In early 2021 it began to distribute vaccines COVAX, “The only global initiative that works with governments and manufacturers to ensure access to anti-covid-19 vaccines for all countries, regardless of their resources”, is explained on the website of this platform formed by WHO, GAVI and the coalition CEPI. COVAX’s goal was to have 2 billion doses by the end of 2021, but according to vaccine panel UNICEF has so far distributed only a few 590 million doses.
COVAX’s goal was to have 2 billion doses by the end of 2021, but according to UNICEF’s Vaccine Panel, it has distributed only about 590 million doses so far.
In addition, the World Health Organization (WHO), the African Vaccine Procurement Fund (AVAT), the African Centers for Disease Control and Prevention (Africa CDC) and COVAX itself have just completed request for donor countries and vaccine manufacturers that donations They are done in a planned way, with a margin of time. With the last minute “the risk of the doses expired dramatically increases”, warn these institutions. Most donations so far have been done this way and “the trend must change”.
“Although the global COVAX vaccine residue rate is extremely low today,” said a GAVI spokesperson Covid Vaccine Media Hub, “This rate is likely to increase as supply grows in the coming months. To reduce this, we urge donor countries to ensure that donated doses have a minimum shelf life of ten weeks when they arrive in the country, except when recipient countries indicate their willingness and ability to absorb doses with a shorter shelf life ” .
This is one of the problems that could be improved, but not the only one. Three Spanish experts give their vision to SINC in Covid Vaccine Media Hub.
“The highest-income countries conquered the market”
“The problem is not economic,” he says. Virginia Rodriguez, responsible for the policy advocacy project of the Global Health Institute of Barcelona (ISGlobal) “COVAX has the resources to acquire the 2,000 million doses, the objective for this year. But higher-income countries monopolized the market by buying doses to vaccinate their populations multiple times. For this reason, and in an unplanned way originally, in recent months COVAX has become a mechanism for distributing the doses of vaccines donated by the countries that have accumulated them”.
The accumulation of vaccines from high-income countries has meant that COVAX remains the last in line at the reception of vaccines produced and to be produced
Raquel González, Doctors without Borders
COVAX channels donations from countries with more resources, but also acts as an intermediary in the purchase of vaccines from 50 low-income countries –It does this by adding up its demand, to improve its negotiation conditions with the industry–. In practice, the large volume of purchases from rich countries has hampered this second capability of COVAX.
“The accumulation of vaccines from high-income countries has meant that COVAX is the last in line to receive the vaccines produced and to be produced”, he says. Rachel Gonzalez, Head of Institutional Relations of Doctors Without Borders. “The world is currently facing a problem of vaccine shortages in low- and middle-income countries,” he adds.
The problem of the lack of vaccines available to low-income countries has worsened after the strong wave in Indiaexplains González: “COVAX is overly dependent on the Serum Institute of India, licensed to produce the vaccine developed by Oxford University and AstraZeneca. Faced with the deadly wave of cases that the country has suffered since March 2021, your government has reduced export doses,” further increasing COVAX’s reliance on vaccine donations from high-income countries.
Adrian Alonso, researcher of the Global Health Center in Geneva (Switzerland), he draws attention to the novelty and complexity of the COVAX system, which “presents a very ambitious target that has never been tested before”.
“Of course he won’t be able to meet his goals this year,” says Alonso. “However, I don’t think blaming COVAX for the failure is entirely fair, as it has had to compete with countries that have signed agreements to vaccinate their population up to five times on the full schedule.” In his opinion, “COVAX could have gained more importance as a mechanism for the purchase and distribution of doses”.
Public financing without conditions of social return
Other factors outside COVAX also contributed to the situation being what it is, says Alonso. One is the fact that Public sector “it financed a large part of the development of vaccines, from fundamental technology to basic research, with conditions that are hardly imposing for social return”.
Public authorities have invested without guaranteeing that their investment will lead to increased global access, production capacity or transparency, leaving the decision on the distribution of vaccines to the market
Adrian Alonso of the Global Health Center
“Not shareholder would invest without an estimate of the return on investment, but public authorities have invested without ensuring that their investment implies an increase in global access, production capacity or transparency and leaving the market to be –who can pay– who decides the destination of the vaccines”, says the specialist. “At worst, some governments have introduced conditions for priority access for their population in relation to the rest of the world,” he continues.
He also criticizes the “frankly conservative” behavior of several vaccine companies, which have dominated “production and distribution, restricting supply, without making major efforts to create or expand production capacity to other regions.”
For Alonso, there were also others missed opportunities to improve global access, such as creating C-TAP, a platform created by WHO and Costa Rica for research institutes and companies to make their knowledge and technology available –for free or in exchange for royalties– for others to apply to increase production capacity, development speed, etc. The pharmaceutical industry did not support this initiative.
In fact, so far only the Spanish government has recently reached an agreement that any company in the world can manufacture an antigen test developed by the CSIC.
Vaccines are not alone
Raquel González highlights that there is a lack of resources and everything needed for a vaccination campaign, in addition to the vaccine itself: “The salaries of health personnel, training or infrastructure of the cold chain” are costs that depend on the national health budgets, which in countries with few resources are already scarce.
Disinformation remains a critical factor in this pandemic
Raquel González, Doctors without Borders
These costs also cover “the awareness strategies and community involvement, something that has been lacking in many contexts, contributing to resistance to vaccination and lack of trust,” adds González.
“O disinformation continues to be a critical factor in this pandemic and adequate resources have not been dedicated to resolving doubts about vaccines”, he emphasizes.
What can Spain do?
Spain has pledged to donate through COVAX a total of 22.5 million authorized vaccines in the European Union and used in Spain, of which at least 7.5 million will go to Ibero-American countries, explained the Government of Spain. Donations started last August.
Thereafter, an increase in donations was announced, reaching 50 million in the first quarter of 2022. ”Spain took significant steps to improve equitable access to vaccines in low- and middle-income countries,” says Raquel González.
Spain has been developing an action different from several western countries
Adrian Alonso of the Global Health Center
“Since last May, where he presented the document “Vaccines for everyone” at the Porto Social Summit, he expressed his willingness to support the temporary exemption of some intellectual property agreements; as well as vital support to C-TAP, where it has shared a new diagnostic test for detecting COVID19. It’s the world’s first shared open license”, says the expert.
Adrian Alonso also believes that “Spain has developed a differentiated performance from several western countries”. This expert also highlights the recent license agreement between CSIC and C-TAP, and recalls that our country “was one of the first western countries to take a stand in favor of lifting intellectual property rights and a new pandemic treaty”.
“In addition, it has participated in the financing of CEPI (public-private organization that finances vaccine development for diseases with epidemic potential, which funded the initial development of vaccines like Oxford, Curevac or Novavax), COVAX and announced support and commitment to strengthen the role and funding of WHO for the future ”, concludes.
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