Why is the COVAX initiative struggling to meet its goal?

This week, the US Biden administration announced that it would work closely with COVAX to send 80 million doses of COVID - 19 vaccines to other countries. On Friday, the European Commission President Ursula von der Leyen also said that the European Union would donate 100 Million doses to the COVAX initiative by the end of 2021. Despite this, this benevolent initiative is far from reaching its modest target of immunising 20 per cent of the populations of the countries around the world, by procuring 2 billion doses by the end of 2021. In fact, it is only 3.4 per cent of its way there.

What is the COVAX agreement?

The COVAX initiative was started by the World Health Organisation, the European Commission and the government of France in April 2020, a month after WHO declared COVID - 19 as a global pandemic. It is now led by GAVI, the Vaccine Alliance, the Center for Epidemic Preparedness and Innovation (CEPI), and the United Nations Children's fund. Most countries around the world, barring a few like Cuba and Tanzania, have participated in the initiative.

The main idea behind this initiative was to prevent global inequity in terms of vaccine distribution and to secure vaccine doses for poorer nations who couldn't afford to pay for them. The vaccines are to be distributed among 180 countries, and while rich countries are to pay for the vaccines, the 92 low-income nations would be assisted by aid and the private sector.

How does it work?

The main plan of action was that COVAX would pre-purchase vaccine doses from a variety of manufacturers. After production, they would be given globally based on population. Bulk purchasing would allow small nations to receive vaccines at the same prices as the larger nations. The 92 poorest nations would be given vaccines for free. COVAX has a variety of funders - Wealthy nations, private organisations like the Bill and Melinda Gates Foundation, and organisations such as the World Bank and the UNICEF.

So why is the plan failing and what is needed?

According to experts, the three main problems are the lack of money, shortage of vaccine supplies and lack of global willingness to share. Many governments made bilateral deals with companies like Pzifer and Moderna, thus, securing for themselves most of the doses to be produced in 2021. As a result, while many countries are yet to receive a single dose, richer countries have obtained doses to vaccinate their populations several times over. Thus, COVAX, already short of money initially, hasn't been able to buy vaccines for poorer countries. Even now, funding is lacking. To complete its goal at the end of 2021, it would have to raise another 2.6 billion dollars. Funding is crucial for COVAX currently so that it can secure doses for late 2021 and early 2022 before wealthy nations gain a monopoly over that too. For this, Japan is hosting the virtual Gavi COVAX Advance Market Commitment Summit on June 2, 2021.

Moreover, another major reason for the sluggish movement of the programme is India's COVID - 19 crisis, and COVAX's over-dependence on the Serum Institute of India, due to its massive capacity, license to manufacture AstraZaneca shots ( One of the first shots to be approved by the WHO for emergency use ) and ability to supply doses at lower costs. According to a recent vaccine supply forecast issued by Gavi on April 7, doses from Serum would make up about 40 per cent of the 2.16bn shots Covax hoped to distribute in 2021. Now, the Serum Institute has halted exports of the COVID - 19 vaccines, thus hurting the COVAX initiative. However, COVAX has made supply deals with other companies including Moderna, and also announced a 200 million dose agreement with Johnson and Johnson on Friday. Yet, most doses may not be available until early 2022.

With the shortage of raw materials and vaccine, companies not only need to ramp up production with global coordination but also reserve a portion for COVAX. Moreover, wealthy nations need to donate their excess doses to those in need. If they have contracts with companies to receive vaccines when they come, they need to give these up to a poor country in need of the doses. Taking the example from Sweden, which has donated 1 million doses to COVAX even though only 30 per cent of its population has been inoculated, countries need to donate doses after it has vaccinated people at high risks, instead of vaccinating each eligible adult. This would prevent a high-risk adult from succumbing to the infection in another country.

The WHO Foundation has also launched a campaign - Go Give one - urging people to donate seven dollars for someone in a low-income country to get a vaccine dose. These donations can come in handy as well. With several countries struggling to innoculate even minuscule parts of their populations due to no vaccine supply, COVAX is their only hope in a dire situation. It is an essential initiative, but struggling to move forward, nonetheless.

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