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
Nabeeha Kazi Hutchins, President and CEO, PAI. 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”?
Vaccines and immunizations are not only among the most cost-effective health interventions in the world; they also work. Accelerating access and use are essential in this next phase for Gavi and should be parallel priorities alongside ongoing R&D and innovation. However, access to and utilization of existing vaccines are strained. From a civil society vantage point, this is due to a lack of trust in health innovation, unreliable systems and services, poor government and health systems accountability, and competing domestic priorities.
COVID-19 has only exacerbated suspicion of vaccine development and immunization program implementation. In addition, the hijacking of health to advance social and political agendas has harmed global health imperatives writ large. Gavi is acutely affected as the attacks on vaccine safety, reliability, and benefits continue and these realities, coupled with a lack of trust in primary health care systems, have a profound impact on vaccination rates and the mechanisms through which Gavi will advance its priorities.
In addition, government and health systems accountability has eroded, given the shrinking space for civil society. With more people voting in elections this year than any other time in history, the reverberations of political change will be felt by global health programs for years to come. Without a well-supported and vibrant civil society as the protectors of progress and the voice of communities, there is no guarantee that governments will continue delivering on commitments for health and development.
Last but not least, the upswell of competing global and domestic priorities that absorb policy attention and funding is a third challenge that Gavi will continue to contend with. When life-saving interventions, such as the human papillomavirus (HPV) vaccine or the hepatitis B vaccine, are challenged due to cultural barriers associated with sexual and reproductive health, or hesitancy towards the diphtheria, pertussis, and tetanus (DPT) increases because of lingering safety concerns and misinformation, policy and resources will divert to other pressing needs that are demanded and desired by communities. Keeping vaccines and immunizations on the policy and funding agendas, both globally and at country level, is essential, while also taking into account Gavi’s mandate in view of the other urgent humanitarian and development challenges that abound.
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, Dr. Nishtar should ensure Gavi prioritizes and elevates the role of civil society to advance evidence, accountability, policy advocacy, and community voices. Gavi has made progress in improving its engagement with civil society for research consultations to inform country-level initiatives and program learning and exchange. A more proactive, intentional, and strategic partnership with regional and Global South civil society networks will better inform future strategies, mitigate harm from misinformation and opposition tactics, and help close the vaccine inequity gap.
Second, Dr. Nishtar can push Gavi to think and act intersectionally by engaging and supporting partners and networks whose mandate is impacted by immunization goals. Bringing in more sectors expands awareness, increases champions, and reduces the community health burden from siloed approaches and policies. For example, engaging the sexual and reproductive health and rights (SRHR) community to advance SRHR-related vaccine access and partnerships with early childhood education advocates to reinforce the safety of child immunization, are intersectional opportunities that can accelerate access through shared agendas and leveraged funding.
Third, Dr. Nishtar has an important opportunity to ensure Gavi approaches future vaccination and immunization goals through a comprehensive lens. Gavi’s agenda can be one that goes beyond a focus on vaccinating communities in the immediate term to also prioritizing a comprehensive policy, community engagement, and accountability approach for sustained impact and achievements. Supporting and building capacity for community sensitization efforts, monitoring progress through mechanisms that are embedded into global and national systems, elevating civil-society advocacy and accountability programs, and translating and amplifying evidence, will enable the achievement of short-term goals, while also ensuring that progress and efforts are maintained in the long term.
What does “success” look like for Gavi’s new CEO?
Success will depend on how effectively Dr. Nishtar makes Gavi’s agenda one that is shared and transparent, validated by national health leaders, supported by the right policies and diverse resources, advocated for by civil society, and desired by communities. Should a groundswell of domestic support be achieved, vaccine hesitancy be reduced, and an enabling domestic policy and health systems environment emerge, the foundation for future impact is unbreakable.
This is a critical moment for Gavi—and Dr. Nishtar is no stranger to what is required. She has served women, youth, and at-risk communities in Pakistan and around the world, with great compassion and thoughtfulness. She brings an equity lens to her work, is trusted, and has always stewarded the interests of local communities as a researcher, physician, civil society advocate, and policymaker. If Dr. Nishtar keeps the perspective of community at the forefront in every step, Gavi’s mandate will be achieved, and the health, well-being, and vitality of communities and the systems that serve our communities will be furthered in immeasurable and lasting ways.
