Conducting an Independent Mid-Term Review of CEPI’s Second Strategic Period (CEPI 2.0)
June 15, 2026
Independent strategic reviews are not just a compliance exercise peripheral to global health initiatives, but a core element of institutional maturity that also serves to demonstrate accountability and the capacity to adapt and sustain impact.
Our client was the Coalition for Epidemic Preparedness Innovations (CEPI), a global partnership established in 2017 with a mission to accelerate the development of vaccines and other biological countermeasures against epidemic and pandemic threats and support equitable access to these health products for populations in need.
Initially, the organisation was guided by the blueprint, CEPI 1.0 and the urgent need to address the Covid-19 pandemic. The lessons drawn from implementation influenced the development and adoption of CEPI 2.0, a five-year, US$3.5 billion, strategic plan, with the ambitious goals of enhancing global preparedness against infectious diseases, including compressing vaccine development timelines to 100 days, alongside expanded objectives related to vaccine manufacturing, equitable access, and ecosystem strengthening, particularly in LMICs.
CEPI 2.0 was being implemented within an exceptionally complex and dynamic global landscape, characterised by a proliferation of new national and international pandemic preparedness initiatives, a renewed focus on regional vaccine development, manufacturing and procurement, and the challenge of sustaining global political and financial commitment as pandemic preparedness competed with other global priorities. CEPI was therefore required to define its role and value-add within this shifting space while aligning diverse stakeholder interests across governments, regional bodies, pharmaceutical manufacturers, multilateral agencies and civil society. Against this backdrop, CEPI commissioned an independent Mid-Term Review (MTR) of CEPI 2.0 to take stock of progress two and a half years into the strategy period, identify lessons learned, and generate actionable recommendations to inform and strengthen implementation through the remainder of CEPI 2.0.
The core focus of the project was to:
The project required the simultaneous application of expertise in global health strategy and evaluation, vaccine research and development, regulatory affairs, pharmaceutical manufacturing in both the global north and the global south, equitable access to medical products, organisational performance and governance, and partnership architecture in global health. With established experience supporting African vaccine manufacturers and governments, Market Access Africa (MAA) contributed technical expertise across these competencies and ensured that LMIC perspectives, particularly those of African regulatory authorities, manufacturers, regional initiatives and ministries of health, were systematically incorporated throughout the assessment.
The work was operationalised through three core workstreams covering whether CEPI was focused on the right things, working in the right ways, and whether it was on course to achieve the right results, complemented by two cross-cutting workstreams on equitable access and on learning and recommendations. A mixed-methods methodology was applied across these workstreams, drawing on document review, key informant interviews with internal and external stakeholders, portfolio analysis, landscape mapping, governance and management review, and the application of process tracing to test causal contribution claims underpinning the strategy.
As part of a consortium led by ITAD, MAA had the mandate of examining the plausibility of meeting the strategic outcomes, outputs, and targets set under CEPI 2.0. The assessment was grounded in the CEPI 2.0 Theory of Change (ToC) and focused on the extent to which CEPI’s portfolios were delivering against the strategic objectives and the 2023 interim KPI milestones. Additionally, MAA led the cross-cutting deep dive on equitable access, framing the enquiry around the integration of equitable access considerations into critical decision points across the product life cycle, the long-term implications of licensing arrangements, the affordability and pricing dimensions of CEPI’s portfolio, and the contribution of CEPI’s investments to building local capacity for vaccine research, development and manufacturing in LMICs. MAA also contributed to the assessment of coherence at the regional and continental level, examining the alignment of CEPI’s portfolio with continental and regional disease priorities, the structure and quality of partnerships with African research institutions, regulatory authorities and manufacturers, and the implications of CEPI’s evolving role for downstream actors. The findings, conclusions and emerging recommendations were tested with the CEPI Management Team through a co-creation workshop process to ensure that the final recommendations were fit-for-purpose, feasible and actionable within the remainder of the CEPI 2.0 period.
MAA delivered an independent Mid-Term Review of CEPI 2.0 that provided a comprehensive, evidence-based assessment of the relevance, coherence, fidelity, effectiveness, impact, and governance and management of CEPI’s operational model and strategy.
On the plausibility of CEPI achieving its intended results under CEPI 2.0, our review found considerable programmatic progress across many areas, towards attainment of the strategic objectives. This was observable under Strategic Objective 1, through which CEPI sought to prepare for known epidemic pandemic threats; CEPI’s investments were assessed as promoting the development of priority pathogen vaccines and contributing to reducing the risks of further coronavirus pandemics. Some progress had been made against both Strategic Objective 2, which sought to transform the response to the next novel threat (albeit with work delayed in some areas), and against Strategic Objective 3, which aimed to connect stakeholders and experts in emerging infectious diseases (EIDs) to enable rapid countermeasure development, effective response and equitable access. CEPI’s added value was found to stem from its unique focus on research and development and equitable access for vaccines against EIDs and from a strong portfolio of investments capable of delivering demonstrable product development progress in a short time frame, with its work on Lassa fever, Nipah and Chikungunya representing a particularly distinctive contribution. Multiple research and development partners reported that CEPI’s value-add extended beyond programmatic progress to their business growth and, in some cases, to their survival.
On coherence, our review confirmed that CEPI was created to fill an evident gap in the vaccine R&D as well as access ecosystems, targeting emerging infectious diseases that affect populations in LMICs; this remains an area where CEPI’s role is unique and adds considerable value. Several other agencies of high-income country (HIC) governments invest alongside CEPI to counter infectious disease threats that are more likely to affect all regions and countries; while CEPI retains a unique single focus on LMICs and equitable access, it is not always clear whether its work in these areas is synergistic or duplicative of that of others, although CEPI has sought to engage these entities to promote alignment.
On equitable access, our review found that CEPI demonstrated a strong commitment to ensuring equitable access to vaccines during the COVID-19 pandemic, and that the Equitable Access Framework builds on this experience by setting out a comprehensive approach to addressing equity across CEPI’s scope of work. In practice, CEPI has sought to advance equitable access across the portfolio, both through the selection of vaccine candidates appropriate for LMIC settings and through the arrangements put in place for manufacturing and access to vaccines once they reach the market.
Beyond the findings themselves, the work strengthened CEPI’s position to advance its strategic agenda through the remainder of CEPI 2.0 and to plan effectively for its successor strategy. Specifically, CEPI is better positioned to recalibrate its results architecture and KPI targets, focus its portfolio around areas of distinctive value add, clarify its positioning relative to other research and development funders, embed equitable access more deeply across the portfolio, and strengthen its engagement with regional initiatives and manufacturers in the Global South. While the realisation of CEPI 2.0’s strategic objectives will ultimately depend on sustained implementation by CEPI itself and on the wider commitment of the global pandemic preparedness community, the MTR has equipped the organisation with the strategic, programmatic and organisational insights required to pursue those objectives from a substantially stronger position.
Market Access Africa conducted an independent Mid-Term Review of CEPI 2.0 that provided a comprehensive, evidence-based assessment of the relevance, coherence, fidelity, effectiveness, impact, and governance and management of CEPI’s operational model and strategy. The review strengthened CEPI’s position to advance its strategic agenda through the remainder of CEPI 2.0 and to plan effectively for its successor strategy.
