Updated eligibility and transition and co-financing policies for Gavi 6.0 and new cash grant policies

At the December 2024 board meeting of Gavi, the Vaccine Alliance, which took place in Indonesia, the board approved several changes to Gavi’s Eligibility and Transition and Co-financing (ELTRACO) policies for Gavi 6.0, and new policy options for update Gavi’s Health Systems and Immunization Strengthening (HSIS) Policy for Gavi 6.0.

Changes to ELTRACO include six strategic shifts, a support package for Small Island Developing States (SIDS), and a new Catalytic Phase. Included in the strategic shifts are increasing the Gavi eligibility threshold to US$ 2,300 Gross National Income per capita in 2026, directly linking country co-financing contribution to the price of the vaccines for specific vaccine markets, where certain conditions are met, introducing a co-financing cap for individual Gavi-supported vaccine programs for countries in Preparatory Transition of 80%.

The new HSIS policy options approved were: i) the consolidation of funding levers to better align programming and simplify processes for countries; ii) a new allocation formula for a consolidated grant; iii) necessary guardrails to protect key investments; and iv) options to promote co-investment from countries in health systems and cold chain equipment. Among several changes, the cash grant policy will use a new allocation formula, that takes into account ability to pay, equity, health system performance and population size using the following indicators: gross national income per capita and three-year averages of the number of children missing the first dose of diphtheria, tetanus, and pertussis vaccine (DTP1), the number of children missing the third dose (DTP3) and the number of children missing the second dose of measles containing vaccine.