Covax, the global scheme to deliver Covid-19 vaccines to poorer countries faces a “very high” risk of failure, potentially leaving billions of people with no access to vaccines until as late as 2024. The bleak warning is contained in a financial risk assessment commissioned by Gavi, an alliance of governments, drug companies, charities and international organisations that arranges global vaccination campaigns and is the WHO’s partner in the Covax scheme. The Covax programme is the main global scheme to vaccinate people in poor and middle income countries against the coronavirus. It aims to deliver at least 2bn vaccine doses by the end of 2021 to cover 20% of the most vulnerable people in 91 countries, mostly in Africa, Asia and Latin America.
It has been beset by a number of issues, including a shortage of doses of approved vaccines, and a decision by India’s Serum Institute, which was initially earmarked to supply Covax, saying it would prioritise supplying India first. The cheaper and easier to transport vaccines that the scheme has banked on, including the Oxford University-AstraZeneca vaccine, have been slower in testing and getting regulatory approval.
Gavi says the programme is struggling from a lack of funds, supply risks and complex contractual arrangements, which could make it impossible to achieve its goals.
“The risk of a failure to establish a successful Covax facility is very high,” says an internal report to the board of Gavi.
The risk of failure is higher because the scheme was set up so quickly, operating in “uncharted territory”, the report says. It also warns that issues with contracts that allow countries to back out of buying doses they have committed to could push up the cost of doses from the $5.20 benchmark and ultimately make the scheme no longer viable.