The relative ambiguity of this vaccine program contradicts its critical role in the global fight against Covid-19. COVAX is indeed the most important acronym of 2021. As vaccine nationalism sticks out its ugly head, it’s the best – perhaps the only – chance to get billions of doses in lower- and middle-income countries.
COVAX is an enterprise run by a coalition that includes the vaccination alliance, known as Gavi, and the World Health Organization (WHO), and is funded by donations from governments, multilateral institutions, and foundations. The mission is to buy coronavirus vaccines in large quantities and send them to poorer countries that cannot compete with rich countries to secure contracts with the big drug companies.
It has secured nearly 2.3 billion doses for distribution this year. Of this total, 1.8 billion should be made available to 92 of the poorest countries in the world, most of which (1.3 billion) will cost free.
Gavi has a lot of experience in vaccinating populations in need – it has helped to vaccinate half of the world’s children against other diseases, such as polio, meningitis and typhoid. But the Covid-19 campaign dwarfs the programs.
Transmission of coronavirus vaccine by COVAX will begin this month and will increase in the second half of the year. Countries in Latin America and the Caribbean will be among the first to receive approximately 35 million doses of Pfizer-BioNTech and AstraZeneca vaccines by the end of June.
Countries must submit a detailed plan for handling and distributing the survey – any country that has signed up for the program can receive vaccination. Some countries finance their own share of the vaccines to be delivered via COVAX, but 92 are eligible for deep discounts or free shipping.
The Pan American Health Organization (PAHO) says no distinction will be made between countries that pay for the vaccines and the countries that receive them for free.
For now, only two vaccines have been approved for distribution by COVAX – those made by Pfizer-BioNTech and AstraZeneca – but Gavi says he will need as many vaccination candidates as possible to reach the target, once they have approved a strict received regulatory legislation. authority and / or pre-qualification by the WHO. “
According to Gavi, Southeast Asia is expected to receive 695 million doses by the end of 2021, and Africa 540 million doses. According to WHO, part of the Middle East, Afghanistan and Pakistan should receive 355 million doses by December. PAHO says it intends to distribute 280 million doses to the United States by the end of the year.
Several countries in Eastern Europe, including Ukraine and Moldova, are also eligible for subsidized COVAX supplies.
More than a billion of the required doses are likely to be produced by the Serum Institute of India (SII), the world’s largest vaccine manufacturer, at a cost of about $ 3 per shot, thanks to the collaboration of Gavi, the Bill & Melinda Gates Foundation and SII.
The big axis
It’s an impressive effort, but hardly sufficient. For a start, ‘secure’ does not mean obtaining. Gavi himself warns there is a major problem with uncertainty regarding capacity, funding and land readiness. ‘Governments need to submit detailed plans to show that they can distribute the doses they receive and identify areas where they need help.
The logistics involved are appalling. The UN Children’s Fund – which will be one of the main distributors – is trying to double its transport capacity this year so that it can move 850 tonnes of Covid-19 vaccines per month.
A bigger obstacle facing COVAX: money. So far, it has raised more than $ 6 billion, but raised an additional $ 2.8 billion in 2021 – $ 800 million for research and development, and at least $ 2 billion for vaccines for lower-income countries. a Gavi spokesman told CNN.
The most important donors so far were the United Kingdom ($ 750 million), the European Union (almost $ 600 million) and Canada ($ 250 million). The Biden administration has promised to rejoin COVAX, which has boycotted the Trump administration.
Nguyen said that “without a real effort, lower-income countries will lag behind due to limitations on their financial capabilities.”
Even if the target of 2.3 billion doses is met, the vast majority of people in lower-income countries will have to wait until at least 2022. Gavi himself predicts that vaccines distributed by COVAX will make up 27% of the population of lower-income countries income will reach. year.
This will depend on a massive boom in the program in the second half of 2021. WHO officials expect that only 3.3% of the population of low-income countries will be vaccinated by the end of June. India, Pakistan and Nigeria will receive the most doses, according to COVAX, receiving 97.1 million, 17.1 million and 16 million doses respectively.
In the case of India, the allocation will cover less than 4% of the population. Latin America and the Caribbean should receive enough doses through COVAX for nearly 20 million people by June, but the region’s population is 500 million.
By contrast, many rich countries aim to have their entire population vaccinated by the last quarter of 2021. In Germany, Chancellor Angela Merkel is setting a September 21 target for every adult to receive a vaccine.
Some middle-income countries in the COVAX program are hedging their commitment, and are moving towards a hybrid approach that includes direct purchases from vaccine manufacturers. Colombia and several countries in the Balkans obtained bilateral transactions while awaiting COVAX.
The African Union has also entered the market – and in addition to the COVAX program has secured 670 million doses of different vaccines.
‘I first’
The biggest challenge for global coverage is a “my-first” attitude criticized by global health officials. WHO Director-General Tedros Adhanom Ghebreyesus says bilateral transactions increase vaccine prices for all.
“Many countries have bought more vaccine than they need,” Tedros said in January. “We now face the real danger that even if vaccines offer hope to those in rich countries, a large part of the world could lag behind,” he said.
It is not right, he added, that younger, healthy adults in rich countries can get the vaccine before health workers and older people in poorer countries, especially as new variants of the virus emerge.
Gavi told CNN: “Every time a new bilateral agreement is made, it reduces the potential supply to COVAX, so we continue to insist on encouraging manufacturers and governments to support our work.”
The longer it takes to achieve worldwide vaccination, the greater the risk that new variants may flourish. However, Gavi told CNN that his partner – the Coalition of Epidemic Preparedness Innovations – is investing in the ‘next generation’ of vaccine candidates, which will offer the world additional options to control Covid-19 in the future.
If, as is commonly expected, the coronavirus vaccine is an annual requirement, the pressure on inventory will not disappoint. Long before most of the developing countries are vaccinated, people in affluent countries can receive their second dose.
Tedros’ comments are reproduced by dr. Seth Berkley, CEO of Gavi, who criticized a sense of “vaccine panic” among richer countries.
“We will only be safe anywhere if we are safe everywhere,” he said.
History is not encouraging. Tedros recalls the H1N1 epidemic in 2009, when developed countries monopolized early vaccine stocks.
Going further, Africa only received life-saving antiretroviral treatments a few years after it became widely available in the developed world, even though the continent suffered catastrophic deaths due to HIV / Aids.
The director of the Africa Centers for Disease Control & Prevention, John Nkengasong, says there is an urgent need to tackle Covid-19.
“We need to reach 60% [vaccination] target within two years “in Africa, he said. Otherwise he warned,” the virus will be endemic in our communities. “
Tedros used stronger language. Unless COVAX gets the necessary resources, the world becomes a ‘catastrophic moral failure’, he said.