172 economies are now engaged in discussions to potentially participate in COVAX, a global initiative aimed at working with vaccine manufacturers to provide countries worldwide equitable access to safe and effective vaccines, once they are licensed and approved. COVAX currently has the world’s largest and most diverse COVID-19 vaccine portfolio – including nine candidate vaccines, with a further nine under evaluation and conversations underway with other major producers.
COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, 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. It is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries.
In order to be able to secure enough doses of vaccines to protect the most vulnerable populations, such as health workers and the elderly, the next step for the partnership is to confirm potential self-financing participants’ intent to participate by 31 August and to turn these into binding commitments to join the COVID-19 Vaccine Global Access Facility (COVAX Facility) by September 18th, with first upfront payments to follow thereafter, and no later than October 9th.
“Equal access to a COVID-19 vaccine is the key to beating the virus and paving the way for recovery from the pandemic,” said Stefan Löfven, Prime Minister of Sweden. “This cannot be a race with a few winners, and the COVAX Facility is an important part of the solution – making sure all countries can benefit from access to the world’s largest portfolio of candidates and fair and equitable distribution of vaccine doses.”
The COVAX Facility is a Gavi-coordinated pooled procurement mechanism for new COVID-19 vaccines, through which COVAX will ensure fair and equitable access to vaccines for each participating economy, using an allocation framework currently being formulated 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 success of COVAX hinges not only on countries signing up to the COVAX Facility, but also filling key funding gaps for both COVAX R&D work and a mechanism to support participation of lower-income economies in the COVAX Facility.
“COVID-19 is an unprecedented global health challenge that can only be met with unprecedented cooperation between governments, researchers, manufacturers and multilateral partners,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “By pooling resources and acting in solidarity through the ACT Accelerator and the COVAX Facility, we can ensure that once a vaccine is available for COVID-19, it’s available equitably to all countries.”
CEPI is leading COVAX vaccine research and development work, which aims to develop three safe and effective vaccines which can be made available to countries participating in the COVAX Facility. Nine candidate vaccines are currently being supported by CEPI; seven of which are currently in clinical trials. Governments, vaccine manufacturers (in addition to their own R&D), organizations and individuals have committed $1.4bn towards vaccine R&D so far, but an additional $1bn is urgently needed to continue to move the portfolio forward.
A further nine candidates vaccines which complement the current CEPI portfolio are currently being evaluated for inclusion in COVAX. Furthermore, COVAX will consider procuring vaccines that complement the portfolio from any producer in the world; conversations are already underway with a number of additional manufacturers not receiving R&D support from CEPI to procure their vaccines if they are successful. Maximizing the portfolio of vaccines increases the probability of success as individual vaccines historically have a high failure rate.
“In the scramble for a vaccine, countries can act alone – creating a few winners, and many losers – or they can come together to participate in COVAX, an initiative which is built on enlightened self-interest but also equity, leaving no country behind,” said Richard Hatchett, CEO of CEPI. “Only by taking a global view can we protect those most at risk around the world from the terrible effects of this disease. COVAX can deliver the vaccines that could end the pandemic, but it needs countries to step forward both to join the COVAX Facility, and also to address the serious funding shortfalls, including for R&D. The decisions that are taken now about COVID-19 vaccines have the power to change our future. We must be courageous and ambitious in striving for a multilateral solution.”
A collaboration between Serum Institute of India (SII), Gavi and the Bill & Melinda Gates Foundation announced earlier this month will ensure up to 100 million doses of AstraZeneca or Novavax’s candidate vaccines, if successful, will be available to low- and middle-income economies through the COVAX Facility at just US$ 3 per dose. The arrangement also provides an option to secure additional doses if COVAX sees a need for it. Separate agreements between Gavi, CEPI and AstraZeneca, announced in June, guarantee a further 300 million doses of their candidate vaccine, if successful, for the COVAX Facility.