What is the COVAX program? Are you managing to get COVID vaccines to poor countries?

Either we all get vaccinated, or we all sink.

It’s a stark warning about the future of the pandemic: Without global access to life-saving vaccines, COVID-19 will never go away.

The virus has traveled to every continent, infecting more than 100 million people worldwide in just over a year since the global health emergency was first declared.

Humanitarian activists and experts are sounding the alarm about vast differences in vaccine distribution between the world’s richest and poorest countries.

They have criticized rich countries for hoarding most doses of COVID-19 vaccines while poor countries run out of vaccines, in a trend that has continued months after injections became available.

“Very quickly, the differences between countries are going to be very important and our main concern is that [los países ricos] they are going to start vaccinating lower risk groups quite quickly from May, while on the other side of the world, we are still not able to fully vaccinate healthcare workers, “says Alain Alsalhani, vaccine pharmacist at the Doctors Without Borders (MSF) Access Campaign.

A study commissioned by the International Chamber of Commerce estimated that the global economy would lose $ 9.2 trillion (€ 7.6 trillion) if governments fail to give developing countries access to COVID-19 vaccines.

We have already verified that the virus has no borders, so leaving countries without vaccines does not seem like an option.

Low-income countries therefore depend on the global effort to secure vaccines: the COVAX program (formally known as the Global Access Mechanism for COVID-19 Vaccines), which is led by the World Health Organization (WHO ), the Coalition for Innovations in Epidemic Preparedness (CEPI) and Gavi, the Alliance for Vaccines.

But is it enough? We take a look at the vaccine situation for developing countries.

What is COVAX?

COVAX’s original idea was to coordinate purchases globally to ensure that poorer countries were not left out of the vaccine race, a bit like the European Union is doing.

The goal was to avoid what is currently happening, in short. In practice, according to experts, it now functions more like a humanitarian aid project to poor countries.

The initiative to accelerate access to COVID-19 vaccines was created in late April 2020 and now plans to distribute more than 330 million doses of vaccines to 145 countries in an initial round of distribution by June 2021.

It will cover an average 3.3% of the total population of those countries, ranging from the rich, such as Canada and New Zealand, which pay for vaccines, to countries like Syria and Yemen, which receive them through international donations.

“It took a long time to establish itself and, because it took so long, the countries [ricos] they did not feel safe buying their vaccines from COVAX and began to negotiate their own bilateral agreements to ensure that their populations had access to the vaccine, “says Antoine de Bengy Puyvallée, a political scientist at the University of Oslo.

“Of course, that played against COVAX, because they were competing for the same doses.”

Now, the initiative is months behind the rich nations, which bought almost all the first doses. The WHO said earlier this month that 90% of COVID-19 vaccines had been administered in wealthier countries.

By June, many of those countries will have vaccinated a much higher percentage of their population than lower-income countries.

COVAX’s first contract in August was for the Serum Institute of India (SII) to manufacture the AstraZeneca and Novavax candidate vaccines. Pfizer and BioNTech, who had their vaccine approved by regulators beforehand, only reached an agreement in late January with COVAX to provide 40 million doses, about 3% of what the company aims to produce in 2021.

According to some experts, it is not unusual for poor countries to be last on the list when new drugs come onto the market. They claim that there are often delays in the arrival of drugs in low-income countries.

But “it is a very unique situation that in reality only the countries that could pay are those that have the vaccines,” said MSF’s Alsalhani. “Under normal circumstances, the vaccine market doesn’t work like that.”

Why do some rich countries receive vaccines through COVAX?

The program consists of two parts: one for 98 countries that pay for their own vaccines and another called COVAX AMC for 92 low- and middle-income countries ranging from Nigeria, India and Ukraine to Syria, Afghanistan and Yemen.

The goal is to vaccinate “at least 20% of the population” of these low-income countries by the end of 2021, in order to achieve “a very significant impact in stopping the spread of the pandemic,” said a Gavi spokesman. to Euronews.

Canada is currently the only G7 country to receive vaccines through COVAX and was criticized at home for wondering if it was taking vaccines from poor countries.

“Our top priority is to ensure that Canadians have access to vaccines,” the country’s Minister for International Development Karina Gould told the CBC, noting that Canada is the second largest contributor to COVAX AMC.

“Our position has always been that we know we have to get vaccines for Canadians, but we also have to get them for the world.”

Although by paying for vaccines through COVAX countries help the program win manufacturing agreements with pharmaceutical companies, critics say countries that already have bilateral agreements should wait.

“The problem is that some of the high-income countries have bilateral agreements and have already started receiving doses,” Alsalhani said.

De Bengy Puyvallée said that he believes that the desire to help other countries, on the one hand, and to vaccinate their own populations, on the other, creates “a dilemma for governments.”

Thus, reaching bilateral agreements while supporting COVAX is an “ambiguous policy”, which “has somewhat undermined the global approach at the same time,” he added.

The EU has reached agreements to vaccinate its entire population twice, but has also contributed some 850 million euros to support COVAX. They have also raised money to help European non-EU countries access vaccines.

Serbia began vaccinating its population early on, relying mainly on the Chinese vaccine.

Many countries in the Balkans rely on COVAX for their first doses, including Bosnia and Herzegovina, which has already started receiving refrigerators from UNICEF to store the Pfizer / BioNTech vaccine they acquired through the initiative.

Vaccine inequality could cause more problems in the future

Many experts and humanitarian activists are pushing for vaccines to be distributed more equitably, warning that if developing countries do not have access to vaccines, this could cause big problems in the future.

“Vaccinating many people in a few countries, leaving the virus unchecked in large parts of the world, will cause more variants to emerge,” said Dr. Jeremy Farrar, director of the charity Wellcome, in a statement.

“The more variants that emerge, the greater the risk that the virus will evolve to a point where our vaccines, treatments and tests are no longer effective.”

WHO Director General Dr. Tedros Adhanom Ghebreyesus also warned that the world was “on the brink of catastrophic moral failure”, noting that rich countries launched vaccination months before developing countries.

“It is not fair that younger and healthier adults in rich countries are vaccinated before health workers and older people in poorer countries,” he added.

Many humanitarian organizations advocate for a fairer effort, urging the UK and EU to donate doses before vaccinating younger adults.

Brandon Locke, director of policy and advocacy for the ONE campaign, said that instead of vaccinating 70% of the population before the summer, as the EU intends to do, countries should “reassess” and “share some of these doses with the lower-income countries, not after vaccinating our entire population, but now that we are vaccinating our own health workers. “

“That’s what is really going to help stop and curb the virus,” Locke said.

Increase production and manufacturing

But it is also about increasing the production of these precious drugs.

One of the ways that many countries hope to do this is by pressuring pharmaceutical companies to be more transparent and share information with the rest of the world.

South Africa and India have called on the World Trade Organization to suspend intellectual property laws to increase knowledge, and some say more effort is needed for the private sector, which received large amounts of public money, to train others in the field. use of your technology.

“It’s clear that the usual approach that we are taking on really sensitive issues like intellectual property, competition rights and the way we work with pharmaceutical companies is not working,” Locke said.

“We have to find a long-term solution to this problem … there is no legal, ethical or rational reason not to.”