What is COVAX?

Source

MORE THAN 200m doses of covid-19 vaccines have been administered around the world since December, when Britain approved the first rigorously tested jabs for mass vaccination. But as rich countries have rushed to inoculate their populations, poorer ones have watched from the sidelines. Only a handful of African countries have been able to afford vaccines, and many lack enough “cold chain” capacity to store them. Vaccine hoarding is also to blame for the unequal roll-out of the jabs. The 54 wealthiest countries are home to 18% of the world’s adult population, but have ordered 40% of all available vaccines. Covid-19 vaccines Global Access Facility (COVAX), a vaccine-sharing scheme, offers a partial solution to the problems this will create. On February 24th Ghana became the first country in the world to receive jabs under the scheme. So what is COVAX?

When vaccine-makers unveiled their covid-19 candidates, governments raced to secure supplies. A recent analysis by ONE Campaign, an advocacy group, shows that rich countries have stockpiled over 1bn doses more than they need. This evoked something of a sense of déjà vu. In 2009 an outbreak of swine flu (known as A/H1N1) killed nearly 285,000 people worldwide. Vaccines were developed within months, and first became available in high-income countries where most doses had been secured through bilateral agreements with drug firms. After shortages and production delays, developing countries found themselves pushed to the back of the queue. By the time jabs were available for them, three months later, the epidemic had peaked and the vaccines were less useful.

COVAX was established to prevent a repeat. One of the scheme’s motivations is humanitarian. Another is to hinder the emergence of new variants resistant to the vaccines (the more widely a virus spreads, the more likely it is to mutate). It is led by the World Health Organisation, Gavi (a public-private vaccine-promoting alliance) and the Coalition for Epidemic Preparedness Innovations (a foundation that finances research into vaccines for pandemics), and aims to ensure that all participating countries have access to inoculations. All countries in Africa have signed up to the scheme, which now has 190 members. Of these, 92 fall into the low- and middle-income group.

Success hinges on international support. COVAX operates through a funding mechanism that gives richer countries a choice. They can pay for their jabs and those of countries unable to afford any, or—if they have already met their own needs through bilateral deals—they can pay only for the doses of poorer countries. The good news is that more countries are stepping up their contributions. Last week leaders of the G7, a club of advanced economies, pledged $4.3bn in new funding, bringing the total amount committed so far to $10.3bn. The scheme is just $800m short of this year’s target.

The jabs, mostly supplied by AstraZeneca/Oxford, are allocated according to countries’ populations. The facility plans to supply enough vaccines for 3% of the participating countries’ people by the summer, which would protect health-care workers. By the end of the year it intends to have delivered 2bn doses, enough for 20% of their populations.

Hurdles loom. First, the logistics are unnerving. The UN Children’s Fund, UNICEF, which will take the leading role in delivering vaccines, is preparing to distribute up to 850 tonnes of jabs per month, or more than double the average weight of vaccines it usually transports. Second, the number of doses allocated to each country is likely to be limited by persistent global shortages (some producers have already fallen behind schedule). And third, countries’ preparedness matters. Gavi says COVAX will not deliver doses to those that cannot store and distribute them. Even so, developing countries may not be able to achieve widespread vaccination until mid-2023 or early 2024, if ever.

For more on the race between injections and infections, listen to The Jab, our podcast on the global vaccination effort. And find more of our coverage of the pandemic at economist.com/coronavirus