This September 2025 document is the final report of the third independent governance review of the Global Polio Eradication Initiative, conducted by IH Associates in association with SRI Executive. Commissioned to assess the effectiveness of GPEI governance structures, accountability mechanisms, and decision-making processes, the review draws on extensive interviews and document analysis involving GPEI leadership, partner organizations, country teams, and oversight committees.

The review covers the full GPEI governance architecture: the Polio Oversight Board (POB), the GPEI Secretariat's relationship with WHO management, the relationships between WHO and the four partner organizations (UNICEF, CDC, Rotary International, Bill & Melinda Gates Foundation), and country-level coordination structures including Inter-Agency Coordination Committees (ICCs). It also examines interfaces with independent monitoring structures — the IMB and TIMB.

Key findings address decision-making authority clarity, resource allocation efficiency, accountability adequacy at global and country levels, and whether governance structures support adaptive management. Areas requiring reform include clarifying role boundaries between the POB and partner organizations, streamlining committee structures, and strengthening country-level accountability. The report presents prioritized recommendations by urgency and feasibility.

The governance review is significant given the midterm challenges: WPV1 persistence, cVDPV2 expansion, and increased financial pressure. Essential reading for POB members, senior leadership of all five GPEI partners, WHO Director-General, GPEI Secretariat directors, country ICC chairs, and donor governments with governance-related conditions attached to contributions.

Who should read this: GPEI Polio Oversight Board members, GPEI partner organization senior leadership, WHO senior management, GPEI Secretariat directors, country ICC chairs, donor government representatives.

Document value: Authoritative independent assessment of GPEI governance effectiveness with prioritized reforms to strengthen accountability and decision-making. Directly influences the governance framework in the final critical years.