The Biden administration has officially committed to Covax, the global effort to finance and supply Covid-19 vaccines worldwide, including to low-income countries.
The government will commit $ 4 billion to Covax, immediately releasing the first $ 2 billion to Gavi, the Vaccine Alliance, which is one of the partners in this effort together with the World Health Organization and the Coalition for Epidemic Preparedness Innovations ( CEPI). Another $ 2 billion will follow in the next two years, an effort to encourage other countries to contribute more money.
The announcement was made during President Joe Biden’s participation in the Group of Seven (G7) meeting of the world’s largest economies, where the pandemic is high on the agenda and where others, including the UK, have made similar commitments to help vaccinations global efforts.
The Biden administration had announced last month who would join Covax, another example of the White House’s greatest commitment to international cooperation. President Donald Trump refused to join, one of the few notable resisters in an initiative that now has more than 190 participating countries.
Congress, however, set aside $ 4 billion for Gavi in his December spending bill, which is the money Biden is using for this announcement.
The US announcement also came in the wake of British Prime Minister Boris Johnson’s pledge to donate the UK’s surplus vaccines. The President of the European Commission (executive arm of the European Union) also said friday that the EU is doubling its contribution to Covax to $ 1 billion.
All of these commitments are welcome news and will make up for the real scarcity of resources in purchasing vaccine doses. At the same time, however, many of these wealthier countries are also rushing to inoculate their own populations, guaranteeing doses to their citizens at all costs and buying far more doses than they need to, while the rest of the world, especially low-income countries, is far behind.
About a quarter of the world’s population, mainly in low- and middle-income countries, may not have access to vaccination until 2022 – a precarious situation that could give a chance for new variants to emerge and that could extend the pandemic to everyone.
This is a good first step, but “vaccine nationalism” is still on the agenda
The COVID-19 Vaccine Global Access Facility, or Covax, was designed as a financing instrument to ensure that all countries – rich and less wealthy – have equitable access to a vaccine. Higher income countries contribute to the fund, pooling their resources to invest in several different candidate vaccines and finance free doses of vaccines for 92 lower income countries.
The advantage for high and middle income countries is that they increase their chances of getting a successful vaccine; these collective investments would also ideally reduce the cost of doses. And, of course, priority groups such as health professionals and the elderly would have early access to the vaccine in low-income countries, reducing the worst number of victims of the pandemic.
The idea came from the lessons learned from the 2009 swine flu pandemic, when rich countries bought all the vaccines and immunized their populations, and only then donated them to other countries, at which point the worst of the pandemic had passed.
A version of this is happening now, only on a more dramatic scale. In January, more than 80 million doses of the Covid-19 vaccine were distributed worldwide, while only 55 doses went to people in low-income countries. The pace has increased since then, but vaccinations have only started in 87 countries, most of them in high- and middle-income countries.
Although many wealthy countries have joined Covax and pledged funds, most still have individual pre-purchase agreements with pharmaceutical companies to bet on promising vaccines and guarantee their own doses.
Rich countries – with 14% of the world population – bought more than 53% of the vaccines most likely to succeed. An analysis of the ONE campaign, an international anti-poverty group, said the United States had an estimated 453 million excess doses of the Covid-19 vaccine, or what would be left after each eligible person in the U.S. had taken at least two vaccines.
But that does not mean that the United States or any other country has millions of doses out there; now, demand still exceeds supply. The wealthier countries, because of these purchase agreements, are often at the front of the line, and their ability to make large purchases can also increase the cost of doses.
All of this means that low-income countries are struggling to even start vaccination campaigns, if they have already started. Covax has set a goal to deliver 2 billion vaccines to poor countries by the end of 2021, with deliveries taking place in the first quarter of this year, most of which will begin in March.
An estimate by the Economist Intelligence Unit suggests that some low-income countries will not really be able to achieve broad vaccination coverage until around 2023. In the United States, by comparison, it may be this summer.
Additional funds for Covax are important, as they will allow Covax to enter into more agreements with vaccine manufacturers and distribute more doses. But as Julia Belluz of Vox reported last month, bilateral vaccine deals have already undermined Covax.
Rich countries “want to have it both ways,” Georgetown professor of global health law, Lawrence Gostin, told Belluz. “They join Covax so that they can proclaim themselves good global citizens and, at the same time, steal from Covax its vital force, which are the doses of vaccine.”
The United Nations has asked the richest countries to donate vaccine supplies, but, apart from Norway, few said they would do so while still trying to inoculate populations at home. The UK said it would donate the surplus supply, although it did not give a deadline. According to CNN, the Biden government is looking to donate doses as soon as “there is enough supply in the US”.
French President Emmanuel Macron said in a recent interview with the Financial Times that the EU and the United States should reserve 5% of their current Covid-19 vaccine supplies and take them to the poorest countries “very quickly, so that people on the ground see it happening. ”
But neither the EU – which recently took dramatic steps to try to secure more doses of vaccine for its own campaign – nor does the US seem ready to make these changes, despite rivals like China and Russia putting on a “vaccine diplomacy” show by sending their doses appropriate for countries in Africa and Latin America.
In addition to distributing doses, rich countries could also do more to increase manufacturing and production capacity in lower-income countries and to pressure pharmaceutical companies to give up intellectual property rights to better share knowledge and technology.
The United States and its allies, putting leadership and money into such efforts, is a public health need. The globe cannot recover from the pandemic or the economic crisis it has created, unless the rest of the world joins wealthier countries to come closer to collective immunity.
The United States and its partners making greater commitments to Covax and other global vaccine efforts is a real and important step towards these efforts. But it is only the first.