WHO, UN set out steps to meet world COVID vaccination targets

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WHO, UN set out steps to meet world COVID vaccination targets
7 October 2021 News release
Working with COVAX, African Vaccine Acquisition Trust and other partners – world can and must meet WHO targets to vaccinate 40% of the population of all countries by the end-2021 and 70% by mid-2022
Vaccine supply gaps to COVAX must be closed immediately for countries to reach the 40% year-end target
United Nations Secretary-General and WHO Director-General call on countries and  manufacturers to make good on their commitments without further delays

The World Health Organization has today launched the Strategy to Achieve Global Covid-19 Vaccination by mid-2022 (the Strategy) to help bring an end to what has become a two-track pandemic:  people in poorer countries continue to be at risk while those in richer countries with high vaccination rates enjoy much greater protection.

WHO had set a target to vaccinate 10% of every country, economy and territory by the end of September but by that date 56 countries had not been able to do so, the vast majority of these are countries in Africa and the Middle East.

The new strategy outlines a plan for achieving WHO’s targets to vaccinate 40% of the population of every country by the end of this year and 70% by mid-2022.

Science has played its part by delivering powerful, life-saving tools faster than for any outbreak in history,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But the concentration of those tools in the hands of a few countries and companies has led to a global catastrophe, with the rich protected while the poor remain exposed to a deadly virus. We can still achieve the targets for this year and next, but it will take a level of political commitment, action and cooperation, beyond what we have seen to date.”

“This is a costed, coordinated and credible path out of the COVID-19 pandemic for everyone, everywhere,” said United Nations Secretary-General Antonio Guterres. “Without a coordinated, equitable approach, a reduction of cases in any one country will not be sustained over time. For everyone’s sake, we must urgently bring all countries to a high level of vaccination coverage.”

To achieve the global vaccination targets, there should be a three-step approach to vaccination, with all older adults, health workers, and high-risk groups of all ages, in every country vaccinated first, followed by the full adult age group in every country and lastly extended vaccination of adolescents.

Vaccinating 70% of the global population requires at least 11 billion vaccine doses.   By the end of September, just over 6 billion doses had already been administered worldwide.  With global vaccine production now at nearly 1.5 billion doses per month, there is sufficient vaccine from a supply perspective to achieve the global vaccination targets provided that there is equitable distribution of those doses.

Substantial financing has already been invested to procure most of the required vaccine doses for low- and lower-middle-income countries through COVAX, the African Vaccine Acquisition Trust (AVAT) and bilateral contracts.  There needs to be additional investment to secure the remaining vaccine doses for these countries as well as investment to support in-country delivery.

 

The Strategy outlines the priority actions needed from the different actors to achieve the targets.
All Countries must:
Establish updated national COVID-19 vaccine targets and plans defining dose requirements to guide manufacturing investment and vaccine redistribution, and financial and programmatic resource needs to guide internal planning and external support;
Monitor vaccine demand and uptake carefully to rapidly adapt services and ensure continuity of vaccine supplies;
Commit to equitable distribution of vaccines in line with the WHO three-step approach;
Revise national vaccination strategies, policies and prioritization as needed to harness emerging evidence to maximize the impact of existing, modified and new vaccines.

 

Countries with high vaccine coverage must:
Swap vaccine delivery schedules, with COVAX and AVAT to enhance coverage in countries in need;
Fulfil and accelerate vaccine dose-sharing and donation commitments to COVAX in the near term, for those with existing pledges;
Establish new dose-sharing commitments to facilitate progress toward the 70% coverage target in every country.

 

Vaccine-producing countries must:
Allow the free cross-border flow of finished vaccines and raw materials;
Enable diversified vaccine production, both geographically and technologically, including through non-exclusive, and transparent licensing and sharing of know-how to allow transfer of technology and scale-up of manufacturing.

 

COVID-19 vaccine manufacturers must:
Prioritize and fulfil COVAX and AVAT contracts as a matter of urgency;
Provide full transparency on the overall monthly production of COVID-19 vaccines and clear monthly schedules for supplies to COVAX, AVAT and low and low-middle income countries, to enable proper global and national-level planning and optimal use of scarce supplies;
Actively engage and work with countries that have high coverage and that have contracted high volumes of vaccines to allow the prioritization of COVAX and AVAT contracts, including through delivery schedule swaps, and facilitate rapid and early dose-sharing;
Commit to share know-how more rapidly, facilitate technology transfer and provide transparent non-exclusive voluntary licenses, to ensure that future vaccine supply is reliable, affordable, available, and deployed to every country in volumes and timing that achieves equitable access.

 

Civil society, community organizations, and the private sector must:
Advocate locally, nationally and internationally for equitable access to COVID-19 vaccines, tests and treatments, calling for and monitoring in particular the specific actions required of manufacturers, governments and multilateral actors;
Mobilize and empower communities, including through social media and community networks, to generate strong vaccine demand and address misinformation and misperceptions that contribute to vaccine hesitancy;
Provide support to the in-country delivery of vaccination programmes and services.

 

Global and regional multilateral development banks and institutions must:
Enable countries to more rapidly access the capital and external support needed for in-country vaccine delivery, prioritizing low-income settings and especially targeting support to the technical, logistics and human resources required;
Engage fully with COVAX/ACT-Accelerator and AVAT, with integrated operations and real-time sharing of information to truly support equitable access;
Support international procurement and allocation mechanisms to enable all countries to equitably, efficiently and rapidly achieve the COVID-19 vaccine targets;
Support vaccine distribution plans and a campaign to convey the life-saving importance of approved COVID-19 vaccinations.

For their part, WHO, Gavi, UNICEF and CEPI must work in close collaboration with World Bank, World Trade Organization, International Monetary Fund, Africa CDC, AVAT, and other key partners to monitor progress, identify changes needed to resolve bottlenecks, coordinate information and prioritize actions; continue to co-lead and manage the COVAX Pillar of ACT-Accelerator; support the equitable allocation of available vaccines, particularly to low-, lower-middle-income and lagging countries; directly support countries to develop and sustain rapid, effective, high-quality COVID-19 vaccine delivery programmes that can achieve the global targets; address key research, policy, safety and regulatory issues that will optimize vaccine impact including effective supply, dosing and vaccine schedules, mixing and matching of products, protection against variants, and other issues; and monitor and report monthly on progress towards the global COVID-19 vaccination goals.

 

Note to Editors:
The Strategy to Achieve Global Covid-19 Vaccination by mid-2022 can be read in its entirety here.
See also:
:: The Global COVID-19 Vaccination – Strategic Vision for 2022 Technical Document
:: Slide deck on the Strategy to Achieve Global Covid-19 Vaccination by mid-2022

Following the WHO declaration of novel coronavirus as a public health emergency of international concern on 30 January 2020, the main global immunization partners developed a global COVID-19 vaccination strategy through the Access to COVID-19 Tools Accelerator (ACT-A) Vaccines Pillar (COVAX). The ACT-A prioritized strategy and budget can be read here. The 2022 Global Vaccination Strategy is intended to complement that strategy.

The immediate goal of the global COVID-19 vaccination strategy is to minimize deaths, severe disease and overall disease burden; curtail the health system impact; fully resume socio-economic activity, and reduce the risk of new variants.

The 2022 Global COVID-19 Vaccination Strategy is based on a technical analysis that established a Conceptual COVID-19 Goal Framework which specifies a sequence of socio-economic and health goals, which could be achieved with various levels of vaccination scope and other interventions. The Conceptual Goal Framework structures the technical analyses of vaccination requirements to achieve ever broader health, social and economic goals and builds upon WHO’s broader COVID-19 Strategic Preparedness and Response Plan (SPRP) first published in 2020 and subsequently updated in 2021. The SPRP’s strategic objectives inform and align with the health and socioeconomic dimensions of the Global COVID-19 Vaccine Strategic Vision Goal Framework.

 

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WHO, WIPO, WTO Workshop on Innovation in, and Access to, COVID 19 Technologies: Intellectual property licensing, technology transfer, and sharing of know-how and clinical trial information
5 October 2021 Departmental news
On September 27, 2021, the World Health Organization (WHO), the World Intellectual Property Organization (WIPO) and the World Trade Organization (WTO) jointly organized a Workshop on Innovation in, and Access to, COVID-19 Technologies. The workshop focused on intellectual property licensing, technology transfer, and sharing of know-how and clinical trial information. It aimed at strengthening the capacity of policymakers and experts coming from WHO, WIPO and WTO members to address the COVID-19 pandemic. This capacity-building activity was conceived to help members update their knowledge and understanding of how intellectual property (IP), know-how and technology transfer work in actuality.

The activity was agreed in a June 15, 2021 meeting among the Directors General of WHO, WIPO and WTO  in which they underscored their commitment to universal, equitable access to COVID-19 vaccines, therapeutics, diagnostics, and other health technologies.

In three panels, speakers addressed the following themes: realizing global equitable access for vaccines, diagnostics, therapeutics and other COVID-19 health technologies; mechanisms and processes to support technology transfer and IP licensing; and enabling factors and policies for technology transfer…

More than 200 participants from a broad range of members of WHO, WIPO and WTO participated in this training. The program, the full summary of key issues addressed by the workshop, as well as presentations shown during the event are posted on the meeting webpage as they become available.

 

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Interim statement on booster doses for COVID-19 vaccination
4 October 2021 Statement
WHO, with support of the Strategic Advisory Group of Experts (SAGE) on Immunization and its COVID-19 Vaccines Working Group, continues to review the emerging evidence on the need for and timing of a booster dose for the currently available COVID-19 vaccines which have received Emergency Use Listing (EUL). This statement reflects the current understanding of vaccine performance and supply, as of the time of update…

Rationale for the administration of booster doses
The current primary goal of immunization in the COVID-19 pandemic remains to protect against hospitalization, severe disease and death. Hence, booster doses may only be needed if there is evidence of insufficient protection against these disease outcomes over time.

The degree of waning of immunity and need for booster doses of vaccine may differ between vaccine products, target populations, circulating SARS CoV-2 virus, in particular variants of concern (VoC), and intensity of exposure. For some vaccines, restricted booster indications have been included into the product label of some jurisdictions.

In a period of continued global vaccine supply shortage equity considerations at country, regional and global level remain an essential consideration to assure vaccination of high priority groups in every country. Improving coverage of the primary vaccination series should be prioritized over booster vaccination…

Conclusions
Introducing booster doses should be firmly evidence-driven and targeted to the population groups in greatest need. The rationale for implementing booster doses should be guided by evidence on waning vaccine effectiveness, in particular a decline in protection against severe disease in the general population and in high-risk populations, or due to a circulating VoC. To date, the evidence remains limited and still inconclusive on any widespread need for booster doses following a primary vaccination series.

In the context of ongoing global vaccine supply constraints, broad-based administration of booster doses risks exacerbating inequities in vaccine access by driving up demand and diverting supply while priority populations in some countries, or in subnational settings, have not yet received a primary vaccination series.  The focus remains on urgently increasing global vaccination coverage with the primary series driven by the objective to protect against severe disease.

SAGE will deliberate on the evidence for a booster dose during an upcoming Extraordinary SAGE meeting in November 2021.