COVAX: Looking for equity after the pandemic
Por Javier Surasky
As countries around the world take action to contain and confront COVID-19 virus from spreading, and science advances in the direction of treatments and vaccines against it, the question of how the vaccine will be distributed has grown in value around the world, and also how an unprecedented mass vaccination campaign will be organized at a global level.
Since vaccines are “impure” global public goods we will only enjoy immunity if the majority of the world’s population is vaccinated. However, the application of a dose to one person excludes its application to another. Looking for an equitable distribution becomes a space where global needs, national interests and economic inequality intersect for access to treatment.
The desire to find a solution to the problem of the enormous research investment that a vaccine implies, the haste to develop it and the imperative of a massive distribution that reaches all people, lead in April 2020 to the creation of the “Access to COVID-19 Tools (ACT) Accelerator” Initiative, a non-institutional collaborative framework that brings together public and private, national and international actors, in an effort to accelerate the development, production and equitable distribution of tests, treatment and vaccines against COVID-19.
The ACT-Accelerator was organized around four pillars: Diagnosis, therapy, strengthening of health systems and vaccines. Within this last pillar, the main working tool is COVAX, a platform coordinated by the Vaccine Alliance (GAVI), The Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health Organization (WHO), in which more than 170 countries of all income levels are participating. Although some of the members have decided not to make their participation or degree of contribution public, for Latin America and the Caribbean, Argentina, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Mexico and Venezuela have done so.
Among the 170 members, 92 will receive support from COVAX without requiring the signing of a prior agreement. Countries from the LAC region include: Bolivia, Haiti, Honduras, El Salvador, Nicaragua, Dominica, Grenada, Guyana, Saint Lucia, and Saint Vincent and the Grenadines.
COVAX operates as a common fund of contributions from its members to facilitate all processes related to mass production and the rapid and efficient distribution of vaccines. According to the contributions made by each party, they can request from COVAX an immunization dose for 10 to 50% of their population. No country that has requested vaccines to cover 20% or more of its population will receive an amount above that percentage until all the others have reached that threshold (with the exception, of course, of those who have chosen to purchase a lower percentage of vaccines).
The initiative, which expects to have two billion doses in its possession by the end of 2021, for which 1.8 billion has been raised until now (October 2020), invests its funds in supporting companies that develop vaccines, and has bought in advance huge packages of doses of the main vaccines under production, thereby obtaining access at a lower price.
Astra-Zeneca was the first laboratory to sign an agreement with COVAX to guarantee the delivery of 300 million doses of its COVID-19 vaccine as soon as it is approved by the WHO. COVAX has also signed an agreement with Moderna laboratory which, together with Asta-Zeneca, are the most advanced laboratories in the testing of vaccines, having reached phase III testing in humans.
The COVAX initiative has been built on the development and distribution of pneumococcal vaccines previous experience. It is a reminder of the need to cooperate as the only way out of the global health crisis that we are facing, and to do so as indicated in the 2030 Agenda: Through broad multi-stakeholder partnerships that “leave no one behind ”.