COVID Vaccines/Immunization – Equity/Access/Dose Sharing

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COVID Vaccines/Immunization – Equity/Access/Dose Sharing


Editor’s Note:
We aggregate below a number of announcements and calls-to-action from the past week around equity/access/dose sharing.

Gavi – Global leaders renew their commitment to address urgency of COVID-19 pandemic
:: At today’s Global Health Summit, hosted by the European Commission and Italy as chair of the G20, leaders pledged their support to the Gavi COVAX Advance Market Commitment (AMC)
:: Italy committed EUR 300 million to the Gavi COVAX AMC, which will count towards COVAX’s goal of procuring 1.8 billion COVID-19 vaccine doses for lower-income economies in 2021.
:: In addition, France, Germany, Italy, The Netherlands, Norway, Spain and Switzerland – as part of Team Europe – pledged to share a combined total of over 100 million vaccine doses with middle- and low-income economies, boosting short term supplies.

Geneva, 21 May 2021 – The Global Health Summit, hosted by the European Commission and Italy as chair of the G20, saw governments announce support to the Gavi COVAX Advance Market Commitment (AMC), including a pledge of EUR 300 million from Italy. The commitment brings the total amount of funds raised for the  Gavi COVAX AMC, the funding mechanism to finance doses of COVID-19 vaccines for 92 lower-income economies within the COVAX Facility, to over US$ 7 billion.


In addition, Team Europe announced the largest dose sharing donation to date, with 100 million doses of COVID-19 vaccines going to lower-income economies with a majority of them through the COVAX AMC. Donors include France and Germany who stated they would be sharing 30 million surplus doses each and Italy who will be donating 15 million doses by the end of 2021.

This additional funding comes at a time when COVAX is looking to secure a total of US$8.3 billion from sovereign donors and the private sector for 2020-21 in order to accelerate access to 1.8 billion COVID-19 vaccine doses for lower-income economies. In addition, to support AMC eligible economies’ that want to buy additional doses through COVAX, a further US$1 billion is being sought from multilateral development banks to support a cost-sharing initiative.

The campaign will culminate at the virtual Gavi COVAX Advance Market Commitment (AMC) Summit – One World Protected – Committed to Deliver on the 2nd June, which will be co-hosted by Japanese Prime Minister H.E. Yoshihide Suga together with José Manuel Barroso, Chair of the Gavi Board.

“COVAX has built the systems to deliver vaccines to low and lower middle income countries; we welcome the support of the G-20 countries to help us scale up volumes and reduce vaccine inequities.  Today’s funding, especially the very generous commitment from Italy and dose donation pledges demonstrate that global leadership understands that it’s time to unleash COVAX’s full potential to bring the acute phase of this pandemic to an end,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance. “Funding the AMC and sharing doses with COVAX are among the most effective interventions a country can make to control COVID-19 and we urge all governments to work with us in protecting people everywhere.”

Securing 1.8 billion doses would enable the Gavi COVAX AMC to protect nearly 30% of the population in 92 lower-income countries, or roughly half the adult population. The additional funds will also help diversify the portfolio in times of supply uncertainty; secure access to doses for delivery in 2021 and early 2022; and plan the scenarios and strategy to meet public health needs for 2022 and beyond…



The COVAX Facility will deliver its 65 millionth vaccine dose this week. It should’ve been at least its 170 millionth. The time to donate excess doses is now
Statement by UNICEF Executive Director Henrietta Fore, as G7 countries gear up for June summit
[Editor’s text bolding] Editor’s text bolding]
NEW YORK, 17 MAY 2021 – “The COVAX Facility – the global COVID vaccine equity scheme – will deliver its 65 millionth dose in the coming days. It should have been at least its 170 millionth. By the time G7 leaders gather in the UK next month, and as a deadly second wave of COVID-19 will likely continue to sweep across India and many of its South Asian neighbours, the shortfall will near 190 million doses.

“We have issued repeated warnings of the risks of letting down our guard and leaving low- and middle-income countries without equitable access to vaccines, diagnostics and therapeutics. We are concerned that the deadly spike in India is a precursor to what will happen if those warnings remain unheeded. While the situation in India is tragic, it is not unique. Cases are exploding and health systems are struggling in countries near – like Nepal, Sri Lanka and Maldives – and far, like Argentina and Brazil. The cost for children and families will be incalculable.

“The longer the virus continues to spread unchecked, the higher the risk of more deadly or contagious variants emerging.


“The clearest pathway out of this pandemic is a global, equitable distribution of vaccines, diagnostics and therapeutics. COVAX, led by the WHO, Gavi and CEPI, with UNICEF as implementing partner, represents such a pathway. But COVAX is undersupplied.

“Among the global consequences of the situation in India, a global hub for vaccine production, is a severe reduction in vaccines available to COVAX. Soaring domestic demand has meant that 140 million doses intended for distribution to low- and middle-income countries through the end of May cannot be accessed by COVAX. Another 50 million doses are likely to be missed in June. This, added to vaccine nationalism, limited production capacity and lack of funding, is why the roll-out of COVID vaccines is so behind schedule.

“G7 leaders will be meeting next month with a potential emergency stop-gap measure readily available. New data analysis provided by Airfinity, the life sciences research facility, and commissioned by the UK National Committee for UNICEF, indicates that G7 nations and ‘Team Europe’ group of European Union Member States could donate around 153 million vaccine doses if they shared just 20 per cent of their available supply over June, July and August. Critically, they could do so while still meeting their commitments to vaccinate their own populations.

“While some G7 members have greater supply than others, and some have further advanced domestic rollouts, an immediate collective commitment to pool excess supply and share the burden of responsibility could buttress vulnerable countries against becoming the next global hotspot.

“Ultimately, the global vaccination race will be won when Member States make sustainable plans to fully fund and supply the COVAX Advance Market Commitment, while supporting the expansion of vaccine manufacturing capacity, including through proactive Intellectual Property licensing and technological transfer. These measures are critical, but they won’t change anything overnight. Sharing immediately available excess doses is a minimum, essential and emergency stop-gap measure, and it is needed right now.”



DG Okonjo-Iweala calls on WTO members to tackle vaccine inequity
Speaking to G20 leaders and the heads of international organizations on 21 May, Director-General Ngozi Okonjo-Iweala said WTO members could contribute to greater equity in the global distribution of COVID-19 vaccines by lowering supply chain barriers, fully using existing production capacity, and addressing issues related to intellectual property, access and innovation.
[No speech transcript posted; Editor’s text bolding]

DG Okonjo-Iweala, who has described equitable access to COVID-19 vaccines, diagnostics and therapeutics as “the moral and economic issue of our time,” told the Global Health Summit, co-hosted by the European Commission and the Italian G20 Presidency, that the pandemic had made clear that “policymakers need to think of preparedness, response, and resilience as one interconnected package”.

International cooperation on trade is important for all three elements of this package, she said, arguing that trade has been a “force for good” in the pandemic by enabling access to much-needed medical supplies. Even as the value of global merchandise trade shrank by more than 7% last year, trade in medical supplies increased by 16%, and by 50% for personal protective equipment, she noted.

With regards to the WTO’s role in addressing the global vaccine scarcity, DG Okonjo-Iweala said members could act on three fronts.

“First, tackling supply chain issues holding back vaccine production, from export restrictions and excessive customs bureaucracy to problems accessing raw materials or hiring skilled workers. The WTO can help with supply chain monitoring and transparency.”

The second action is helping manufacturers scale up by “keeping supply lines open and matching underused capacity with unmet needs,” which DG Okonjo-Iweala declared as “necessary to save lives now”.

In the longer run, especially if COVID is with us for years, we need a more geographically diversified global vaccine manufacturing base. … Having less than 0.2% of capacity in Africa is not a recipe for supply resilience.”

The Director-General said the WTO would work with the World Health Organization, Gavi and the Coalition for Epidemic Preparedness Innovations on the COVAX vaccine manufacturing taskforce to advance equitable access.

Finally, DG Okonjo-Iweala said WTO members “must address issues related to technology transfer, knowhow and intellectual property,” including the proposed temporary waiver from WTO intellectual property rules for vaccines and other pandemic-related products.

“We must act now to get all our ambassadors to the table to negotiate a text,” she urged. “This is the only way we can move forward quickly, we can’t move forward with speeches and polemics.”

“I am hopeful that by July we can make progress on a text and by our Twelfth Ministerial Conference in December, WTO members can agree on a pragmatic framework that offers developing countries near automaticity in access to health technologies, whilst also preserving incentives for research and innovation.”



IFRC – Asia: Vaccines run dry as COVID surges in Asia to new record death levels
Asia Pacific, Bangladesh, India, Malaysia, Nepal, Philippines
Kuala Lumpur/Kathmandu/Delhi/Geneva, 21 May 2021 – Instant action is needed by governments and pharmaceutical companies to fix a COVID-19 vaccine supply crisis in Asia as countries run out of stocks while suffering grim record daily death tolls.  Nepal …
21 May 2021

IFRC – Red Cross Red Crescent: We need new extraordinary steps to increase access to COVID-19 vaccines and we need them now
The following statement can be attributed to the President of the International Federation of Red Cross and Red Crescent Societies, Francesco Rocca, and to the President of the International Committee of Red Cross, Peter Maurer: The Internationa …
18 May 2021



Despite Positive Efforts, Too Many Migrants Face Challenges Accessing COVID-19 Vaccines
IOM / International Organization for Migration
2021-05-18 09:33
Geneva – Government policies, operational realities and administrative requirements like identification cards and residency permits may be impeding access to national vaccination efforts for some migrants in 53 of the more than 160 countries where the International Organization for Migration (IOM) has collected information on access so far. Irregular and undocumented migrants and those forcibly displaced are at particular risk.

“We have been impressed with efforts made in dozens of countries to make vaccination roll-outs as equitable as possible, but barriers to health services have been systemic since before the pandemic and remain a reality for too many migrants in too many places,” said IOM Director General António Vitorino.

“What we are seeing in some cases is a disconnect between what is being committed to on paper and what is actually happening in practice.”


Some 47 countries have already taken concrete steps to ensure that migrants, including those in irregular situations, can access the vaccine. Many nations are still awaiting doses to begin their vaccination roll-outs. Even when they start, IOM has identified more than 53 countries, territories or areas where current policies and operational realities will make vaccine access unattainable for the most vulnerable.  

Administrative, communication and logistical hurdles 
IOM notes with particular concern close to 40 countries where administrative processes – such as requirements to present a national ID or valid residence permit, or to pre-register with national insurance schemes – may present an obstacle for some categories of migrants and forcibly displaced persons.


Other types of barriers have been identified in several locations, including prioritization of citizens and exclusion of non-nationals from vaccination campaigns; the lack of a “firewall” between health providers and immigration authorities which leads many migrants in irregular situations to fear arrest or deportation should they seek immunization; general vaccine hesitancy due to insufficient targeted outreach through linguistically and culturally appropriate channels; continued mobility as a challenge for vaccines requiring two doses, and the need to have a smartphone, a computer or an internet connection to enroll…

The report Migrant Inclusion in Covid-19 Vaccination Campaigns is available here.



Five Steps to Urgently Advance COVID-19 Vaccine Equity
The following was released jointly by PhRMA, ABPI, BIO, EFPIA, ICBA, IFPMA and Vaccines Europe.

WASHINGTON, D.C. (May 19, 2021) – Innovative vaccine manufacturers and biotech companies are at the forefront of the global effort to develop and manufacture COVID-19 vaccines. This massive effort is succeeding. After more than 200 clinical trials and nearly 300 partnerships and collaborations among manufacturers worldwide, production has increased, in just a few months from zero to 2.2 billion COVID-19 vaccine doses by the end of May with an astounding estimate of 11 billion doses by the end of 2021 (Airfinity data here). This will be enough doses to vaccinate the world’s adult population.
Critically, however, COVID-19 vaccines currently are not equally reaching all priority populations worldwide.


Manufacturers, governments, and non-governmental organizations must work together to take urgent steps to further address this inequity. Immediate action must focus on stepping up responsible dose sharing and maximizing production without compromising quality or safety. To do so, innovative vaccine manufacturers and biotech companies commit to: 
:: Immediately work with governments that have significant domestic supplies of COVID-19 vaccine doses to share a meaningful proportion of their doses with low- and lower-middle-income countries in a responsible and timely way through COVAX or other efficient established mechanisms;
:: Expend every effort to make additional uncommitted COVID-19 vaccine doses available to low- and lower-middle income countries, through COVAX or other efficient established mechanisms.


:: Undertake all practicable efforts to maximize COVID-19 vaccine output without compromising safety and quality, including through additional collaborations with partners that can produce significant quantities;
:: Work with governments and individual suppliers of raw materials and components to determine how to quickly and safely facilitate scale up needed for COVID-19 vaccine manufacturing.


:: Identify trade barriers for critical input materials and support Coalition for Epidemic Preparedness Innovations’ (CEPI’s) effort to create an independent platform that would identify and address gaps in these inputs and facilitate voluntary matchmaking for fill and finish capacity through the newly established COVAX Supply Chain and Manufacturing Task Force
:: Urge governments, in coordination with the World Trade Organization (WTO), to eliminate all trade and regulatory barriers to export and to adopt policies that facilitate and expedite the cross-border supply of key raw materials, essential manufacturing materials, vaccines along with the prioritized movement of skilled workforce needed for COVID-19 vaccine manufacturing.


:: Partner with governments on COVID-19 vaccine deployment, particularly in low- and lower-middle income countries, to ensure that they are ready and able to deploy available doses within their shelf life;
:: Mitigate the risks to the production and deployment of other vaccines that remain vital to public health worldwide.


:: Prioritize the development of new COVID-19 vaccines, including vaccines effective against variants of concern;
:: Urge governments to guarantee unhindered access to pathogens (e.g. samples and sequences) of any COVID-19 variants to support the development of new vaccines and treatments.