In the 42 days since the first shipment of vaccines through the COVAX facility arrived in Ghana, the World Health Organization (WHO) has announced in a statement that more than 100 countries have been reached. India, meanwhile, has reaffirmed its commitment to COVAX after it suspended exports amidst an ongoing surge in cases.
The COVAX facility is an effort jointly led by the WHO, Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi to ensure the availability of vaccines to lower- and middle-income countries, amidst concerns over vaccine nationalism and wealthier nations stockpiling supplies. Such concerns have become manifest in reality in recent months. As Health Issues India reported in late February
“An analysis by the ONE Campaign, a movement which seeks to end poverty and preventable disease by 2030, said a cohort of wealthy nations had stockpiled more than a billion COVID-19 vaccine doses than required. The report examined contracts with five leading manufacturers of COVID-19 vaccines – AstraZeneca and the University of Oxford, Johnson & Johnson, Moderna, Novavax, and Pfizer and BioNTech. It found that Australia, Canada, the European Union, Japan, the United Kingdom, and the United States had secured through deals more than three billion vaccine doses, despite only needing 2.06 billion to fully vaccinate their populations.”
COVAX, the bulwark against global disparities in vaccine access, has succeeded in delivering in excess of 38 million vaccine doses produced by AstraZeneca, Pfizer-BioNTech and Serum Institute of India (SII) to over 100 economies, spanning six continents. “COVAX has given the world the best way to ensure the fastest, most equitable rollout of safe and effective vaccines to all at-risk people in every country on the planet,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “If we are going to realise this great opportunity, countries, producers and the international system must come together to prioritise vaccine supply through COVAX. Our collective future, literally, depends on it.”
“it is tremendously gratifying that the roll-out of COVAX doses has already reached one hundred countries,” said Dr Seth Berkley, chief executive officer (CEO) of Gavi. “COVAX may be on track to deliver to all participating economies in the first half of the year yet we still face a daunting challenge as we seek to end the acute stage of the pandemic: we will only be safe when everybody is safe and our efforts to rapidly accelerate the volume of doses depend on the continued support of governments and vaccine manufacturers. As we continue with the largest and most rapid global vaccine rollout in history, this is no time for complacency.”
Concurring, executive director of UNICEF – one of COVAX’s partners – Henrietta Fore stated “this is no time to celebrate; it is time to accelerate. With variants emerging all over the world, we need to speed up global rollout. To do this, we need governments, along with other partners, to take necessary steps to increase supply, including by simplifying barriers to intellectual property rights, eliminating direct and indirect measures that restrict exports of COVID-19 vaccines, and donating excess vaccine doses as quickly as possible.”
The statement iterates “according to its latest supply forecast, COVAX expects to deliver at least two billion doses of vaccines in 2021. In order to reach this goal, the COVAX Facility will continue to diversify its portfolio further, and will announce new agreements with vaccine manufacturers in due course.
Yet there is a potential hurdle when it comes to India. As the SII is the world’s largest vaccine manufacturer, India has long been-anticipated to assume a pivotal role in the global inoculation drive. Yet India’s task of vaccinating its own population of over 1.3 billion has been recognised virtually from the outset as challenging – and SII CEO Adar Poonawalla has said manufacturing capacity in the country is “very stressed” and that “we are still short of being able to supply to every Indian.” Difficulty importing vital raw materials from the United States due to an export banis accredited to the production difficulties facing the country’s largest manufacturers, including the SII. Plans by the SII to scale up production to 100 million doses a month by March are now delayed to June, according to Poonawalla.
As states in India face shortages, the knock-on effect for COVAX is patent. In late-March, amidst concerns over vaccine supply and the rise in cases, India suspended vaccine exports. UNICEF said at the time “we understand that deliveries of COVID-19 vaccines to lower-income economies participating in the COVAX facility will likely face delays following a setback in securing export licences for further doses of Covid-19 vaccines produced by the Serum Institute of India, expected to be shipped in March and April.”
Nonetheless, India has affirmed its commitment to COVAX. “SII has pledged that, alongside supplying India, it will prioritise the COVAX multilateral solution for equitable distribution,” Gavi said in a statement. This is despite a significant shortfall in the number of doses promised by the SII. The Institute was expected to produce more than 100 million doses February and May, excluding supplies for India, but is behind target – so far, COVAX has received approximately 18.2 million.
Equity in the global vaccine rollout is critical, as without it, the pandemic will be prolonged. The balancing act India faces, of both aiding the global rollout and pursuing its ostensible strategy of vaccine nationalism and of inoculating the second-largest population on Earth, will certainly be a tough one. Going forward, the question will be how such a balancing act is struck.