Over the past 20 years, Gavi has helped immunize more than 1.1 billion children worldwide. As countries’ economies grow and they transition out of Gavi’s support, many face the challenge of maintaining strong immunization programs to sustain and build on this progress.
Gavi’s sustainable financing model encourages countries to take over funding their immunization efforts as soon as they can afford it. However, many still require assistance to ensure their health systems remain resilient enough to preserve decades of gains, explains Charles Bleehen, Head of Development Finance at Gavi.
Multilateral development banks (MDBs) play a crucial role by providing affordable financing to help countries invest in immunization infrastructure. These institutions, supported by multiple governments, offer loans, grants, and expert advice often at concessional terms, helping developing countries tackle poverty, fragile economies, and infrastructure deficits.
MDBs tailor financing terms to each country’s capacity to repay, with the poorest often receiving grants and others benefiting from low-interest loans with extended repayment periods. This approach supports stronger primary health systems, which underpin sustainable immunization programs.
Since its founding, Gavi has partnered with the World Bank, which has co-financed $3.2 billion in health and nutrition programs across 12 countries, alongside $278 million in Gavi grants. Recent joint efforts include programs in Indonesia, Pakistan, and Laos. Gavi funds immunization-specific investments such as cold chain equipment and community health worker training, while the World Bank supports broader health system improvements and technical assistance.
Bleehen notes that while Gavi contributes to strengthening health systems, MDBs invest far larger sums. To help countries transition successfully from Gavi support, Gavi is pursuing innovative financing partnerships that leverage these greater investments for immunization.
Beyond vaccine costs, MDB financing helps countries cover major upfront investments needed to introduce and sustain vaccine coverage under terms they can afford. Though countries will eventually repay these loans, the long-term economic benefits—healthier populations, improved productivity, and fewer workdays lost—make these investments worthwhile.
Building on its existing partnerships, Gavi is deepening collaboration with the World Bank and expanding ties with other MDBs, including the European Investment Bank (EIB) and the Asian Development Bank (ADB). During the COVID-19 pandemic, Gavi worked with these banks to help lower-income countries acquire additional vaccines beyond COVAX allocations.
The EIB now provides Gavi with €1 billion to accelerate access to vaccines targeting pandemic threats like Ebola, as well as routine vaccines against measles, malaria, and HPV. Gavi is exploring new initiatives with the EIB to shape vaccine markets and reduce the cost of new vaccines.
Gavi’s partnership with the ADB is evolving into a broader effort to help Gavi-eligible countries in Asia and the Pacific secure sustainable financing for health and immunization programs, develop climate-resilient health systems, and enhance advocacy and knowledge-sharing.
On May 13, 2025, Gavi and the Asian Infrastructure Investment Bank (AIIB) announced a landmark partnership to unlock up to $1 billion in health financing for AIIB members eligible for Gavi support. The collaboration aims to strengthen immunization and health systems, support vaccine introductions in middle-income countries, and assist nations transitioning out of Gavi funding. They will also explore innovative mechanisms like donor liquidity facilities to quickly mobilize funds for immunization and emergency responses.
Through these expanded partnerships, Gavi aims to ensure countries can sustain and grow their immunization efforts, safeguarding the health gains achieved over the past two decades.
Related Topics
