Drastic change of model is needed for possible future pandemics
Geneva, 22 June 2021 - As the Gavi board meets this week (23-24th June 2021), one topic on their agenda will be changes to the COVAX Facility. The COVAX Facility is the global procurement mechanism that was supposed to deliver COVID-19 vaccine equity; it is coordinated and legally administered by Gavi, the Vaccine Alliance. While COVAX was being envisioned and set up, MSF in June 2020 cautioned Gavi not to repeat mistakes that were made in a previous mechanism created for the pneumonia vaccine.
COVAX is currently grossly behind on achieving its goals. COVAX had aimed to provide 2 billion doses by the end of 2021, but so far has only distributed 88 million (the goal by the end of June was to distribute around 337 million). Less than half of one percent of total populations of COVAX countries have received at least a first dose of vaccine through COVAX. As the global health community increasingly discusses models to be prepared for future pandemics, MSF cautions that the shortcomings of the COVAX model must not be replicated.
Kate Elder, Senior Vaccines Policy Advisor at MSF’s Access Campaign:
“COVAX is severely off course right now to reach its goals, with the growing global divide between the vaccine haves and have nots a glaring testament to this model’s major shortcomings. Many countries where we work still don’t even have enough doses to cover their health care workers and most vulnerable people.
“Loud calls early in the pandemic to depart from a business as usual approach were ignored—pharmaceutical corporations developing vaccines received billions in government money without any strings attached, so were free to charge prices they chose and to sell to the highest bidder. Unsurprisingly, this led to the very same governments that had touted the importance of equity at the ACT-A launch – and the governments that Gavi spent so much time courting to join the COVAX Facility – ultimately pursing national interests and securing the bulk of future promised vaccines.
“COVAX was not set up to succeed. It was constructed to work within the current parameters of the pharmaceutical market, where you see how much money you can raise and then see what you can negotiate with industry for it. COVAX was left behind as wealthy governments secured their doses through bilateral deals with an industry that acted as expected: selling doses first to the buyers who could afford to pay the most.
“While COVAX initially presented itself as the most attractive purchaser in the world since it claimed to represent the majority of the world’s countries, the model is now largely relying on charity dose donations from wealthy countries to plug the huge divide.
“The fact that Gavi’s board is now reviewing the way in which wealthier countries (so called ‘Self-financing participants’) can continue to participate in the facility is in part a recognition that the set up does not work. Allowing wealthy countries so much flexibility to decide how they join COVAX and how many vaccines they procure, has caused delays and undermined its objectives. A more equitable model would have encouraged regional leadership with decentralized methods of procurement at their core. In the future, we must support these regional initiatives that aim for self-sufficiency and self-determination.”
“Any future model for pandemic response must break from the status quo of the current pharmaceutical model: conditions need to be attached to public funding, non-exclusive licensing and technology transfer need to be promoted to ensure true sharing of the fruits of medical innovation, and there needs to be transparency around costs and prices – all contracts should be public.”