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Get the latest updates and view the progress made in one of global health's most ambitious reform programmes.

Simplicity·Transparency·Synergy

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Progress at a glance

Eleven reform areas, one direction of travel

See how far we've come and how far we have to go in each area.

Before → Implemented → Results → Next

Progress tracker

Pick a reform area, then open a sub-topic to follow its full journey.

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Country centricity and sustainability reforms

In progress
How it was before
  • Countries had limited decision making authority over key aspects of immunisation support.
  • Technical assistance delivered largely through predefined partner arrangements, with countries having little influence over the selection of partners supporting major parts of their immunisation programmes.
  • Gavi funding was spread across multiple earmarked funding streams, each with separate requirements and application processes, constraining countries’ ability to allocate resources according to their priorities and reduced flexibility to respond to evolving needs.
Changes put in place
  • Decision-making authority has been significantly shifted to countries.
  • The introduction of a single country vaccine and cash budget provides greater predictability and flexibility, enabling countries to take a longer-term view of immunisation planning and allocate resources in line with national priorities.
  • Countries have a stronger role in determining which technical partners support their immunisation programmes, based on expertise and ability to deliver.
  • With support better tailored to local contexts and priorities, accountability to national stakeholders, and country leadership of immunisation programmes are both strengthened.
  • Technical partners are encouraged to be more responsive to country needs and delivering support where it adds the greatest value.
Results achieved
  • Feedback received from countries on the changes made was overwhelmingly positive.
  • First country applications for vaccine and cash budget have been submitted, demonstrating strong adoption of the concept.
Next steps
  • Roll out of the new funding architecture across all Gavi-supported countries is expected to be completed by the end of 2027.
How it was before
  • Multiple funding levers, each with separate guidance, applications, budgets and submission windows.
  • High administrative burden and transaction costs for countries.
  • Fragmented grant cycles and funding processes.
  • Limited visibility of grant status and reliance on manual grant management processes.
Changes put in place
  • One consolidated cash grant, replacing multiple funding levers.
  • One funding guideline and one country application with a single budget, narrative and accountability framework.
  • Grant cycles aligned with Gavi’s 5-year strategy to improve predictability and planning.
  • Digital Grants Management Systems (GMS) launched, providing countries, partners and the Secretariat with end-to-end transparency through dedicated portals.
  • Country letters, workshops, guidance and change-management support provided to facilitate the transition.
  • End-to-end grants system replacing manual workflows, covering application development, submission, project management and close-out in one tracked system.
Results achieved
  • Significant reduction in administrative burden and transaction costs for countries.
  • Greater transparency and real-time visibility of grant status, funding decisions and programme implementation.
  • First two country applications have been submitted via the GMS. Foundational funding grants live in the system.
Next steps
  • Finalisation of country portal submissions, and additional digital capabilities (October 2026).
  • Complete full lifecycle functionality to make the system truly end-to-end.
How it was before
  • Grant making system operated on a first come first serve basis, which resulted in unintended intercounty inequities and periodic overshooting of the forecast.
Changes put in place
  • Country vaccine budgets have been introduced to ensure transparency, inter-country equity, and greater country choice.
Results achieved
  • Country vaccine budget policy approved in 2025 and successfully implemented in 2026.
Next steps
  • Policy has been communicated to countries and its implementation is underway.
How it was before
  • AVMA was structured as a $1bn, 10-year instrument to support African manufacturing, structured around a set of tiered incentive payments.
  • Changes in the African manufacturing ecosystem led to risk that support to manufacturers could be delayed, threatening sustainability of key players in the market.
Changes put in place
  • An additional $190m “AVMA+” approved by the Gavi Board in July 2026 to respond to changes in the operating environment and support African Vaccine Sovereignty.
  • $ 140m targeted towards supporting the purchase of African-made vaccines during the 6.0 period – helping to maintain sustainability and competitiveness of near to market vaccines.
  • $50 targeted towards supporting development of the broader manufacturing ecosystem through key activities at Africa CDC, WHO and the African Medicines Agency.
Results achieved
  • Following AVMA+ reforms, the first AVMA payments to African manufacturers are expected to be awarded at the end of 2026/early 2027, depending on regulatory progress and tender results.
Next steps
  • A ‘rapid course correction’, to be completed by December 2026, has been approved by the Gavi Board to examine levels of support provided to manufacturers under AVMA’s tiered incentives to ensure they remain fit-for-purpose.
How it was before
  • In Gavi 5.0, the financial assurance and technical assistance model was applied in a more standardized way across countries.
  • The level and scope of financial management assurance, AP support and technical assistance were not significantly differentiated according to country risk, capacity, grant complexity or implementation needs.
  • As a result, support was less tailored to specific country contexts or need.
Changes put in place
  • Gavi 6.0 has adopted a more differentiated and risk-based country financial management model, with Financial Management Risk Assurance (FMRA) rolled out to strengthen the use of country systems while managing financial risk, and Assurance Providers (AP) technical assistance is assessed and tailored according to country needs.
  • Terms of Reference and scopes of work are more closely aligned to countries’ risk profiles, capacity gaps and implementation context, enabling more targeted assurance and support.
  • Partnership collaborations put in place, specifically targeting training for in-country finance professionals and budget owners at Ministry level.
Results achieved
  • Gavi 6.0 has enabled a more targeted use of financial management assurance and technical assistance resources
  • Support better matched to country risk and capacity needs
  • Enabled greater use of country systems, while supporting improved cash management, absorption and financial oversight
  • Provided a clearer framework for prioritizing assurance and support, rather than applying a uniform approach across countries.
Next steps
  • Continue rolling out FMRA and differentiated AP technical assistance to strengthen the use of country systems while maintaining appropriate financial controls.
  • Further embed risk-based assurance, improve cash management and absorption monitoring and continue advancing digital payments and country digitisation as priorities for sustainability.
How it was before
  • Lack of financing mechanism and partner ecosystem available to countries to scale up high impact immunisation delivery innovations.
Changes put in place
  • A partnership was established between Gavi, Grand Challenges Canada (GCC) and 500 Global to offer a mix of concessional finance, commercial capital and technical assistance to innovators and countries to de-risk and sustainably finance the scaling up of high impact immunisation delivery innovations.
Results achieved
  • Pipeline of 80 potential investment opportunities has been built, with due diligence in progress on a shortlist.
Next steps
  • First financing close expected by end of 2026, to be followed by initial investment approvals.
How it was before
  • Joint-financing arrangements between Gavi and the World Bank was limited due to ad hoc approach to aligning immunisation financing in countries.
Changes put in place
  • Strategic programme established to enable more joint financing in Gavi-supported countries linking Gavi’s cash support and MDB concessional financing.
  • MOUs agreed between the World Bank, ADB and AIIB with agreed balance sheet capacity to support a significant expansion of joint financing in 6.0 – should this be supported by Gavi countries.
  • Revised guidance to countries on joint financing and the MDB multiplier issued as part of the Gavi LEAP reforms
  • Briefings held with MDBs, Alliance Partners and Countries to clarify the scope of the initiative – and to stress its voluntary nature.
Results achieved
  • 5 countries ‘tracer’ countries identified for pilot joint financings in 2026 or 2027.
  • Second tier of opportunities identified for later in the strategic period – dependent on lessons learned.
Next steps
  • Delivery of planned ‘tracer’ countries’ financing to be approved by Gavi and by MDB Board in 2026-2027.
  • Broader roll-out of the programme, if warranted, to be shaped by learnings from tracer countries. .

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