GAVI has been criticized for giving private donors more unilateral power to decide on global health goals,[8] prioritizing new, expensive vaccines while putting less money and effort into expanding coverage of old, cheap ones,[9] harming local healthcare systems,[8] spending too much on subsidies to large, profitable pharmaceutical companies[10] without reducing the prices of some vaccines, and its conflicts of interest in having vaccine manufacturers on its governance board
Public-sector workers and academics public health have criticized GAVI, and other global health initiatives (GHIs) with private-sector actors, saying that they have neither the democratic legitimacy nor the capacity to decide on public health agendas. Private donors often find it easier to exert influence through public-private partnerships like GAVI than through the traditional public sector. There is also criticism that staff at GHIs are often recruited directly from elite educational institutions, and have no experience in health care systems, especially those in poorer countries
https://en.wikipedia.org/wiki/GAVI