The relative obscurity of this vaccine program belies its critical role in the global battle against Covid-19. Indeed, COVAX may well be the most important acronym of 2021. As vaccine nationalism rears its ugly head, it’s the best — perhaps the only — bet on getting billions of doses to lower- and middle-income countries.
COVAX is an entity run by a coalition that includes the Vaccine Alliance known as Gavi and the World Health Organization (WHO), and is funded by donations from governments, multilateral institutions and foundations. Its mission is to buy coronavirus vaccines in bulk and send them to poorer nations that can’t compete with wealthy countries in securing contracts with the major drug companies.
It has secured almost 2.3 billion doses for distribution this year. Of that total 1.8 billion should be made available to 92 of the world’s poorest countries — the majority of which (1.3 billion) will be at no cost.
Gavi has plenty of experience in getting vaccines to populations in need — it has helped vaccinate half the world’s children against other diseases, such as polio, meningitis and typhoid. But the Covid-19 campaign dwarfs those programs.
Shipments of coronavirus vaccine through COVAX will begin this month and ramp up in the second half of the year. Countries in Latin America and the Caribbean will be among the first in line, receiving some 35 million doses of the Pfizer-BioNTech and AstraZeneca vaccines by the end of June.
Countries have to submit a detailed plan for handling and distributing the shot — any country that’s signed up to the program is eligible to receive a vaccine. Some nations are financing their own share of vaccines to be delivered through COVAX, but 92 are eligible for deeply discounted or free shipments.
The Pan American Health Organization (PAHO) says no distinction will be made between countries that are paying for the vaccines and those that are receiving them for free.
For now only two vaccines are approved for distribution through COVAX — those made by Pfizer-BioNTech and AstraZeneca — but Gavi says it will need as many vaccine candidates as possible to reach its target, “once they have received approval from a stringent regulatory authority and/or prequalification by the WHO.”
According to Gavi, Southeast Asia is projected to receive 695 million doses by the end of 2021, and Africa 540 million doses. A swath of the Middle East, Afghanistan and Pakistan should receive 355 million doses by December, according to WHO. PAHO says it aims to distribute 280 million doses to the Americas 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 doses needed are likely to be produced by the Serum Institute of India (SII), the world’s biggest vaccine maker, at a cost of about $3 per shot, thanks to collaboration by Gavi, the Bill & Melinda Gates Foundation and SII.
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