The U.S. government was one of GAVIs six original donor countries. Initially contributing $48 million in 2001, the U.S. has increased its annual contribution to GAVI resulting in a total of $422 million over seven years. Although the U.S. government has been a consistent provider of direct funding to the Alliance, it has not contributed resources to either the IFFIm or the initial AMC.
One challenge for USG of participating in a large international partnership effort is that the decisions of the partnership do not necessarily reflect the preferences of the U.S. government. The Board of the GAVI Alliance includes permanent seats for the Gates Foundation, WHO, UNICEF, and the World Bank. Other seats rotate among members of key stakeholder groups. The United States is not guaranteed a seat at the table. The current board structure includes five seats for OECD countries. Since 2006, Dr. Kent Hill, the Assistant Administrator for the Bureau of Global Health at USAID has held one of the rotating OECD seats, but this seat will rotate in July 2009.