"The current ‘me first’ approach will ultimately cost more, in terms of lives," says Diane Abad-Vergara, COVAX communication focal point, WHO.
The Global COVAX Facility is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries.
Here are five things to know about the challenges facing COVAX, and how they can be overcome.
1) Export controls: the weakest link?
Early on in the pandemic, UNICEF built up a stockpile of half a billion syringes in warehouses outside the countries producing them.
Its foresight paid off: countries put export controls on syringes, prices spiked, and supplies were limited.
Several countries also placed export controls on vaccines, prompting WHO to warn against “vaccine nationalism”, which encourages hoarding, and has the effect of pushing prices up and ultimately prolonging the pandemic, the restrictions needed to contain it, and human and economic suffering.
Getting doses into people’s arms requires a complex global supply chain. From the ingredients needed to produce the vaccine, to the glass and plastic stoppers and tubes, to the syringes.
Because of this, export bans or controls on any of these products can cause major disruptions to vaccine rollouts.
2) Getting vaccines to those who need them is not easy
While all of the countries that are part of COVAX have the infrastructure needed to get pallets of vaccines off cargo planes and into refrigerated warehouses, the next steps can be more complicated.
“We want to ensure that no-one misses out,” says Gian Gandhi, UNICEF’s global COVAX coordinator, “but, in the short term, the concentration of doses in cities at least means that the vaccination of health and other frontline workers in urban areas, where the higher population density puts them at a higher risk of exposure, is being prioritized.”
3) More funding is needed to help rollout in the poorest countries
One way to speed up the vaccine rollout, and the delivery from urban warehouses to remote areas is, quite simply, cash.
“Funding is a perennial concern, even in pandemic response,” says Ms. Abad-Vergara. “To continue providing vaccines to its 190 members, COVAX needs at least $3.2 billion in 2021. The faster that this funding target is achieved, the faster that vaccines can get into people’s arms.”
UNICEF estimates that an additional $2 billion is needed to help the poorest 92 countries to pay for essentials such as fridges, health worker training, expenses for vaccinators, and fuel for the refrigerated delivery trucks.
4) Richer countries should share
COVAX is finding itself in competition with individual countries doing direct deals with pharmaceutical companies, putting extra pressure on the available supply of COVID-19 vaccines.
At the same time, richer countries may find themselves with an over-supply of doses.
“The current ‘me first’ approach favours those who can pay most and will ultimately cost more financially, and in terms of lives,” warns Abad-Vergara.
“But it’s important to note that bilateral deals do not prevent a country from either receiving doses or contributing to COVAX, particularly through dose-sharing.”
5) Vaccine hesitancy: a continued cause for concern
Despite the overwhelming evidence that vaccination saves lives, vaccine hesitancy, which exists in every country, is still a problem that needs to be constantly addressed.
This phenomenon is partly driven by misinformation surrounding all aspects of COVID-19, which was a concern even before a global health emergency was declared.
In May, the UN launched the Verified campaign, which fights lies and distorted messages, with trusted, accurate information surrounding the crisis.
