A New CEO at Gavi: Three Opportunities for Impact

Today, Dr. Sania Nishtar assumes her role as Gavi's new CEO. A lot has changed—both within Gavi and in the external environment—since the process began to replace Dr. Seth Berkley, who stepped down last year.

Dr. Nishtar’s appointment comes at a critical time for Gavi. As CEO, Dr. Nishtar will play a central role not only in shaping Gavi’s future direction and setting ambition levels for the next strategy (known as “Gavi 6.0”) but also in ensuring a successful replenishment campaign that will kick off later this year. And she will have to do so as a rapidly changing global landscape is putting pressure on Gavi’s operational model, with implications for its ability to deliver impact.

With this hefty charge in mind, here are three opportunities we see with Dr. Nishtar’s leadership that we’ll be keeping a close eye on over the coming months:

1. Articulate a clear vision for Gavi, backed by a focus on results and impact

As part of setting the overall level of ambition for Gavi 6.0, Dr. Nishtar has an opportunity to institute bold changes—including some that we highlighted in a CGD paper—to ensure Gavi remains fit-for-purpose. “One of the questions for the CEO is, to what extent do I make changes in 6.0 for 6.0? And to what extent do I make changes through experiments in 6.0 that could lead to the big changes in 7.0?,” as Orin Levine, CGD non-resident fellow, raised during a recent CGD event. Gavi’s leadership—and board—must think beyond these next five years to Gavi’s longer-term trajectory for the post SDG-era.

Bringing clarity on key strategic questions will be a critical first step for the new CEO. As Kate O’Brien, Director of the Department of Immunization, Vaccines, and Biologicals at the World Health Organization, underscored at the CGD event: “There are some existential questions we’re struggling for with the Gavi 6.0 strategy development, which is, where’s the balance between equity, meaning access to products and support for programs, and efficiency of the funds that will be provided by donors for gains? And those two are in tension with each other.”

Alongside her breadth of leadership roles across the global health landscape, Dr. Nishtar knows Gavi well, having served as an independent member of its Board in 2016. She was also Chair of Gavi’s Evaluation Advisory Committee, which provides oversight of Gavi’s organizational and programmatic evaluation activities, from 2011–2014. This background can position Dr. Nishtar to help ensure Gavi’s vision is backed by a solid focus on results, impact, and value-for-money—which will be even more critical in this next period as donors’ budgets are increasingly stretched thin.

2. Recenter Gavi on the needs and priorities of Gavi-eligible countries

Dr. Nishtar previously served as a Senator in her home country of Pakistan, where she held numerous roles in the national government, including at the Federal Minister level. A CEO with firsthand experience at the country level—an important first for Gavi—could mark a step towards rebuilding trust with Gavi-eligible countries, especially following the inequities that characterized the COVID-19 pandemic.

Centering perspectives from partner countries will be essential to shift the center of gravity of global health initiatives. “What puts countries in the driver’s seat is working with them, supporting them if you feel they don’t have the strength to set their own priorities, and aligning behind country priorities,” as Justice Nonvignon, Head of the Health Economics Programme at Africa Centres for Disease Control and Prevention and CGD non-resident fellow, noted at the CGD event.

Further, Dr. Nishtar, a Pakistani native, brings a critical perspective to Gavi’s strategic focus on equity and reaching the unreached. As of 2022, Pakistan was home to over 400,000 of the world’s 14.2 million zero-dose children. Understanding and addressing the barriers to reaching un- and under-immunized communities and delivering immunization in these settings will be critical to achieving Gavi’s mission.

3. Champion women’s leadership

It’s been well documented that women are generally missing from leadership roles in the global health and development space, as in many other industries. Estimates for 2023 suggest that only 34 percent of CEOs and board chairs of global health institutions were women. Yet women play a particularly important role in health and immunization outcomes. There are well-established links between children’s immunization status and women’s decision-making, agency, and education, among other factors (see here and here).

As the first woman to hold this position at Gavi, Dr. Nishtar is positioned to help elevate women’s interests and considerations at the highest levels. And she deserves allies—men and women—dedicated to helping her lead Gavi in this critical next chapter.

Shaping the Agenda of Gavi’s New CEO

Dr. Nishtar faces a difficult road ahead. In view of the many—and likely competing—demands on Gavi’s next strategic period, CGD is launching a virtual forum, Shaping the Agenda of Gavi’s Next CEO. This forum will feature commentaries from a range of practitioners, policymakers, civil society leaders, and researchers on the upcoming priorities, opportunities, and challenges for Gavi as Dr. Nishtar takes the helm. Stay tuned for more—and in the meantime, check out this recent event and the rest of our ongoing work on Gavi 6.0.

Thanks to Orin Levine and Javier Guzman for helpful suggestions on an earlier draft.


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.

Image credit for social media/web: UNICEF Somalia/Lisa Hill