Covax’s latest supply forecast-a plan to share the COVID-19 vaccine globally-suggests that accelerating vaccination in low-income countries looks unlikely. Covax estimates that by the end of 2021, it will distribute 1.425 billion doses of vaccine, well below its target of 2 billion doses earlier this year.
As of September 15, 2021, 280.5 million doses of COVID-19 vaccine have been vaccinated through Covax alone. Because some high-income countries in many low-income countries introduced boosters and vaccinated children even before the first dose of adults, vaccine inequality is increasing and there is no sign of disappearing.
It is not surprising that Covax failed to meet its initial forecast for 2021. The CEO of the Serum Institute of India was initially the largest scheduled supplier for the plan, but shortly after the plan was released, he doubted the 2 billion figure and stated that it would take 6 to reach this milestone. Months.
A major problem is getting a good position in the vaccine cohort. Although Covax is raising funds after its launch in June 2020, many high-income countries have already purchased most of the initial supply from manufacturers. The Director-General of the World Health Organization (WHO) Dr. Tan Desai believes that despite the financial support provided, the world’s largest economy has weakened Covax.
However, the biggest setback occurred in late March, when the export of COVID-19 vaccines from India (the world’s largest manufacturer of COVID-19 vaccines) was suspended. In view of the country’s devastating second wave of epidemics, India’s production has been redirected to domestic supply. The Serum Institute of India was originally scheduled to supply more than 1 billion doses to Covax in 2021. Exports have not yet recovered, and the country has only exported 20 million doses to Covax.
Therefore, low-income countries, which are the main targets of the plan, are still far behind in terms of COVID-19 vaccination. Low-income countries receive an average of 3 doses of COVID-19 vaccine for every 100 people, while high-income countries receive more than 120 doses.
What is the next step for low-income countries?
Covax stated in its latest forecast that it is “in ongoing dialogue with the Indian government on the supply of COVID-19 vaccines” and that “the timing and extent of the issuance of Indian export controls” is a major cause of uncertainty. Although the US government has also joined efforts to promote India’s resumption of exports to Covax, the signs are not optimistic. A senior Indian government official was recently quoted as saying that India will not resume sharing doses until all adults in the country are vaccinated.
Although India has made rapid progress in vaccination, with more than 780 million doses of vaccine, only 196 million people have received dual vaccines. India’s goal is to achieve full adult immunization by the end of 2021-there are approximately 1 billion adults in the country.
Covax has also put forward other requirements to donors and manufacturers, especially for countries with high vaccine coverage, which give up their place before Covax in the manufacturer’s cohort, and from the population with a high proportion of people who have been vaccinated. More donations from the country. These requests are not new, and the head of the WHO admitted that his requests “may sound like a broken record.”
So far, vaccine donation pledges have not made substantial progress in actually getting people vaccinated. In June of this year, the G7 countries pledged to donate 1 billion doses to “poor countries”, and the UK pledged to donate 100 million doses. However, so far, the UK has only provided Covax with 5.1 million doses of vaccine, and a total of only 10.3 million doses have been sent abroad.
At the same time, the UK has actually taken the dose of Covax it is entitled to (many other wealthy countries have waived their right to share). In June, the same month the UK made its 100 million dose pledge, the UK received 539,000 doses of vaccine from Covax, more than twice the dose Covax sent to Africa in the same month.
To further complicate the problem, the position in the previous vaccine cohort of Covax is occupied by countries that now include boosters in their vaccination programs. The United Kingdom, the United States, and Israel have all decided to introduce more vaccines-given the shortage of vaccines, Covax desperately needs all these vaccines.
In early August, the WHO called for a moratorium on the use of boosters before the end of September, saying that giving them would “increase inequality”. The moratorium has recently been extended to the end of 2021. But this has not stopped the UK from launching its booster program.
The priorities that the entire world needs are clear. Sara Gilbert, the main developer of the Oxford/AstraZeneca vaccine, believes that given the “first dose of the greatest impact”, the vaccine should be distributed to countries with low vaccination rates. Compared with providing boosters to people who have been vaccinated, vaccinating people who have not previously been vaccinated can save more lives. However, national priorities continue to dominate.
Mike Ryan, Executive Director of the WHO Health Emergencies Programme Already described Giving booster shots is like distributing extra life jackets to those who already have life jackets to keep those who are not drowned. Marchidiso Morty, WHO’s director for Africa, said the enhanced plan “is a fair mockery of vaccines.”
The inclusion of children in the vaccination program further weakened Covax’s prospects for obtaining more vaccines. It is planned to start vaccinating children between 12 and 15 years old in the UK by the end of September. Both Gilbert and Mike Ryan of the WHO believe that people in low-income countries need more doses.
The catastrophic moral failure of wealthy countries hoarding vaccines that Tedros warned in January was imminent. This kind of vaccine nationalism is not only morally problematic, but by helping the virus to spread in certain parts of the world, it may have dangerous new mutations and may hinder the global economic recovery.
Covax needs to get large doses as quickly as possible-but these needs continue to be bypassed. Forget the dual vaccinations in high-income countries. It is Covax who needs booster vaccines.