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Covax: How Many Covid Vaccines Have The US And The Other G7 Countries Pledged?

The US has pledged to donate 500 million more doses of the Pfizer vaccine to poorer nations from next year - bringing its total commitment to more than one billion.

"To beat the pandemic here, we need to beat it everywhere," US President Joe Biden told a virtual Covid-19 summit.

The donation will be routed through Covax - the international scheme designed to ensure low-income countries aren't left behind in the fight against Covid.

It came amid growing warnings over the pace of global vaccinations, and inequity of access.

What is the Covax scheme?

Covax was created last year to ensure that Covid vaccines are made available around the world, with richer countries subsidising costs for poorer nations.

The scheme hopes to distribute enough vaccines to protect at least 20% of the population in 92 low- or medium-income countries - starting with healthcare workers and the most vulnerable groups.

Its initial goal was to provide two billion doses of vaccines worldwide in 2021, and 1.8 billion doses to 92 poorer countries by early 2022.

Covax is run by a number of international organisations, including the World Health Organization (WHO) and the UN children's charity, Unicef.

Ghana was the first country to receive Covax vaccines in February.

Since then, more than 303 million doses have been shipped through Covax to 142 countries around the world, including Bangladesh, Brazil, Ethiopia and Fiji.

Most doses are going to poorer countries, but some have been sent to wealthier countries such as Canada, which defended its request.

Which countries are donating vaccines and how many?

Covax works with with governments and vaccine manufacturers around the world. Supporters include the US, the UK, Canada, Japan, Australia, New Zealand, the UAE, France, Germany, Italy, Spain, Sweden, and Portugal.

Countries have pledged to donate both money and surplus doses from their own vaccine supplies.

The US joined Covax after President Biden took office in January 2021

The UK, Japan, Canada and the European Union are among those to have committed to supplying tens of millions of doses.

WHO director-general Tedros Adhanom Ghebreyesus previously criticised wealthier nations for "gobbling up" the global vaccine supply.

G7 countries have purchased over a third of the world's vaccine supply, despite making up only 13% of the global population.

What vaccines does Covax use?

Six vaccines have been given "emergency use authorisation" by the WHO, meaning they can be shared via Covax: AstraZeneca, Pfizer, Janssen, Moderna, Sinopharm and Sinovac.

However, only Pfizer and AstraZeneca doses have been delivered so far.

Moderna has agreed to supply 500 million doses at its "lowest-tiered price", but most won't be available until 2022.

How has the Covax rollout gone?

Covax has been criticised for being slow. Some initial targets were missed, partly as a result of the poor health infrastructure in many of the recipient countries, and partly because of vaccine hesitancy.

Covax supplied AstraZeneca Covid vaccines arriving in Madagascar in May 2021

Covax has told the BBC that too many donations have come in small quantities, at the last minute and with little time left before they expire. This makes it very hard to get them to where they are needed.

Representatives of the scheme also note that only a small percentage of the pledges made earlier this year have turned into actual doses.

Unicef executive director Henrietta Fore said countries needed to "accelerate their donation plans", with low-income nations unable to wait any longer.

While many high-income countries have now given at least one shot to more than half their populations, only 2% of people in low-income countries have had their first dose, according to data from the University of Oxford.

Covax says it is now expecting to hit its "key milestone" of releasing two billion doses for delivery some time early next year.

Can Covax help end the pandemic?

In total, some six billion doses of coronavirus vaccines have been administered, in over 195 countries worldwide.

However, while some countries have fully vaccinated a large amount of their population, many others have only just begun, or in some cases are still waiting for their first doses to arrive.

Covax aims to close that gap. "With a fast-moving pandemic, no one is safe, unless everyone is safe," the WHO says on its website.

But even if Covax meets its goal to vaccinate 20% of the population in its 92 target countries, that's well short of the level of immunity that experts say is needed to end the pandemic.

The WHO has suggested that figure is at least 70%. People may also need booster doses to remain protected.

Covax Vaccine-sharing Scheme Delivers First Doses To Ghana

The WHO and Unicef said the delivery was a momentous occasion

Ghana has become the first country to receive coronavirus vaccines through the Covax vaccine-sharing initiative.

A delivery of 600,000 doses of the AstraZeneca vaccine arrived in Accra on Wednesday. The first recipients are due to be healthcare workers.

The Covax scheme aims to reduce the divide between rich countries and poorer nations unable to buy doses.

The programme is planning to deliver about two billion vaccine doses globally by the end of the year.

Ghana, which has a population of over 30m, was chosen as the first recipient of the free vaccines after promising quick distribution and meeting the criteria set by Covax.

Further deliveries are expected to neighbouring Ivory Coast later this week, the Covax alliance says.

Vaccinations are expected to start in Ghana next week, and, as well as health workers, those over 60, people with underlying health conditions, and senior officials are due to be prioritised.

The vaccines delivered to Accra were produced by the Serum Institute of India and developed by AstraZeneca and Oxford University. The vaccine has been approved by the World Health Organization (WHO) and its roll-out in Ghana is not part of a trial.

The doses being sent to lower-income countries such as Ghana are funded by donations. As well as procuring and delivering the vaccines, Covax partners are supporting local authorities in areas such as training people to administer the jabs and helping provide an adequate cold-chain storage and delivery system.

Many nations in the developed world, which began their own vaccinations months ago, have faced criticism for buying or ordering more vaccines than they need.

But many of those countries placed orders for doses with pharmaceutical companies before knowing whether the vaccine in development would be effective. They were hedging their bets - placing multiple orders in the hope that at least some of them would work out.

Covax vaccine plan: What is it and how will it work?

The Covax scheme is led by the WHO and also involves the Global Vaccine Alliance (Gavi) and the Coalition for Epidemic Preparedness Innovations (Cepi).

In a joint statement, the WHO and the United Nations children's fund (Unicef) said it was a momentous occasion and "critical in bringing the pandemic to an end".

Ghana has recorded more than 80,700 cases of coronavirus and 580 deaths since the pandemic began. These numbers are believed to fall short of the actual toll because of low levels of testing.

Though the vaccines are not generally intended for children, Unicef is involved in the scheme because of its expertise in procurement and the logistics of vaccine delivery.

What is Covax?

The Covax scheme was set up by the WHO, the Gavi vaccines alliance and the Coalition for Epidemic Preparedness Innovations (CEPI) to try to prevent poorer countries from being pushed to the back of the queue.

The programme is designed so that richer countries buying vaccines agree to help finance access for poorer nations, too.

It hopes to deliver more than two billion doses to people in 190 countries in less than a year. In particular, it wants to ensure 92 poorer countries will receive access to vaccines at the same time as 98 wealthier countries.

The AstraZeneca vaccine is known as Covishield in India, where the doses delivered to Ghana were made

It aims to reach up to 20% of the populations of poorer countries, at no cost to their governments.

Commenting on Wednesday's first shipment, the Director-General of the WHO, Tedros Adhanom Ghebreyesus, said it was a major first step but just the beginning.

"We will not end the pandemic anywhere unless we end it everywhere", he added.

'This is just a start'

Analysis by BBC Africa health editor Anne Mawathe

The arrival of the first Covax vaccines in Ghana follows sharp criticism that African countries could be left behind in the fight against Covid-19. Western countries have been condemned for their rush to purchase more vaccines than they needed, leaving little left over for the rest of the world.

But this is just a start.

Ghana, a country with a population of about 31 million people, has now got a total of 600,000 doses of the vaccine.

Africa, a continent with about 1.4 billion people, is largely still waiting on Covax to deliver.

It is unlikely that many governments on the continent will go to the market and fight it out with countries with more financial muscle. In fact, most African countries will be buying the vaccines at a higher price than their Western counterparts, partly because they didn't pre-order.

Some have called for the big pharmaceutical companies to stop blocking a patent waiver, which would lead to lower prices and mean more vaccine would be produced.

But the companies have not agreed to this, knowing it could dent any profit margin.

Covax has so far raised $6bn (£4.3bn), but says it needs at least another $2bn to meet its target for 2021.

The scheme has faced some criticism for not moving quickly enough. One WHO board member, Austria's Dr Clemens Martin Auer, said it had been slow to secure vaccine deals and deliver doses.

The joint statement on Wednesday said the shipment to Ghana represented "the beginning of what should be the largest vaccine procurement and supply operation in history".

Nana Kofi Quakyi, who is a health policy research fellow at New York University's School of Global Public Health, told the BBC that Ghana would still struggle to compete with wealthier nations to make up the shortfall in doses it needed to find, even with the Covax initiative.

"The challenge that countries like Ghana are having is that in an open market, our bargaining power for bilateral deals is just not competitive against other wealthier countries that... In some cases, are buying more than they even need."

How many vaccines are rich countries sharing?

Why most of Africa has missed global vaccine target

The cost of not counting the dead

COVAX Vaccine Supply Outstrips Demand For The First Time

 

People stand in line to receive a COVID-19 vaccine, at the Narok County Referral Hospital, in Narok, Kenya, December 1, 2021. [Reuters]

The global project to share COVID-19 vaccines is struggling to place more than 300 million doses in the latest sign the problem with vaccinating the world is now more about demand than supply.

Last year, wealthy nations snapped most of the available shots to inoculate their own citizens first, meaning less than a third of people in low-income countries have been vaccinated so far compared with more than 70% in richer nations.

As supply and donations have ramped up, however, poorer nations are facing hurdles such as gaps in cold-chain shortage, vaccine hesitancy and a lack of money to support distribution networks, public health officials told Reuters.

In January, COVAX, the global vaccine programme run by Gavi and the World Health Organization (WHO), had 436 million vaccines to allocate to countries, according to a document published in mid-February.

But low-income nations only asked for 100 million doses for distribution by the end of May - the first time in 14 allocation rounds that supply has outstripped demand, the document from the COVAX Independent Allocation of Vaccines Group said.

Asked to comment, a Gavi spokesperson said COVAX was now in a situation where there was enough current supply to meet demand, but acknowledged that the roll-out of vaccines was an issue in several less-developed nations.

"We will only close the vaccine equity gap once and for all if we are able to help countries roll out vaccines rapidly and at scale," the spokesperson said.

Vaccines that are not assigned by COVAX in this round can be allocated again later.

While wealthy countries are opening up their economies, the WHO and other public health experts warn that the slow roll-out of vaccines in poorer regions will give the coronavirus a chance to mutate again and potentially create new variants.

FRIDGES AND FREEZERS

The low demand for vaccines in the January allocation is partly explained by recent increases in supplies. COVAX has already assigned tens of millions of doses to be delivered in the first quarter and delivered its billionth dose in January.

Officials involved in vaccine distribution said that meant countries were reluctant to take on more doses that they would not be able to use. 

A summit to address distribution challenges is taking place on Wednesday in Abuja, Nigeria, convened by the African Union's Africa Vaccine Delivery Alliance with WHO, Gavi and others rolling out shots across Africa attending.

There had been hopes that African countries would be able to administer billions of doses of COVID-19 vaccines given their experience in dealing with deadly diseases from Ebola to malaria. 

But two years into the crisis, a survey seen by Reuters by the United Nations Children's Fund (UNICEF) in January on the equipment needed to ramp up vaccine distribution highlighted some of the challenges.

It found "critical gaps" across 44 of the African Union's 55 member states: 24 countries said they needed fridges, 18 were in need of deep freezers, 22 required walk-in freezers and 16 did not have sufficient walk-in cold rooms.

A UNICEF spokesperson said more than 800 ultra-cold chain freezers had already been delivered to nearly 70 countries, as well as 52,000 fridges.

"We are continuing to help countries identify and close cold chain capacity gaps as supply increases and governments adjust national-level vaccination targets in response," she said.

DISINFORMATION AND FUNDING

The problem is particularly acute for COVAX because the Pfizer-BioNTech (PFE.N), shot that needs to be kept super-cold has replaced AstraZeneca's (AZN.L) vaccine as the main one being offered by the global programme.

Some African countries, such as Burundi and Guinea, have gaps at every point in the cold chain, from national level to local distribution centres, the UNICEF survey showed.

The findings are likely to underscore growing concerns that COVAX did not invest quickly enough in infrastructure and equipment for countries it was delivering vaccines to.

The issue is exacerbated by a lack of funding and because countries have not had enough notice of deliveries - particularly donations - making it harder for them to plan vaccination campaigns, public health officials have said.

Officials involved in the distribution of vaccines in Africa also said more focus needed to be placed on communicating the importance of getting vaccinated - and addressing disinformation.

"Communication is one of the biggest issues ... If we don't get the messaging right, everything else we are doing is futile," one of the officials said, speaking on condition of anonymity.

Money has also started to dry up for global initiatives as richer nations seek to move on from COVID.

Gavi says it has only raised $195 million out of the $5.2 billion it has asked for this quarter. The money is used to procure and ship vaccines, as well as provide syringes and delivery support in countries.

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