The global effort to distribute COVID-19 vaccines more fairly is set to end over the next two years. The board of the Vaccine Alliance, a key partner in the project, voted on December 8th to phase out much of its support for COVID-19 vaccines in middle-income countries.
Critics of COVAX would not mourn its demise. Some 1.84 billion vaccine doses have been delivered to 146 countries, but many of them arrived too late to make a difference. The National University of Bogot has an expert on access to medicines. Christian said that it was a failure and should be admitted.
Some people have a better take. Lawrence Gostin is an expert on global health law at Georgetown University. It had a lot of shots in it's hands. Gostin says that he fully understands Gavi's reasoning. Gavi wants to focus on campaigns that have been lagging during the crisis, such as vaccinations against the human papillomaviruses and ensuring no child fails to receive routine childhood vaccinations.
The Coalition for Epidemic Preparedness Innovations formed an alliance with the World Health Organization and the COVID-19 Vaccines Global Access Facility. The initial goal was to get 2 billion doses of vaccine. It would be sufficient to cover health care workers and high risk groups. The World Health Organization set a goal of fully vaccinating 70% of the population in developing countries by the middle of this year, but many experts say that was never really feasible due to the fact that young people are less likely to develop serious disease from COVID-19. The plan was to purchase vaccines in bulk for both rich and poor countries. The doses would be based on the population of the country.
Wealthy countries bought up a lot of vaccine for themselves at higher prices, leaving COVAX at the back of the line. Victorine de Milliano is a policy adviser for the Doctors Without Borders Access Campaign. COVAX didn't make it.
In the spring of 2021, India banned the export of vaccines in the middle of the Delta wave. The Serum Institute of India, one of COVAX's main suppliers, has stopped its delivery. It was difficult for recipient governments to plan effective vaccine campaigns when COVAX shipped vaccines.
COVAX had only distributed 500 million doses by the time most Western countries started to give booster shots. 18 countries didn't receive any vaccines at all and less than 2% of CovaX country populations were fully vaccined. Some 81% of health care workers in COVAX-recipient countries are now fully vaccine free, and only eight countries still have low vaccine rates.
Demand for the vaccine has fallen. The Omicron variant that started circulating early this year seemed to cause less severe disease than the big COVID-19 waves that came and went.
The board moved to adopt a planning framework that focuses on seasonal boosting of high-risk groups rather than trying to cover the whole population. 37 middle-income countries will no longer receive free vaccines or support for their distribution in the years to come. They would get a one-time sum to boost their ability to purchase and distribute vaccines through COVAX. 54 of the poor countries are still eligible for free vaccines.
Some people think that Gavi did not consult the affected countries. The countries that were going to benefit were not included in the decision making. They are not included in the wrap up. Gavi thinks that they know better than the countries themselves. The WHO report acknowledged that low- and medium-income country governments were not included in planning.
When the board meets again in June, they will discuss the topic further. John-Arne Rttingen, a global health expert at the Norwegian Ministry, said that in the meantime, Gavi will ask for input from affected countries, collect more data on the state of the Pandemic and assess how much difference vaccines can make in populations now that the virus has
The world needs to do better next time a vaccine drive is needed. It will require a major rethink. We can't just say, 'OK, we did our best' Gostin says, "We didn't really achieve our goal, but let's wind it down" A COVAX 2.0 that goes beyond COVID is what we should have.
Developing countries need to be less reliant on donors. The system should support countries to make their own vaccine rather than creating a situation where there are donors on one end and recipients on the other.
Some actions are being taken in that direction. It established a hub in South Africa in order to transfer messenger RNA vaccine technology to companies in low and middle income countries. At last week's meeting, the board voted to support the development of a vaccine manufacturing system that helps countries and companies decide which vaccine to make. There is a possibility of setting up a specific fund to purchase vaccines.
Making vaccines where they are needed is the way forward according to Gostin. It's a fact of life. Vaca Gonzlez concurs. Buying vaccines developed in wealthy countries from large pharmaceutical firms was the original sin of CovaX.
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