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COVAX continues to promote equity as a cornerstone of global vaccine distribution

J.P. Carroll
J.P. Carroll
June 3, 2021

As the world continues to contend with the challenges of  the COVID-19 pandemic, one of the most important ways that the virus is being combatted is through COVAX, the global mechanism for equitable access to COVID-19 vaccines jointly led by the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi – The Vaccine Alliance, alongside delivery partner UNICEF.

Recently, the COVAX Manufacturing Task Force was established to address issues such as bottlenecks in the supply of raw materials as well as trade barriers which are impeding the effectiveness of COVAX. This new task force is being led by the entities that co-lead COVAX in partnership with the Bill & Melinda Gates Foundation, IFPMA, DCVMN, and BIO, which is proud to be a part of this effort.

The COVID-19 pandemic has revealed and exacerbated health inequities around the world, which is what makes COVAX so essential in ensuring the defeat of the virus. According to BIO’s Senior Manager for International Affairs Hilary Stiss, COVAX remains “the best way” to ensure that equity is “taken into account in global vaccine distribution.”

Thanks to COVAX, more than 38 million doses of vaccines from manufacturers AstraZeneca, Pfizer-BioNTech, and Serum Institute of India have now been delivered, after the first international delivery to Ghana on February 24, 2021. Since then, COVAX has reached over 100 economies worldwide—61 of which are among the 92 lower-income economies receiving vaccines funded through the Gavi COVAX Advance Market Commitment (AMC).

Ultimately, COVAX expects to deliver 2 billion doses of vaccines in 2021 to cover 20% of the most vulnerable people in 92 poor and middle-income countries. This will be accomplished by continuing to announce new agreements with vaccine manufactures over the course of this year.

While there is much optimism about COVAX and support for its mission, many countries who are a part of it have also taken matters into their own hands.

The World Trade Organization (WTO) and equity

At the moment, WTO member countries around the world are being asked to consider a temporary patent waiver for COVID-19 vaccines proposed by India and South Africa with the backing of more than 80 other WTO members. WTO Director-General Ngozi Okonko-Iweala has urged WTO members to address inequities in vaccine access and to move forward in negotiations regarding this proposal. U.S. Trade Representative Katherine Tai said such inequities between more economically developed countries and emerging markets are “completely unacceptable.” The Biden administration followed up on these remarks, expressing its support for the suspension of patents on COVID-19 vaccines and is planning to engage in text-based negotiations at the WTO.

Dr. Michelle McMurry-Heath, President and CEO of BIO, joined a letter to President Biden expressing the need for U.S. leadership in global vaccinations.

“The U.S. must act now to leverage rapidly increasing U.S. domestic vaccine production, export ever-larger volumes of our surplus supplies, and go to work on the massive technical and logistical challenges to vaccine development on a global scale,” says the letter.

“U.S. support for the Intellectual Property waiver being promoted by the WTO would make little difference and could do harm,” the letter continues, because it “does not consider the proper materials, equipment, training, and infrastructure necessary to manufacture the vaccine safely and successfully (in addition to being a potential disincentive for future innovation).”

In addition, Dr. McMurry-Heath individually sent a letter on behalf of BIO to President Biden proposing the establishment of a COVID Global Strategy for Harnessing Access Reaching Everyone (SHARE) Program. The SHARE Program would ensure sufficient global supply of vaccines and safe and expeditious global access to them as well as strengthen and support healthcare systems in low and middle-income countries in addressing COVID.

Direct purchasing

According to an internal report to the board of Gavi obtained by Reuters, “The risk of a failure to establish a successful COVAX Facility is very high,” due to its unprecedented nature. Because of news reports such as this, many emerging and frontier market countries have decided to hedge their bets and purchase COVID-19 vaccines directly from companies that manufacture them or accept donated vaccines.

Equatorial Guinea, for example, received a donation of vaccines from China. This decision by Equatorial Guinea makes sense given that, according to data published by Gavi regarding the first round of allocations of vaccines, Equatorial Guinea does not seem to have received vaccines through COVAX yet.

In Honduras, private sector leaders are trying to buy as many as 1.5 million doses of COVID-19 vaccines that they would then distribute through public health agencies at no cost to recipients. According to Juan Calros Sikaffy, President of the Honduran Private Business Council, who is spearheading the effort, the government has agreed to the plan. There are concerns among experts as to whether such a plan will ultimately put poorer citizens at a disadvantage. This plan was announced following criticism of Honduran health officials for not having purchased vaccines more quickly. 

Innovative partnerships

To ensure widespread access of vaccines for as many people as possible, several companies producing vaccines are establishing local manufacturing partnerships.

One notable partnership is between Maryland-based Novavax, a late-stage biotechnology company, and the Serum Institute of India Private Limited (SIIPL). Through this agreement, SIIPL will also manufacture the antigen component of NVX‑CoV2373, Novavax’s COVID‑19 vaccine candidate. Clinical-stage biotechnology company GeoVax in Atlanta, Georgia has partnered with BravoVax in Wuhan, China, to jointly develop a vaccine against COVID-19. These are just some of the many partnerships to confront COVID-19.

COVAX is by no means perfect—but both its mission and size are unprecedented. Ensuring that equity remains a central part of the vaccine distribution process is of the utmost importance. No country or person should be limited by economic barriers in preventing the spread of COVID-19. BIO is proud to do its part in tackling the COVID-19 pandemic by partnering with the entities leading COVAX.

Listen: On a recent episode of the I am BIO Podcast, BIO’s Dr. Michelle McMurry-Heath spoke with international experts about how we can share vaccines globally—and why a patent waiver won’t lead to vaccine equity. Listen here.