# GAVI Alliance - 2009 review

GiveWell aims to find the best giving opportunities we can and recommend them to donors. We tend to put a lot of investigation into the organizations we find most promising, and de-prioritize others based on limited information. When we decide not to prioritize an organization, we try to create a brief writeup of our thoughts on that charity because we want to be as transparent as possible about our reasoning. The following write-up should be viewed in this context: it explains why we determined that we wouldn't be prioritizing the organization in question as a potential top charity. This write-up should not be taken as a "negative rating" of the charity. Rather, it is our attempt to be as clear as possible about the process by which we came to our top recommendations.

## What do they do?

GAVI provides funds to developing world governments aiming to increase immunization coverage.1 However, based on reviewing available financial reports for GAVI, it appears that GAVI also offers significant funding outside of these channels, by funding "Investment Cases." For example, in 2007, GAVI provided $428.5 million to "Investment Cases." These appear to be direct grants to the Global Polio Eradication Initiative, Measles Initiative, Maternal and Neonatal Tetanus Initiative, and the Yellow Fever Initiative.2 According to GAVI's 2007 Progress Report, cumulative disbursements from 2000-2007 through "normal" channels totaled$1.41 billion.3 Thus, GAVI's "investment case" grants for 2007 alone were almost 25% of their cumulative allocations for 2000-2007. Given this information, we are unsure of how GAVI allocates its funds and how additional donations would likely be used. (We wonder whether the significant allocation to "Investment Cases" indicates that GAVI has more money that it can reasonably spend through "normal" channels.)

## Does it work?

Expanding immunization coverage is a proven, cost-effective means of saving lives and improving health in the developing world. (For more information, see our full report on expanding immunization coverage.) However, because of our questions about how GAVI allocates its funds (see above), we are not confident that GAVI increases immunization coverage.