Gavi’s ability to catalyze domestic resource mobilization for immunization services. Dr. Nishtar will also need to help make the case to countries that investing in immunization services is a key part of investing in broader health systems. Beyond vaccines, we also need healthcare workers, suitable equipment, necessary logistic frameworks, and strong supply chains to serve unreached populations. Relatedly, Gavi must also appreciate that many countries, particularly in Sub-Saharan Africa, are nearing debt crisis levels.

Integration and adapting to increasing regionalism will also be a top agenda item. Because of the pandemic, most countries are increasingly focused on national resilience and self-reliance. Gavi played a pivotal role during the COVID-19 pandemic in availing vaccines, particularly for marginalized communities. Gavi has already made strides in response to lessons learned from the COVAX experience and calls for greater support for market shaping and decision-making at the country level.

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

Success will be measured in different ways. One of Dr. Nishar’s immediate tasks will be to mobilize resources for the new replenishment cycle—and therefore, I think an immediate measure of success would be to sustain the investment amount, if not, increase it. I, for one, will champion that we are going to need extra dollars to address the current challenges, including climate change, economic disruptions, and conflict states.

Another measure of success will be to increase the resiliency of health systems. Dr. Nishtar should lead Gavi in working more closely with countries to strengthen health systems, especially to better serve unreached populations.

As a public health practitioner, as part of the civil society community, and having worked in this space for a while, I stand to support Gavi’s CEO and wish her the best of luck in this endeavor. I want her to know that she does have partners at hand who will be able to help her achieve her mandate.


CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.