five questions about the Covax program

Less than five months after the start of the first mass vaccination campaigns, in December 2020, more than a billion doses of Covid-19 vaccines were administered worldwide, according to data compiled from government sources by the Our World in Data project, from the University of Oxford (United Kingdom).

While most countries around the world have now launched their vaccination campaign, vaccination remains a privilege of countries with “High income”, in the terminology of the World Bank. The latter, which house 16% of humanity, thus concentrate 47% of the injected doses; countries to ” low income “ for the moment being satisfied with 0.2% of the doses.

Twelve countries do not yet vaccinate: seven in Africa (Tanzania, Madagascar, Burkina Faso, Chad, Burundi, Central African Republic, Eritrea), three in Oceania (Vanuatu, Samoa, Kiribati), one in Asia (North Korea) and one in the Caribbean (Haiti).

In mid-April, the head of the World Health Organization (WHO), Doctor Tedros Adhanom Ghebreyesus, launched this shocking statistic: one in four people is vaccinated in some rich countries against one in five hundred in some poor countries.

” This is unacceptable “, abounded, during a WHO conference on April 23, the French President, Emmanuel Macron. “The time has come to share. “

• What is the Covax program?

Covax is one of the three pillars of device to accelerate access to tools to fight against Covid-19 (ACT), which was launched at the end of April 2020 by the WHO, the European Commission, France and the Bill and Melinda Gates Foundation. ACT brings together governments, global health organizations, manufacturers, scientists, the private sector and civil society, with the aim of providing access “Innovative and fair” diagnostics, treatments and vaccines.

It is this last aspect that Covax covers. This public-private partnership under the aegis of the WHO, the Vaccine Alliance (GAVI) and the Coalition for Innovations in Epidemic Preparedness (CEPI), aims to ensure equitable distribution of vaccines. Nowadays, 191 states are involved in the program.

Covax acts as a platform to support the research, development and manufacture of a wide range of vaccine candidates and negotiate their prices, details the GAVI. It aims to acquire 2 billion doses by the end of 2021, in particular for the 92 low- and middle-income countries through a funding and donation mechanism.

• Which are the beneficiary countries?

The list of first beneficiaries of the program and the quantity of vaccines they will get until June had been unveiled in early February. The approximately 337 million doses were expected to cover 3.3% of the population in 145 countries and territories.

Otherwise, a stock of approximately 5% of the total number of doses available is set aside, in order to constitute ” a stockpile “ can be used in humanitarian contexts or in the event of serious epidemic outbreaks.

On February 24, Ghana inaugurated the device. By the end of April, nearly 49 million doses of vaccine had been distributed in 120 countries around the world, according to the latest data from Unicef.

• What vaccines are used?

The Covax device manages a catalog of vaccines “The largest and most diverse in the world”, with nine vaccine candidates in development and nine more under evaluation, according to GAVI. However, the WHO has so far issued its emergency approval to only three vaccines: the one developed by Pfizer-BioNTech (on December 31, 2020), that of the Swedish-British AstranaZeneca (on February 11) and that by US pharmaceutical giant Johnson & Johnson (March 12).

Easy to keep, because it can be stored in conventional refrigerators, the formula from the AstraZeneca laboratory is the main one used in the device. Few countries receive the Pfizer-BioNtech vaccine, purchased at cost and which must be stored between – 80 ^oC and – 70 ^ovs.

• How does the funding work?

In 2020, 2 billion dollars (1.65 billion euros) were raised to finance the Covax project, and WHO estimates that an additional $ 5 billion is needed to complete it. “In order to be able to reserve vaccines, it is necessary to have funding”, recalled, on April 15, the head of the GAVI, the doctor Seth Berkley.

The European Union participated in the scheme to the tune of 850 million euros, France gave 100 million, Spain 50 million and the United States 2 billion dollars (1.6 billion euros). The Greta Thunberg Foundation will also participate by donating 100,000 euros.

“The supply of vaccines and funding is still insufficient, and there is an urgent need to strengthen the Covax program in order to ensure equitable access to safe, effective and quality vaccines for developing countries”, argued, in mid-April, the Japanese Foreign Minister, Toshimitsu Motegi, whose country will organize a summit in June on the financing of this system.

• What difficulties is Covax facing?

For the time being, the program is struggling to reach cruising speed and remains far from the initial target of delivering 500 million doses at the end of the first half of 2021. Especially since the blocking of exports of doses from the AstraZeneca vaccine manufactured in India will be accompanied by delivery delays. The country, the largest vaccine producer in the world, has indeed taken this step in the face of an epidemic of unprecedented magnitude.

Several rich countries have also preferred to source directly rather than rely on Covax. Under the pressure of their public opinion, many leaders – in the EU and the United States, for example – have thus secured their needs, even if it means having a surplus. In contradiction with Covax’s goal, which is that all countries have equal access to vaccines from the moment they are placed on the market. The shortage of available doses therefore deprives poorer countries of access to vaccines.

On April 23, Emanuel Macron announced that France had sent doses of AstraZeneca vaccine to countries in West Africa and will give at least 500,000 doses of various vaccines by mid-June. For its part, the White House announced, on April 26, that it would unblock the sending of 60 million doses of the same pharmaceutical group for the benefit of other countries. The United States had until then been very criticized for refusing to export this vaccine, which is not even authorized on their territory yet.