By Emmanuel Oluebube, Correspondent UK

64 higher income economies have joined the COVAX Facility, a global initiative that brings together governments and manufacturers to ensure eventual COVID-19 vaccines reach those in greatest need, whoever they are and wherever they live. These 64 economies include commitments from 35 economies as well as the European Commission which will procure doses on behalf of 27 EU member states plus Norway and Iceland.

By pooling financial and scientific resources, these participating economies will be able to insure themselves against the failure of any individual vaccine candidate and secure successful vaccines in a cost-effective, targeted way.

The 64 members of the Facility will be joined by 92 low- and middle-income economies eligible for support for the procurement of vaccines through the Gavi COVAX Advance Market Commitment (AMC), a financing instrument aimed at supporting the procurement of vaccines for these countries. This means that 156 economies, representing roughly 64 per cent of the global population in total, are now either committed to or eligible for the COVAX Facility, with more to follow.

With the Commitment Agreements secured, the COVAX Facility will now start signing formal agreements with vaccine manufacturers and developers, which are partners in the COVAX effort, to secure the doses needed to end the acute phase of the pandemic by the end of 2021. This is in addition to an ongoing effort to raise funding for both R&D and for the procurement of vaccines for lower-income countries via the Gavi COVAX AMC.

“COVAX is now in business: governments from every continent have chosen to work together, not only to secure vaccines for their own populations, but also to help ensure that vaccines are available to the most vulnerable everywhere,” said CEO of Gavi, the Vaccine Alliance, which is coordinating the COVAX Facility, Dr Seth Berkley. “With the commitments we’re announcing today for the COVAX Facility, as well as the historic partnership we are forging with industry, we now stand a far better chance of ending the acute phase of this pandemic once safe, effective vaccines become available.”

The COVAX Facility is part of COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, which is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance, and the World Health Organization (WHO) – working in partnership with developed and developing country vaccine manufacturers, UNICEF, the World Bank, Civil Society Organisations and others.

The allocation of vaccines, once licensed and approved, will be guided by an Allocation Framework released today by WHO following the principle of fair and equitable access, ensuring no participating economy will be left behind. Policies determining the prioritisation of vaccine rollout within economies will be guided by recommendations from the WHO Strategic Advisory Group of Experts on Immunization (SAGE), which has recently released a Values Framework laying the groundwork for subsequent guidance on target populations and policies on vaccine use.

“COVID-19 is an unprecedented global crisis that demands an unprecedented global response,” said WHO Director-General, Dr Tedros Adhanom Ghebreyesus. “Vaccine nationalism will only perpetuate the disease and prolong the global recovery. Working together through the COVAX Facility is not charity, it’s in every country’s own best interests to control the pandemic and accelerate the global economic recovery.”

The commitment of fully self-financing economies will now unlock vital funding and the security of demand needed to scale up manufacturing and secure the doses needed for the Facility. CEPI is leading COVAX vaccine research and development work, which aims to develop at least three safe and effective vaccines which can be made available to economies participating in the COVAX Facility. Nine candidate vaccines are currently being supported by CEPI; eight of which are currently in clinical trials.

“This is a landmark moment in the history of public health with the international community coming together to tackle this pandemic. The global spread of COVID-19 means that it is only through equitable and simultaneous access to new lifesaving COVID-19 vaccines that we can hope to end this pandemic”, said CEO of CEPI, Dr Richard Hatchett. “Countries coming together in this way shows a unity of purpose and resolve to end the acute phase of this pandemic, and we must now work closely with vaccine manufacturers – who play an integral part in the global response – to put in place the agreements needed to fulfil COVAX’s core aim: to have two billion vaccine doses available by the end of 2021. Today, we have taken a great leap towards that goal, for the benefit of all.”

The success of COVAX hinges not only on economies signing up to the COVAX Facility and commitments from vaccine manufacturers, but also filling key funding gaps for both COVAX research and development (R&D) work and the Gavi COVAX AMC to support participation of lower income economies in the COVAX Facility.

Governments, vaccine manufacturers (in addition to their own R&D), organisations and individuals have committed US$ 1.4 billion towards vaccine R&D so far, but a further US$ 700-800 million is urgently needed to continue to move the portfolio forward in addition to US$ 300 million to fund WHO’s SOLIDARITY trial.

The Gavi COVAX AMC has raised around US$ 700 million from sovereign donors as well as philanthropy and the private sector, against an initial target of US$ 2 billion in seed funding needed by the end of 2020. Funding the Gavi COVAX AMC will be critical to ensuring ability to pay is not a barrier to accessing COVID-19 vaccines, a situation which would leave the majority of the world unprotected, with the pandemic and its impact continuing unabated.

The Commitment Agreements also commit higher income governments to provide an upfront payment to reserve doses by 9 October 2020. These funds will be used to accelerate the scale-up of vaccine manufacturing to secure two billion doses of vaccine, enough to vaccinate one billion people assuming the vaccine requires a two-dose regimen. Further details on these upfront payments are available in Gavi’s COVAX Facility Explainer.

As well as procuring doses for participating economies, the COVAX Facility will also maintain a buffer of doses for emergency and humanitarian use.

Participating Country Comments

“COVID-19 poses serious health concerns to people everywhere, and that’s why Canada is committed to working with partners around the world to end the pandemic,” said the Rt. Hon. Justin Trudeau, Prime Minister of Canada. “Equitable, timely, and affordable access to a safe and effective COVID vaccine will be critical to help protect people’s health. Canada supports the objectives and principles of the COVAX Facility as the only global pooled procurement mechanism for countries to collaborate on this monumental undertaking. Our country is a part of this important global response.”

“New Zealand’s commitment to the COVAX Facility supports access to vaccines against COVID-19 for other countries too,” said Prime Minister of New Zealand, Rt Hon Jacinda Ardern.

“COVAX and the idea of equal access to a COVID-19 vaccine, regardless of ability to pay, is not just a moral imperative, it is the only practical solution to this pandemic. Protecting everyone is the only way we can return our world – our trade, tourism, travel, business – to normal,” said the Minister of Health and Wellness for Botswana, Honourable Dr Edwin G. Dikoloti. “We urge those countries who have not yet signed up to do so. Let us work together to protect each other.”

“Immunisation saves lives. Investing in immunisation infrastructure helps strengthen health systems. We have seen this time and again through our work with Gavi and Alliance partners,” said Dr Lia Tadesse, Minister of Health for Ethiopia. “By being a part of the COVAX Facility and the AMC we can continue this work and protect our citizens – and the world – against the impact of COVID-19.”

“With COVAX, the world is joining forces and proving that together, we are stronger – and together, we can defeat this pandemic,” said Minister of Health for Georgia, Ekaterine Tikaradze,. “Georgia will be joining the COVAX Facility to give our citizens the best chance at having access to safe vaccines. By doing this, we also make sure health care workers and other high risk persons all over the world have access to these life-saving tools, helping to bring the pandemic under control – and we can all recover and rebuild.”

“Joining the COVAX Facility was not a difficult decision – not only will this give Kuwaiti citizens access to COVID-19 vaccines as they become available, it will also mean our friends and partners outside our borders also get access,” said Minister of Health of the State of Kuwait, His Excellency Sheikh Dr Basel Humoud Al-Sabah. “We need a global solution to this global pandemic: we believe COVAX is that solution.”

“We believe international cooperation – a global effort – is key,” said Minister of International Development for Norway, Dag-Inge Ulstein. “We must continue to work for equitable access to vaccines, tests and treatments. To defeat the coronavirus pandemic, well-off countries need to act swiftly and boldly to make vaccines and treatments available to those who cannot afford to pay themselves. With the commitments to the COVAX facility we are heading in the right direction.”

“This is a hugely important initiative, which could offer us a path out of the acute phase of this pandemic and a return to normality,” said Minister of Health of the Sultanate of Oman, His Excellency Dr Ahmed Mohammed Obaid Al Saidi. “I would urge every country that has not yet done so to sign up, for all our sakes. It is far better for us to work together than apart.”

Partner Comments

“The history of vaccines will be defined by our response to COVID-19; the COVAX facility is at the epicentre of this response. Industry is at the forefront in vaccines development and manufacturing leading to supplies of several billion doses within the next few years”, said President of the Developing Countries Vaccine Manufacturers’ Network (DCVMN), Mr. Sai D. Prasad. “The COVAX facility will have a major impact on lives, livelihoods and accelerate the return to normalcy for countries. The DCVMN is fully engaged with its partners to enhance its mission of global public health and to leave no one behind.”

“It is very encouraging to see so many countries move from talk to full commitment,” said Director General of the International Federation of Pharmaceutical Manufacturers (IFPMA), Thomas Cueni. “The Facility can only work, and equitable access can only be achieved, if there is solidarity between rich and poorer countries. Today vaccine makers who have the unique skills and expertise to scale up manufacturing to levels never seen before, stand ready, together, to take up the challenge of providing two billion doses of yet unknown COVID-19 vaccines. This is no mean feat, as it requires doubling existing capacity in record time. Today, marks a significant step forward, and is a historic mark of solidarity which has the power to bring the acute phase of this pandemic to an end; and we are proud to be part of this unique endeavour to leave no one behind.”

“Uniting our efforts through COVAX must guarantee fair allocation and equitable delivery of the COVID-19 vaccine to those who need it most, and not just those who can afford it,” said Secretary-General of the International Federation of Red Cross and Red Crescent Societies, Jagan Chapagain. “We all have a moral and public health imperative to protect the poor in rural communities as the affluent in cities, the old in care homes as the young in refugee camps. The power of our humanity and the success of COVAX will be measured by how we collectively protect the most vulnerable among us.”

“Global cooperation must be the cornerstone of our global response to COVID-19,” said Chief Executive of Save the Children, Kevin Watkins. “The COVAX Facility has the potential to help ensure universal and equitable access to future COVID vaccines. For this to happen, we need to ensure people in low- and middle-income countries get their fair share and can access the vaccines they need to help overcome the biggest public health and child rights crisis of our generation.”

“Seeing such unity in the face of the COVID-19 crisis gives us confidence that, together, we can ensure the equitable delivery of COVID vaccines globally,” said Henrietta Fore, UNICEF Executive Director. “With our globe-spanning supply chain and on-the-ground presence across 190 countries, UNICEF is proud to support this historic effort.”