I didn’t want to let the recent appointment of a new chair at the International Finance Facility for Immunisation ( IFFIm ) pass without paying tribute to the work of this phenomenal multilateral fund and its work over 20 years. If you are looking for examples of how capital markets can facilitate outcomes with positive and direct real-world impacts, it’s hard to find a better one than IFFIm.

The agency has issued more than US$10 billion in bonds since it was established to fast-track the delivery of the global child vaccination programme funded by its proceeds.

The organization announced in October that Georgina Baker, a 32-year veteran of the International Finance Corporation, will succeed former World Bank treasurer Ken Lay from January 1 2026. This continues the line of accomplished leaders and capital market experts from the development finance community on the IFFIm board since the organization was formally established in 2005.

The proposal for IFFIm was initially referenced in a UK Treasury statement of January 2003, which defined its goal as providing additional financing to help meet the Millennium Development Goals. The MDGs, if you recall, were a distillation of the United Nations Millennium Declaration, adopted in 2000, whose aim was to combat poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women.

Securitization of sovereign pledges

IFFIm has an innovative model: the agency is funded by grants from 11 sovereign sponsors but to secure funds up-front, IFFIm issues bonds in the international capital markets – effectively a securitisation of future grant flows. The World Bank provides IFFIm’s treasury functions and accounting services.

It’s a model that clearly works; the vaccine programme that IFFIm funds has now reached more than 1.2 billion children in the world’s poorest countries, saving an estimated 20.6 million lives. Fifty-four countries are currently eligible to apply for support from the Global Alliance for Vaccines and Immunisation ( Gavi ), based on 2024 average per capita gross national income of equal to or below US$1,810 per annum.

The vaccination programme is delivered by the Gavi, a Swiss-incorporated non-profit public–private partnership of the World Health Organization, UNICEF, the World Bank, national governments, vaccine manufacturers, civil society and an array of private-sector donors and philanthropists. The Gates Foundation has pledged in excess of US$4 billion since Gavi was founded in 1999.

The regular flow of funding from IFFIm bonds has been a vital lifeline to Gavi and one that’s accelerated the provision of breakthrough vaccines. IFFIm’s vaccine bonds pre-date the emergence of labelled ESG bonds by two years, making it a pioneer issuer. Its inaugural bond was a US$1 billion 5%, five-year offering in November 2006 with Deutsche Bank and Goldman Sachs at the helm as joint lead managers. Fast forward to June 2025 and the agency’s over-subscribed £300m three-year bond, predominantly sold to UK institutional investors, brought its total issuance since that debut deal, as I referenced above, to more than US$ 10 billion. IFFIm bonds have emerged in eight currencies across maturities, in syndicated and non-syndicated format, in the public market and as private placements as well as Sukuk.

The triple A rated organization says its weighted average borrowing costs are broadly aligned with the average of its donors ( Australia, Brazil, Canada, France, Italy, Netherlands, Norway, South Africa, Spain, Sweden and the UK ). The UK is by far the largest donor, accounting for 43.5% of the roughly US$9.72bn pledged since IFFIm’s inception. ( IFFIm is regulated by the UK Charity Commission ).

Georgina Baker’s tenure as new board chair will coincide with the start of Gavi’s sixth five-year plan ( Gavi 6.0 ) that runs to 2030. This has four strategic goals and 10 principles. The top-line strategic goals are to introduce and scale up vaccines; strengthen health systems to increase equity in immunisation, improve programmatic and financial sustainability of immunisation programmes, and ensure healthy markets for vaccines and related products.

The 10 principles dictate that the agency will work to:

1. Bolster country leadership to sustainably finance and deliver immunisation
2. Engage communities and civil society organisations in planning, implementation and oversight of immunisation
3. Prioritize children missing out on vaccination, including among migrants, displaced and other vulnerable populations
4. Identify and address gender-related barriers to promote immunization equity
5. Target and tailor support to regional, national and subnational needs, including fragile, conflict and humanitarian contexts
6. Strengthen integration of immunisation and primary health care to reach missed communities in support of Universal Health Coverage
7. Help countries leverage immunisation to address the challenges of global health security, antimicrobial resistance and other major global issues
8. Support countries to adapt to the consequences of climate change and mitigate the carbon footprint of the Alliance
9. Identify and scale up innovative products, practices and services to support Gavi’s goals
10. Accelerate purposeful partnerships with regional and global health institutions to collectively and efficiently respond to countries’ needs.

Over the lifetime of Gavi 6.0, the agency will seek to mobilize an additional US$2.4 billion through IFFIm, continuing its sourcing of what it called this long-term, predictable and flexible source of funding.