Only 9.3 vaccines were delivered to low-income countries per 100 people, according to the data, including 7.1 through Covax. This compares to 155 for high-income countries, of which 115 were received under known bilateral and multilateral agreements, according to data compiled by Unicef.
The data highlights how Covax, a procurement program put in place last year to give people in poor countries equitable access to vaccines, has largely failed so far. The consequences are serious, as insufficient vaccination in the poorest regions could lead to an increase in cases and the emergence of more virulent strains, and slow down the global economic recovery.
As the west prepares for winter, the gap between the haves and have-nots remains wide. Less than 3% of people in low-income countries have received at least one dose, according to Our World in Data, compared to three-quarters in rich countries.
“You really need to take a really close look at the model,” said Kate Elder, senior vaccine policy advisor at Doctors Without Borders’ New York access campaign. “We need a structural change if we are to avoid repeating this catastrophe in the future. “
By bypassing the WHO-backed program in the race to buy vaccine supplies from manufacturers, wealthier economies rolling out booster shots have prevented millions of the world’s poorest people from getting their first vaccine , forcing Covax to rely heavily on donations.
The program only delivered around 400 million doses out of an already reduced annual projection of 1.4 billion. And, after slashing its supply forecast last month, it faces the challenge of delivering around 1 billion doses in 68 days – nearly 14 million doses per day – to meet its 2021 targets.
Covax was supposed to facilitate the supply of vaccines for poorer countries by using collective bargaining power to expand access as much as possible. But he faced delays in shipments – when they arrived at all.
As rich countries made their own vaccine contracts with manufacturers, poorer countries sought to do the same.
The conclusion of separate vaccine deals weakened the facility’s overall bargaining power as Covax had to negotiate on behalf of fewer nations.
Another failure, said a senior official with direct knowledge of the problem, was that Covax had “no power” to compel manufacturers to honor their contracts through, for example, legal action.
“Covax is definitely being left behind, [the] the industry gives priority to other bilateral contracts, ”said the official.
The International Federation of Pharmaceutical Manufacturers and Associations, a pressure group, insisted there was “no ‘prioritization.” “Manufacturers are just fulfilling their contracts; whether they are with governments or Covax, ”he said.
To increase vaccine availability, WHO issued a new call for dose swapping earlier this month and called for a global moratorium on booster injections until the end of the year.
“Our priority now is to work with manufacturers, donor countries and. . . participants to ensure that the conditions are in place for efficient large-scale delivery during this time and beyond, ”said Gavi, a vaccine alliance aimed at improving access to immunization that has established Covax alongside the Coalition for Epidemic Preparedness.
But people with first-hand knowledge of Covax’s supply system say an underlying lack of vaccines and leverage will persist in the months to come.
African Union officials predict that Covax will deliver around 470 million doses to African countries by the end of the year, less than a quarter of what would be needed for its entire population of 1, $ 3 billion with two-shot regimens.
The impact of Covax’s problems worsened earlier this year when India’s Serum Institute, which manufactures the bulk of Oxford / AstraZeneca shooting for the developing world, was ordered by the Indian government to ‘Stop exports in order to fully immunize the country’s population amid an increase in cases.
A 600million Oxford / AstraZeneca extra dose deal, reached between New Delhi and the Serum Institute last month, has left Covax, university and company officials worried that projections will have to be reduced further, although the vaccine maker said exports could resume. starting this month.
“If they do not restart, it will further affect the availability of vaccines for other countries,” said Bruce Aylward, senior adviser to the WHO director general, noting however that there would be “other options. Such as using vaccines made by other manufacturers. “It depends on when they want to serve those contracts. ”
The Serum Institute, the University of Oxford and AstraZeneca declined to comment. Gavi said easing export restrictions would increase its expected supply.
Covax beneficiary countries continue to have only month-to-month visibility on deliveries, making planning difficult, officials said.
“We have managed to solve the vaccine supply, thanks to large donations, but the current proportion is 60% public investment in vaccines and 40% donations,” said a senior Angolan official, in the statement. capital of the country, Luanda.
“When the pandemic started, we thought the world had changed, and. . . there would be more solidarity, ”the official said. “But hey, the rest is history. “
Additional reporting by Amy Kazmin in New Delhi, Katrina Manson in Washington DC and Hannah Kuchler in London