Last week, GAVI took its first steps into the world of health startups, with the launch of its INFUSE workshop — a two-day event held down the street from its Geneva headquarters. Around 60 companies and entrepreneurs applied to the program after it was announced at this year’s World Economic Forum; 18 projects were selected for a final round of vetting before a panel representing both private companies and organizations like the World Health Organization (WHO) and UNICEF. At the end of last week’s workshop, the panel chose seven "pacesetters" that will work with GAVI on scaling up their projects and bringing them to new countries.

Since launching in 2000, GAVI has emerged as a prominent player in vaccine delivery, with nearly $10 billion in funding. (The Bill and Melinda Gates Foundation has donated $1.5 billion.) As an alliance of governments, NGOs, and private companies, GAVI works to negotiate with drug companies for lower-priced vaccines in poor countries, and provides aid until those countries can afford to pay for the drugs themselves. GAVI’s efforts have helped to immunize more than 500 million children so far, according to its website , though the organization has faced some criticism for its close ties to pharmaceutical companies and how its prices are negotiated. Some aid groups say GAVI should do more to make its low prices available to other organizations.

At the very top of a tall glass building, in a room overlooking Lake Geneva and Mont Blanc, a group of entrepreneurs are working on new ways to get vaccines to the people who need them most. They’ve come here from all over the world, and they’ve all launched pilot projects in poor countries — everything from wearable health monitors and online mapping tools to vaccine refrigerators that plug into cell towers. Now, they’re looking for what some say could transform their companies: a stamp of approval from the Bill Gates-backed GAVI alliance .

"We are trying to disrupt. GAVI is a disruption instrument." The idea, according to GAVI, is to provide poor countries with promising, data-based technologies to help monitor and carry out vaccine delivery. Vaccination rates across the world have risen significantly since the 1990s, but one in five children born today do not receive the most basic vaccines — mostly in remote areas of poor countries, where infrastructure is unreliable and health systems lack the staff or technology to ensure delivery. GAVI CEO Seth Berkley believes the organization could reach that so-called "fifth child," in part, by supporting and promoting new ideas. The INFUSE workshop felt like a competition at times, though GAVI organizers stressed that it wasn’t. Over the course of two days, participants used whiteboards and TED Talk rhetoric to make the case for why GAVI should support their ideas, tirelessly practicing their pitches to one another and swapping business cards. Buzzwords like "disruption," "ecosystem," and "platform" were tossed around liberally, and several participants drew comparisons to companies like Uber and SpaceX when discussing their ambitions. "We are trying to disrupt," Berkley says. "GAVI is a disruption instrument, and by bringing together all the partners we think we can make a difference."

GAVI CEO Seth Berkley addresses participants at INFUSE in Geneva, Switzerland. (GAVI)

There was no direct funding at stake during the event, but those who attended say that GAVI’s approval alone would be enough to open doors to new markets. "We want to monitor and protect every vaccine on Earth," says Nithya Ramanathan, co-founder of Nexleaf Analytics, which produces ColdTrace, a refrigerator monitoring and alert system. "And we can’t do that one country at a time." Nexleaf Analytics was one of several INFUSE startups focusing on refrigeration. From the moment they’re manufactured to the second they’re administered, vaccines need to be stored within a narrow temperature range (usually between 35 degrees Fahrenheit and 46 degrees Fahrenheit). But maintaining this so-called "cold chain" can be challenging in low-income countries, where power sources are often unreliable. ColdTrace aims to tighten up the cold chain with small temperature sensors that can be placed inside vaccine refrigerators. The sensor sends data on the fridge temperature and grid power availability to a central server, and if conditions start to threaten the vaccines, it will send a text message alert to local health workers. The startup has received support from Google.org and Intel, and is currently present in India and six other countries. "Gavi can open up doors." Energize the Chain takes a more direct approach by connecting vaccine refrigerators to cell towers. Since launching in 2013, the US nonprofit has installed more than 300 refrigerators in Zimbabwe, and is preparing to complete 30 more in Ghana. "We realized that cell towers are literally everywhere, and if there's a cell tower, there are electrons," says Harvey Rubin, a professor at the University of Pennsylvania medical school who spearheaded the project. "And we just said, plug the refrigerator in the cell tower, and you solve the problem." Rubin and Ramanathan were among the seven INFUSE teams selected to work with GAVI, and they’re confident that the support will help them break out of "pilotitis" — a cycle in which startups launch small pilot projects in various regions without ever scaling up. "GAVI can open up doors," says Ruchit Nagar, the 23-year-old co-founder of Khushi Baby, which makes a wearable device that uses near-field communication technology to store the immunization records of both mothers and children. The not-for-profit Khushi Baby, another GAVI finalist, currently has a staff of around 20 people working in the Indian state of Rajasthan, and aims to expand its operations throughout the country with the help of GAVI. "GAVI can connect you with ministries of health, and it can give you catalytic funding to get over these pilot phases," Nagar adds.

A child in India wears the Khushi Baby wearable device. (Khushi Baby)