What is covex |what we’retrying to stop through COVAX.

I try to make a distance from my family. This is my reason tolive here in the living room. It’s hard that you live in one house, but you feel as though you live in another place. Hanna Samson is a nurseat the St. Paul’s hospital in Ethiopia. Like manylow-income countries, Ethiopia has struggled to secure vaccines leaving its frontline workersin a vulnerable position. In December 2020, Hannacontracted the virus while working at aCOVID-19 treatment center. They took me in the hospital. When I arrived at theMillennium COVID care center I lost my consciousness because I’m afraid and everybody is comingand caring of myself. And they took me in a high dependency unit. I spent for the 16 days andthey give me oxygen, they gave me unexplainable supportfor me, they saved my life. For Hannah and manyother health care workers in the world’s poorest countries getting a vaccine, hasn’t been an option. I was afraid when I was sick and when I heard ourcolleagues are dying. It’s a difficult time for me, for my family,for my friends, colleagues. But a global initiative called COVAXis trying to ensure that people in all corners of the worldget access to vaccines. Because of COVAX Hanna was able to get vaccinated and it might be the best bet for immunizing the rest of the world too.This article Based on Hanna samson interview.

As rich countries race toinoculate their populations poor countries have fallen behind in the biggest vaccinationcampaign in history and that’s a problem for everyone. Wildly uneven and unfair that’s how the U.N. describes the distribution of COVID vaccines around the world. Very few of those doses,a very small proportion of them have been used in lowand middle income countries. There’s five or six of these variants that I would say are of concern out there. The thing that we worryabout the most, that it will essentially evade theprotection of the vaccine. The pandemic has weighedheavily on developing economies, take the example of Ethiopia. It’s long been seen as one of Africa’s mostpromising economies, but the country hasa sizeable debt. At the end of 2019 it’s total public foreigndebts stood at $27.8 billion according to The World Bank. The pandemic has put pressure on the healthcare system and the economy, leading Ethiopia to ask for debt relief under a G20 program tohelp poor countries reeling under the economic impact of coronavirus. For many low-income countries,even before the pandemic were facing financialconstraints, huge debt loads and really didn’t havethe financial capacity to negotiate bilateral dealswith the vaccine developers like developed countries,Europe and the U.S. were able to. I’ve long argued that pandemics are an evolutionary certainty. 

Seth Berkley is the head of Gavi, the Vaccine Alliance. He’s an epidemiologist and you know, he’sreally devoted, you know the past year to fighting the pandemic. He conceived of this COVAX initiative at Davos in January, 2020, realizing that when the pandemic reallyhit and we had vaccines the real challenge would beproviding equitable access to countries that couldn’tafford to buy them on their own. My job is to try to solvethese problems and put in place systems to do that. And so at this Davosmeeting, we heard about this new epidemic that was going on. It was early days, wedidn’t know if there were people to people, transmission but I sat down with Richard Hatchett, who’s the CEO of CEPI, the Coalition For EpidemicPreparedness Innovations, and we discussed what we were doing. So that really was thebeginning of the collaboration. Of course, a lot happened since then, at the end, they focused on the R&D, we focused on theprocurement and delivery, and WHO focuses on thenormative side of things. But we came together working like we do in the Alliancewith multiple partners. For the first time we’ve seen the whole worldcome together at least in name in terms of COVAX andwanting to move forward. More than 190 countries are participating in the COVAX facility,the wealthy countries are participating throughpaying for their doses through this purchasingpool that COVAX has set up, while COVAX providesthe low-income countries with doses for free through money it is raised from governments,development agencies, as well as, private sector contributions. When we decided to do COVAX,we didn’t have any deals, we didn’t have any money,we had to go out and raise money. We had to begin to talk tomanufacturers and of course to make a deal with a manufacturer you have to have the finance in place. COVAX is a huge international effort. The biggest international effort since the Paris Climate Accords. It has required a massivefundraising effort from governments around the world. It’s a procurement challenge,they’ve had to negotiate deals with pharmaceuticalcompanies to secure doses on timing and deliveryand then at the same time, they’ve had to prepare countries around the world for therollout on the ground. And that is but a huge, youknow, logistical challenge. The arrival of this particularvaccine has come as a great relief to heath workersand a lot of Ghanians. COVAX is aiming to deliver 2 billiondoses by the end of the year. It has so far raised almost $7 billion,it just came out with a new initiative toraise an additional $2 billion. But there’s still a long way to go, they need more money andthey need more doses. Is it enough what they have achieved? Of course it’s not but it’snot a question of money for the time being, it’sa question of what access to vaccines arethey going to be given by others so that they can take care of the majority of the world’s population. What is surprising isthat wealthy countries haven’t donated more toCOVAX given that it’s really in their self-interest,if the virus continues to rage in low-incomecountries, that will only mean that it’s likely to boomerangback into the developed world. New mutant strains will develop and it will be incredibly hardto stop COVID in its tracks. Right now we have a situationwhere wealthy countries have orded many times of theamount of doses they need. It’s really time now to turn that around and either begin to makethose doses available through dose sharing orto free up the places in the manufacturing queue and that will allow dosesto go across the world and that will allow dosesto go across the world get us to a place wherewe can end the acute phase of the pandemic as quickly as possible. But it’s not just the wealthiest countries complicating COVAX’s efforts.

It’s been pretty challenging for COVAX to get its own supplies, vaccine nationalism isso front and center. Vaccine nationalism is a huge challenge for the COVAX initiative,it’s heavily dependent on the AstraZeneca vaccine because of its low cost and easy distribution. AstraZeneca is producing the vaccine on its own, as well as throughan independent manufacturer in India called the Serum Institute. But India itself is facinga second way of infections and has curbed large-scaleexports of the vaccine. The other challenge thatCOVAX faces is its dependency on the AstraZeneca vaccine,which has seen these reports of rare blood clotsassociated with the shot. And that has given riseto a vaccine hesitancy around the world. You’ve seen reports of people not showing upand doses going to waste because of concerns about thesafety of the vaccine, even though those reports areexceedingly rare, I think it does pose a challenge forrolling out doses worldwide. There are also majorchallenges to produce the vast quantity of vaccinesneeded around the world. Normally in the world, we use about three and a half billiondoses of vaccine a year. If you add flu to that, itends up being about 5 billion. People are talking about tryingto cover the whole world. That would be another10 to 15 billion doses that would have to be donein the course of this year. That would be a quadruplingof global supply. That is very ambitious notjust for the manufacturing capacity but also the rawmaterials, the supplies, the staff and so this is areal challenge for the world. Pharmaceutical companieshave been criticized for not releasing their formulas so that more manufacturerscan produce at scale. Some say COVAX should bedoing more to pressure them. Anna Marriott, the healthpolicy advisor for Oxfam argues that these manufacturing issues could have been mitigated by COVAX. You know, I think rightfrom the outset COVAX should have used its enormous leverage. It could have pushed thosepharmaceutical corporations to share the vaccine science and know-how. We know that there are many offers on the table frommanufacturers, from Bangladesh, Pakistan to Denmark and Canadawho are coming forward now and saying we could helpmake these vaccines. If the vaccine science was shared and the intellectual property rules removed. If we’d done that much earlier on those manufacturerscould be helping us now making those vaccines. It’s certainly not too late, we do have to act now. But COVAX argues the issue lies But COVAX argues the issue lies in teaching other manufacturersthe detailed analytics, tests, and quality assurance procedures needed to make the vaccines.This article interview based on hena samson, Stephaine Baker.

The issue is not for vaccines that patents are the blocker. There may be a patent or two, but those could be gottenaround if one needed to. The real challenge is canyou get those thousands of pages of know-how and canyou have those transferred? Beyond the immediatemanufacturing problems hampering COVAX’s rolloutlies an even bigger problem. The initiatives donationswill provide doses that will cover onlyabout 30% of populations in low-income countries. That’s nowhere near what’sneeded to achieve herd immunity. Countries like Ethiopia for instance, is entirely dependenton the COVAX initiative. It has something like 110 million people and so far it’s onlyadministered about 400,000 doses. So they have a long way to go before they get anywhere near what, you know scientists believe is herd immunity to stop the pandemic in its tracks. COVAX may not be a silver bullet to the world’s vaccine equity problem, but ending the pandemic will bealmost impossible without it. Well, COVAX is this solution to it,there is no other one. Tell me which other organization hastried to bite the bullet here? Which other organizationhas been so ambitious that they are promising to do everything that it takes to give a vaccine also to those who cannot afford it? There is no other one, sothey have to be supported. Of course, at the end of the day the real question now iswill the doses be available? Will the companies make the doses? Will as high-income countriesreach a certain threshold begin to say we’ll release some of the excess doses that wehave and make those available? And will we be ableto scale up manufacturing? If we can do that, thenwe’ll be in a world where the world has beenprotected during a pandemic. 

If we can’t do that,we will be in a world that is very unfairand very inequitable and that’s exactly what we’retrying to stop through COVAX.