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How can we vaccinate the world? Five challenges facing the UN-backed COVAX programme

Vaccines are a key a part of the answer to ending the COVID-19 pandemic and, since the early levels of the disaster, the World Health Organization (WHO) has argued that there wanted to be coordinated consideration given to making sure that everybody, not simply folks residing in wealthy international locations, would obtain enough safety from the virus, because it unfold quickly throughout the world.

Out of this concern grew the Global COVAX Facility, the solely international initiative that’s working with governments and producers to make sure COVID-19 vaccines can be found worldwide to each higher-income and lower-income international locations.  

Here are 5 issues to find out about the challenges facing COVAX, and the way they can be overcome.

A health worker picks a vial of the AstraZeneca COVID-19 vaccine from a cooler box in Uganda.

© UNICEF/Adrian Musinguzi

A well being employee picks a vial of the AstraZeneca COVID-19 vaccine from a cooler field in Uganda.

1) Export controls: the weakest hyperlink?

Early on in the pandemic, UNICEF constructed up a stockpile of half a billion syringes in warehouses outdoors the international locations producing them. Its foresight paid off: international locations put export controls on syringes, costs spiked, and provides had been restricted.

Diane Abad-Vergara, WHO Communications Officer for COVAX and COVID-19 vaccines

Diane Abad-Vergara, WHO Communications Officer for COVAX and COVID-19 vaccines, by WHO

Several international locations additionally positioned export controls on vaccines, prompting WHO to warn towards “vaccine nationalism”, which inspires hoarding, and has the impact of pushing costs up and in the end prolonging the pandemic, the restrictions wanted to comprise it, and human and financial struggling.

Getting doses into folks’s arms requires a fancy international provide chain. From the substances wanted to provide the vaccine, to the glass and plastic stoppers and tubes, to the syringes. Because of this, export bans or controls on any of those merchandise can trigger main disruptions to vaccine rollouts. 

Because of the some ways during which export controls can restrict provide, poorer international locations may have a a lot better likelihood of defending their residents if they can manufacture vaccines themselves. 

“WHO supports countries in their efforts to  acquire and sustain vaccine production technology and capacity”, says Diane Abad-Vergara, COVAX communications lead for the company, “through such initiatives as the Developing Countries Vaccine Manufacturers Network, and helps them to build additional manufacturing bases — especially in Africa, Asia, and Latin America — which will be essential to meeting ongoing demand for COVID-19 booster shots and future vaccines. Expanding production globally would make poor countries less dependent on donations from rich ones”.

In Uganda, vaccines are being delivered to remote areas on foot, boats and motorcycles.

© UNICEF/Henry Bongyereirwe

In Uganda, vaccines are being delivered to distant areas on foot, boats and bikes.

2) Getting vaccines to those that want it isn’t simple

Gian Gandhi, COVAX Coordinator for the UNICEF Supply Division.

Gian Gandhi, COVAX Coordinator for the UNICEF Supply Division., by © UNICEF/John McIlwaine

Whilst all of the international locations which might be a part of COVAX have the infrastructure wanted to get pallets of vaccines off cargo planes and into refrigerated warehouses, the subsequent steps can be extra sophisticated.

“Ghana, the first country to receive COVAX doses, has had a good record of distributing doses”, says Gian Gandhi, UNICEF’s international COVAX coordinator, “but other countries, such as those in Francophone West Africa, have found it difficult to muster the resources needed to divide up doses and distribute them throughout their territory to the towns and villages where they’re needed. This means that, in many poorer countries, most doses are being distributed in large urban centres”.

“We want to ensure that no-one misses out”, says Mr. Gandhi, “but, in the short term, the concentration of doses in cities at least means that the vaccination of health and other frontline workers in urban areas, where the higher population density puts them at a higher risk of exposure, is being prioritized”.

3) More funding is required to assist rollout in the poorest international locations

One method to velocity up the vaccine rollout, and the supply from city warehouses to distant areas is, fairly merely, money. “Funding is a perennial concern, even in pandemic response”, says Ms. Abad-Vergara. “To continue providing vaccines to its 190 members, COVAX needs at least $3.2 billion in 2021. The faster that this funding target is achieved, the faster that vaccines can get into people’s arms.”

Contributions from a number of international locations, notably the EU, the UK and the US have gone an extended method to closing the vaccine funding hole. However, funding for the supply of these vaccines is extra problematic.

UNICEF estimates that an extra $2 billion is required to assist the poorest 92 international locations to pay for necessities comparable to fridges, well being employee coaching, bills for vaccinators, and gasoline for the refrigerated supply vehicles, and is looking on donors to make $510m of this out there instantly as a part of a humanitarian enchantment to handle pressing wants.

Mongolia started vaccinating people in March with the Pfizer/BioNTech COVID-19 vaccine provided through the COVAX facility.

© UNICEF/Khasar Sandag

Mongolia began vaccinating folks in March with the Pfizer/BioNTech COVID-19 vaccine offered via the COVAX facility.

4) Richer international locations ought to share

COVAX is discovering itself in competitors with particular person international locations doing direct offers with pharmaceutical firms, placing additional strain on the out there provide of COVID-19 vaccines. At the similar time, richer international locations could discover themselves with an over-supply of doses.

The present ‘me first’ method will in the end price extra, by way of lives Diane Abad-Vergara, COVAX communication focus, WHO

“We’re calling on these countries to share their excess doses, and engage with COVAX and UNICEF as soon as possible”, says Mr. Gandhi, “because it will take some legal, administrative and operational gymnastics to get them to where they’re needed. Unfortunately, we’re not currently seeing too many high-income countries willing to share”.

“The current ‘me first’ approach favours those who can pay most and will ultimately cost more financially, and in terms of lives”, warns Ms. Abad-Vergara. “But it’s important to note that bilateral deals do not prevent a country from either receiving doses or contributing to COVAX, particularly through dose-sharing”.

In New Delhi India, a poster plays a role in dispelling myths about the COVID-19 vaccine.

© UNICEF/Sujay Reddy

In New Delhi India, a poster performs a task in dispelling myths about the COVID-19 vaccine.

5) Vaccine hesitancy: a continued trigger for concern 

Despite the overwhelming proof that vaccination saves lives, vaccine hesitancy, which exists in each nation, continues to be an issue that must be always addressed. 

This phenomenon is partly pushed by misinformation surrounding all features of COVID-19, which was a priority even earlier than a world well being emergency was declared and, in May, the UN launched the Verified marketing campaign,  which fights lies and distorted messages, with trusted, correct data surrounding the disaster. 

“Throughout the pandemic there has been a huge amount of misinformation swirling around”, says Ms. Abad-Vergara. “WHO is working exhausting to fight it, in addition to constructing belief in vaccines, and fascinating totally different communities”.

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