Johnson & Johnson says an emergency use listing is critical for supplying vaccines to poor and middle-income countries.
Low and middle-income countries have fallen behind in the race to vaccinate against COVID, but successful worldwide vaccination is key to ending the coronavirus pandemic.
On Wednesday, Ghana became the first country to receive vaccines under COVAX – an initiative to reduce vaccine disparity between high- and low-income countries – with 600,000 doses of the AstraZeneca-Oxford vaccine arriving in the capital Accra.
This is COVAX’s first success, but it has struggled to secure sufficient supplies from drug companies.
Here is what you need to know about COVAX:
What is COVAX?
COVAX is a partnership between the World Health Organization (WHO) and two international groups – the Gavi vaccine alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) – which aims to send vaccines to developing countries.
The majority of its funding has come from high-income countries and international organisations like the Bill & Melinda Gates Foundation. At a recent summit of industrial nations, several leaders announced significantly increased contributions to the scheme.
What is its goal?
COVAX aims to provide two billion vaccine doses to people in 190 countries this year, ensuring at least 20 percent of populations are vaccinated. Most importantly, it aims to send vaccines to 92 lower-income countries at no cost.
High- and middle-income countries are also part of the scheme in a self-financing capacity. COVAX’s pricing mechanism is set so richer countries pay a premium to subsidise poorer countries.
What has it achieved so far?
COVAX has made bilateral agreements with several major companies producing COVID-19 vaccines, including Pfizer and Johnson & Johnson. But most of the jabs allocated in the first half of this year were produced by AstraZeneca whose vaccine does not need the ultra-cold storage that other vaccines do.
COVAX says it has collected 1.12 billion shots so far, with most deliveries expected to start in March, and a few smaller shipments due in late February. In its interim distribution forecast published early February (PDF), it laid out its plan to distribute an initial batch of 336 million doses of the AstraZeneca vaccine by mid-2021. It also aims to begin shipping 1.2 million doses of the Pfizer-BioNTech vaccine in the first quarter.
What are the challenges?
COVAX initially aimed to deliver vaccines to poor countries at the same time as rich nations were receiving their first doses. But high-income countries secured bilateral deals with vaccine manufacturers and progressed with vaccine rollouts as COVAX struggled to obtain enough doses to begin shipping.
Some rich countries, such as the United Kingdom and Canada, have secured enough doses to fully vaccinate their populations more than once. The UN has sharply criticised the “wildly uneven and unfair” distribution of vaccines, pointing out that by mid-February, just 10 countries had administered 75 percent of all vaccinations. By contrast, 2.5 billion people who live across 130 countries have not been administered one dose, according to the WHO.
The roll-out in Ghana is a milestone for COVAX, which is trying to narrow a politically sensitive gap between the millions of people being vaccinated in wealthier countries and the comparatively few who have received shots in less developed parts of the world.