Already Americans, Britons and Canadians are receiving coronavirus vaccines. Coronavirus has exposed vast inequities between countries.
“The whole call for global solidarity has mostly been lost,” said Dr. Katherine O’Brien, WHO’s vaccines chief.
Kate Elder, vaccines policy adviser at Doctors Without Borders, said “it’s increasingly looking like the ship has sailed on equitable vaccine distribution”
As more countries in the West authorize the vaccine, “the difference between people in rich countries getting vaccinated and the lack of any vaccines for the developing world will become quite stark,” said Anna Marriott, health policy manager at Oxfam. “And it will only prolong the pandemic.”
COVAX was created to ensure the entire world has access to COVID-19 vaccines. COVAX was set up by the World Health Organization, vaccines alliance GAVI and CEPI, a global coalition to fight epidemics, to avoid the international stampede for vaccines that has accompanied past outbreaks and would reinforce those imbalances.
But COVAX has secured only a fraction of the 2 billion doses it hopes to buy over the next year, has yet to confirm any actual deals to ship out vaccines and is short on cash. Some experts say the chances that coronavirus shots will be shared fairly between rich nations and the rest are fading fast. With vaccine supplies currently limited, developed countries, some of which helped fund the research with taxpayer money, are under tremendous pressure to protect their own populations and are buying up shots. Meanwhile, some poorer countries that signed up to the initiative are looking for alternatives because of fears it won’t deliver.
“It’s simple math,” said Arnaud Bernaert, head of global health at the World Economic Forum. Of the approximately 12 billion doses the pharmaceutical industry is expected to produce next year, about 9 billion shots have already been reserved by rich countries. “COVAX has not secured enough doses, and the way the situation may unfold is they will probably only get these doses fairly late.”
COVAX’s only confirmed, legally binding agreement is for up to 200 million doses, though that includes an option to order several times that number of additional doses, GAVI spokesman James Fulker said. It has agreements for another 500 million vaccines, but those are not legally binding. The 200 million doses will come from the Serum Institute of India, the company that will likely make a large portion of the coronavirus shots destined for the developing world. CEO Adar Poonawalla says it has a confirmed order for 100 million doses each of a vaccine developed by Oxford University and AstraZeneca and one from Novovax.
“We don’t have anything beyond that in writing,” he told The Associated Press. “If they want more, they’ll have to place more orders.”
He said the lack of commitment from COVAX will mean a much longer wait for people in developing countries.
Even with vaccines in hand, the rollouts will take many months, even in rich countries, and many developing ones are facing serious logistical challenges that will add to delays, noted Dr. Gagandeep Kang, an infectious diseases expert at the Christian Medical College at Vellore in southern India.
According to a report GAVI, the alliance itself concluded that the risk COVAX will fail is “very high,” saying it was “established in record time and has to navigate unchartered territory.”
Amid fears COVAX can’t deliver, some developing countries are pulling out entirely or seeking their own private deals. Earlier this month, the tiny Pacific island nation of Palau announced it was abandoning the initiative and would get donated vaccines from the U.S. instead. Other low and middle-income countries, including Malaysia, Peru, and Bangladesh, have stayed in the initiative but also recently inked their own deals with drug-makers as a Plan B.
Anban Pillay of the South African Ministry of Health said that joining COVAX was just a stop-gap measure before signing bilateral deals with pharmaceutical companies.
South Africa and India have asked the World Trade Organization to waive some provisions regulating intellectual property rights to make it easier for manufacturers in poor countries to make COVID-19 drugs and vaccines. But many rich countries are reluctant to do that.