1.8bln COVID-19 vaccine doses for poor nations by this year, says Covax chief

Covax is a global collaborative effort that is speeding up the development and production of Covid vaccines, and ensuring that no country is left behind, as the world battles to bring the pandemic under control.

Barroso, who is also a former prime minister of Portugal and president of the European Commission, believes the worst of the pandemic could be over by 2022 — if the vulnerable in poor nations get vaccines on time and production is boosted.

With India facing vaccine shortages and limiting exports, what is Covax doing to help vaccines reach poorer nations?

As India confronts a truly dreadful wave of the pandemic, it is clear that Indian vaccine production — for the next month, at least — will be committed to protecting its own citizens. We offer the government of India our full support in their effort to bring the virus under control and stand ready to help in any way we can, as we continue to maintain an active dialogue with the government.

Anticipating these types of challenges is one of the reasons Covax has sought to diversify its portfolio from the beginning. As a result, we are in conversations with other manufacturers of other candidates on supply schedules and will announce further rounds of allocation to Covax participants in due course.

We also anticipate being able to announce new deals for vaccines soon, as well as agreements on dose-sharing from higher-income countries, either donating excess supply, or transferring their own Covax allocations to participants supported by Gavi Covax Advance Market Commitment (AMC).

Is Covax working with developed nations on vaccine production and distribution? Is the US keeping excess stock of vaccines to itself?

Covax was set up as a multilateral mechanism, and active engagement and collaboration has been its driving force since launch. It is the only global initiative that is working with governments and manufacturers to ensure that Covid-19 vaccines are available worldwide to both higher-income and lower-income countries.

So far, Covax has negotiated access to over two billion doses of vaccines. Our goal is to expand this further, giving us as many tools as possible to achieve our vision of rapid, equitable access to vaccines. To do this, we need the continued support of global manufacturers and higher income countries; otherwise, vaccine inequality will never be overcome, and the pandemic will continue to rage and mutate.

Chinese vaccines have not been approved by the WHO yet. Do you think they are an affordable option for poorer countries?

China has committed to making its Covid-19 vaccine a global public good and their commitment to supplying early doses to the Covax Facility, once they have the necessary approvals, is welcome.

Gavi is in discussions with numerous vaccine manufacturers to secure doses for the Covax Facility and will consider procuring vaccines that complement our existing portfolio from any producer in the world, once they have received approval from a stringent regulatory authority and/or prequalification by the WHO.

How many vaccines does the world need to prevent another wave? Is there a funding shortfall?

Covax's immediate goal is to ensure every country has enough doses to be able to protect frontline health and social care workers, the elderly and those with underlying health conditions. For the 92 lower income economies eligible for donor-funded vaccines via the Gavi Covax Advance Market Commitment (AMC), this will require around 1.3 billion doses. However, we believe we can access 1.8 billion doses in 2021 with the help of our donors, which will allow even more people to be immunised.

In order to secure and finance 1.8 billion doses for AMC economies, we have raised US$6.6 bn to date. This is out of a total fundraising ask of US$8.3 bn. We are currently talking to public and private sector donors about raising the remaining cash, which we hope to secure by June, when we will co-host, along with the government of Japan, the Gavi Covax AMC Summit.

The bottom line is, until the virus is brought under control everywhere, we will not be safe anywhere. That is why we are also exploring other sources of doses: for example, dose-sharing by higher income economies that currently have surpluses, and “co-financing”, whereby countries are able to access greater volumes of doses through Covax by borrowing funds from development banks such as the World Bank.

Questions have been raised about the safety of the Janssen and AstraZeneca vaccines. How has it affected vaccinations in poorer countries?

The small numbers of adverse events we are seeing as a result of all vaccines just goes to show how important it is that we continue to monitor the deployment of vaccines even after they have been granted regulatory approval and are being distributed globally.

It is right that in some cases concerns over safety have led to temporary delays in supply and this is the appropriate course of action. The truth is that, even while vaccines have been developed for Covid-19 faster than they have for any other disease in the past, the same stringent levels of safety have been observed at every stage in their development.

South East Asia and Africa have still not begun mass vaccinations in earnest. Can they afford to wait further?

The Covax Facility has already delivered over 49 million vaccine doses to 121 economies, including to 72 of the 92 economies eligible for vaccines through Covax AMC mechanism, many of which are in South East Asia and Africa. The reality is, without Covax, the world’s lower and even middle-income countries would have little hope of getting access to doses of safe and effective Covid-19 vaccines. That is why it was so important that we avoided a repeat of the H1N1 pandemic in 2009, when a few wealthy countries tied up almost all global supply.

When does Gavi expect to get the pandemic under control?

Our goal is to help end the acute phase of the pandemic as quickly as possible by ensuring those that are most vulnerable to the virus are protected wherever they are. This could happen in 2022, but there is still so much work to do, and it is imperative more efforts are made to boost global production — especially production ring-fenced for lower income economies — and overcome the supply chain disruptions, export bans and bilateral deals that are currently slowing down the global effort.

It is likely that we will continue to see new spikes of infections in countries across the world — often due to the spread of new variants of the virus that are more transmissible. That is why early provision of vaccines is so critical to try and protect people’s health and health systems, but also to prevent the emergence and spread of new variants.

Vaccines are the best tool, but they must be used in combination with testing, treatment and non-pharmaceutical interventions, like masks and social distancing until the critical population is vaccinated.

Do you expect improved, new-generation vaccines to be produced in the coming months?

The global response to Covid-19 has already been set back by the emergence of new, more virulent strains of the virus that are proving easier to transmit and more resistant to certain vaccines and treatments.

Their emergence underscores the importance of continued investment in developing new vaccines and improving existing ones, as well as in the need to ensure funding is in place to enable additional variant booster shots or new formula vaccines should they prove necessary.

Manufacturers say vaccine immunity may last 6-12 months? Is that enough? Or will annual Covid shots be a way of life?

It is too early to predict whether we will need booster jabs due to the duration of protection or new variant jabs to keep us immune from the new variants that are emerging.