The UK, Switzerland, Canada and Australia are among roughly 150 countries that are working toward an international cooperative effort to develop and distribute a COVID-19 vaccine—an effort that will not include the United States as the Trump Administration said Tuesday it “does not want to be constrained by multilateral groups like the World Health Organization.”
The statement follows Trump’s July decision to pull the United States out of WHO, claiming it is in need of reform and takes “advantage” of the U.S. The COVID-19 Vaccines Global Access Facility, or COVAX, is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO.
The goal of COVAX is to deliver 2 billion doses of safe, effective vaccines that have passed regulatory approval and/or WHO prequalification by the end of 2021. The vaccines will be offered equally to all participating countries, proportional to their populations, initially prioritizing healthcare workers then expanding to cover vulnerable groups, such as the elderly and those with pre-existing conditions.
“In the scramble for a vaccine, countries can act alone, creating a few winners, and many losers, or they can come together to participate in COVAX, an initiative which is built on enlightened self-interest but also equity, leaving no country behind,” said Richard Hatchett, CEO of CEPI.
COVAX currently has the world’s largest and most diverse COVID-19 vaccine portfolio, including nine candidate vaccines, a further nine under evaluation, and multiple conversations underway with major vaccine manufacturers. These vaccine candidates include four versions from the U.S., including Moderna’s vaccine that is currently in Phase III trials. Of the COVAX candidate vaccines, only the Moderna version and a second by AstraZeneca and the University of Oxford are in the final trial stage. The other candidates still in preclinical, Phase I and Phase II development and testing hail from Germany, China, Australia and a multi-national partnership.
The COVAX facility is coordinated by Gavi, a non-profit devoted to reducing poverty and protecting against the treat of epidemics through vaccination. It is supported by WHO, UNICEF, The World Bank and the Bill & Melinda Gates Foundation. Gavi describes COVAX as a “pooled procurement mechanism” for equitable distribution of COVID-19 vaccine(s) through an allocation framework currently being developed by WHO.
“The COVAX Facility will do this by pooling buying power from participating economies and providing volume guarantees across a range of promising vaccine candidates, allowing those vaccine manufacturers whose expertise is essential to large scale production of the new vaccines to make early, at-risk investments in manufacturing capacity—providing participating countries and economies with the best chance at rapid access to doses of a successful COVID-19 vaccine,” the non-profit explained.
The success of COVAX hinges on countries not only signing up for the initiative, but also higher-income countries filling funding/R&D gaps to support lower-income countries.
“In order to save lives in this pandemic, we must make sure that COVID-19 vaccines are available to all countries, including the most vulnerable,” said Dag-Inge Ulstein, Norway’s Minister of International Development.
Thus far, 80 higher-income countries have announced their intent to participate in COVAX. These countries will partner with 92 low- and middle-income countries that will be supported by the COVAX Advance Market Commitment (AMC), if it meets its funding targets. Launched in June 2020, AMC has raised more than $600 million against an initial target of $2 billion seed needed by the end of 2020. Together, this group of 172 countries represents more than 70% of the world’s population. Among the group are representatives from every continent and more than half of the world’s G20 economies—excluding the U.S.
“For higher-income countries it represents a win-win: not only will you be guaranteed access to the world’s largest portfolio of vaccines, you will also be negotiating as part of a global consortium, bringing down prices and ensuring truly global access,” said Dr. Seth Berkley, CEO of Gavi. “Signing up to the COVAX Facility gives each country its best chance at protecting the most vulnerable members of their populations, which in turn gives the world its best chance at mitigating the toll this pandemic has taken on individuals, communities and the global economy.”
After equally distributing approved vaccines to cover the most vulnerable groups in each partner country, COVAX will make additional doses available based on need, vulnerability and COVID-19 threat. The initiative will also maintain a buffer of doses for emergency use, including the possibility of another severe outbreak.