The COVAX Humanitarian Buffer: Frequently Asked Questions

The COVAX Humanitarian Buffer: Frequently Asked Questions:
8 November 2021 :: 15 pages – 38 questions
This FAQ document has been prepared by the IASC Working Group on the Humanitarian Buffer. The Working Group was tasked by the IASC Emergency Directors Group to work with Gavi, the Vaccine Alliance, on the establishment and operationalization of the COVAX Humanitarian Buffer. These FAQs are intended for all IASC entities, humanitarian partners, and external stakeholders. The FAQs will be updated and re-circulated as required to ensure they reflect the most relevant and up-to-date information.

[Selected FAQs/excerpts]
1. What is the COVAX Humanitarian Buffer?
The Humanitarian Buffer is a mechanism established within the COVAX Facility to act as a measure of
‘last resort’ to ensure access to COVID-19 vaccines for high-risk and vulnerable populations in humanitarian settings. The Humanitarian Buffer is only to be used where there are unavoidable gaps in coverage in national vaccination plans and micro-plans, despite advocacy efforts.

National governments are responsible for ensuring access to COVID-19 vaccines for all people within their respective territory. The ‘first resort’ for all populations of concern, irrespective of legal status, is that they are included in national vaccination plans and reached during the implementation of those plans. Gavi, IASC partners, civil society and others will continue to advocate with national governments to ensure the inclusion of all populations regardless of their legal status in line with the WHO Strategic Advisory Group of Experts on Immunization (SAGE) ‘Values Framework’ and ‘Roadmap For Prioritizing Uses Of COVID-19 Vaccines in The Context Of Limited Supply’ and will advocate for the revision of national plans and micro-plans if required.


6. Which groups are considered as populations of concern for the Humanitarian Buffer?
Populations of concern in humanitarian settings may include refugees, asylum seekers, stateless persons, internally displaced persons, minorities, populations in conflict settings or those affected by humanitarian emergencies, and vulnerable migrants irrespective of their legal status.


7. What is the estimated size of the populations of concern?
The IASC estimates there are approximately 167 million people at risk of exclusion from COVID-19 vaccination, noting that these numbers are highly variable and subject to change due to unexpected shocks (such as conflicts, natural disasters etc.). The current number of refugees, IDPs and stateless populations is over 80 million. Even in the ideal scenario of all countries including all populations of concern in their national plans, it is estimated that 60-80 million people in non-government-controlled areas could remain beyond national authorities’ reach.

These estimates are based on data from the 2021 Global Humanitarian Overview (GHO). However, the populations of concern for the Humanitarian Buffer will not be limited to populations in the 2021 GHO. The Humanitarian Buffer is designed to be flexible and agile to respond to dynamic situations and risks of exclusion and can be used to reach any population of concern in a humanitarian setting that is not being vaccinated by national authorities, regardless of whether or not they are included in the 2021 GHO.


8. How will populations of concern be prioritized? Will the Humanitarian Buffer vaccinate everyone caught up in humanitarian crises?
The Humanitarian Buffer is neither designed nor intended to cover the entirety of populations of concern, nor to prioritize them over any other population. Prioritization decisions will be in line with WHO SAGE guidelines, and will ensure parity with coverage levels and the standard COVAX vaccine rollout in a specific country. The Humanitarian Buffer intends to provide enough doses for high-risk groups within a given population of concern to cover frontline healthcare workers, the medically vulnerable, and those who meet nationally set age criteria. Based on IASC estimates, 20-30%% of the 167 million people at risk of exclusion from COVID-19 vaccination would account for approximately 33-50 million people. Assuming a two-dose regimen, this would mean that a rough, indicative planning assumption would be that 66-100 million doses would be required for the Humanitarian Buffer. This target may shift with the evolution of the pandemic and the availability of supply globally.


19. How will Humanitarian Buffer allocation decisions be made?
A decision group comprising experts from IASC entities has been established to take decisions on allocations to the buffer and will report to the IASC EDG. They will receive secretariat support from the Joint Allocation Taskforce (JAT) of the COVAX Facility…The decision group will decide by consensus, based on the information provided. If, in exceptional circumstances, the decision group cannot reach consensus, it may refer the request to the Emergency Directors’ Group (EDG) for input before deciding. The final decision remains with the decision group. Applications will be received on a rolling basis.


20. Which agencies are part of the IASC decision group?
The decision group will comprise of up to 10 IASC agencies: WHO, UNICEF, OCHA, IOM, UNHCR, ICRC, IFRC, MSF and a representative from the IASC’s NGO consortia. Gavi will be an observer. WHO will chair the decision group. If a member of the decision group represents an organization which is applying to the buffer, that member will recuse themselves from consideration of the request in question.


30. Will there be a standard unit cost per dose for humanitarian buffer allocations?
Yes. The unit cost per dose of delivery will be set at between $3.00 per dose. Certain contexts may have higher operational/ delivery costs, in which case additional funding will need to be mobilized. In some cases, UNICEF will be able to cover the additional costs of delivery. In other cases, other sources of financing will be required.


38. How will monitoring and evaluation and learning be undertaken for Humanitarian Buffer doses?
Countries, territories, and humanitarian agencies that receive doses through the Humanitarian Buffer will be responsible for reporting on their use. When applying for Humanitarian Buffer doses, applicants will be required to provide information on specific metrics within a specified timeframe following the implementation. UNCTs/HCs/RCs, and Health Clusters/Sectors will also support monitoring at country-level. With secretariat support from the JAT, the decision group will ensure that lessons learned are incorporated into its decision making.