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Now almost in its 10th month, the COVID-19 pandemic is still wreaking havoc on economies and lives around the world. But while the end of the crisis seems as distant as ever, the fact is that we are approaching a possible tipping point. World leaders now have a chance to seal the deal in a global framework that places international cooperation above vaccine nationalism to stop the pandemic.
The moment of truth was midnight on September 18. That was the deadline for countries to join the Center for Global Access to the COVID-19 Vaccine (COVAX), an initiative launched by Gavi, the Vaccine Alliance, the World Health Organization (WHO), and the Coalition to Innovations in Epidemic Preparedness (CEPI). COVAX represents the best opportunity we have to provide people in all countries with prompt, fair and equitable access to COVID-19 vaccines as soon as they are available.
The initiative has already reached extraordinary scale, with more than 170 countries (representing 70 percent of the world’s population) already signaling their intention to join. At a time when most countries are experiencing unprecedented crises, governments are eager to find solutions that benefit everyone.
Nothing like COVAX has ever been tried, and the short time in which it has been assembled makes it even more remarkable. If successful, it will be the first time that the international community has come together to ensure equitable and simultaneous access to new pandemic interventions that save lives for rich and poor alike.
As we approach fall, and COVID-19 continues to spread, the global death toll is approaching a million, with monthly economic losses estimated at $ 500 billion. Under these conditions, ensuring universal and fair access to vaccines is not just the right thing to do. It is also necessary if we want to end the crisis. Until everyone is protected, everyone will remain at risk for the disease, its adverse economic effects, or both.
As the only truly global approach available, the importance of COVAX cannot be underestimated. Although there are more than 200 COVID-19 vaccines in development and at least 35 clinical trials underway, the vast majority are likely to fail. Historically, candidate vaccines in the preclinical stage have less than a 10 percent chance of success.
And of those that advance to the clinical trial stage, only about 20 percent will eventually be approved. Given these odds, even wealthy governments currently negotiating bilateral deals with individual vaccine manufacturers cannot guarantee access to a vaccine on their own.
Rather, COVAX is specifically designed to maximize your chances of success by investing in the development and manufacture of a large number of candidate vaccines at the same time. With the world’s largest and most diverse vaccine portfolio, currently comprising nine candidates already in development and nine or more under evaluation, COVAX will act as a global insurance policy.
Under this framework, member countries that have bilateral agreements will still have vaccine access options should those bets fail, and most countries that have no other options will have a critical lifeline. COVAX’s initial goal is to have two billion doses of vaccines available by the end of 2021, as that should be enough to protect vulnerable and high-risk populations and front-line healthcare workers. But to achieve that goal, we first need the legally binding commitments of as many countries as possible.
After the September 18 registration deadline, the priority now is to complete the development and testing process to ensure that all upcoming vaccines are effective and safe. COVAX will need to establish agreements with drug manufacturers so that it can begin distributing vaccines on a large scale as soon as they are approved. And donor funds will be needed to subsidize the purchase of vaccines for low- and lower-middle-income countries.
But even with financial solutions in place, the vaccine distribution process will pose significant challenges. The COVID-19 vaccine delivery will be the largest vaccine deployment the world has ever seen, and it will have to take place at a time when misinformation (the “infodemic”) threatens to undermine public confidence in the safety of vaccinations
Although the pandemic is far from over, at least we have a global solution in sight. COVAX represents the best hope we have for a swift end to the crisis. When people look back and marvel at the speed with which the scientific community and development professionals responded to the threat of COVID-19, they will be able to point to the speed with which governments are bypassing national interests in the name of international cooperation and solidarity.
Whatever specific time historians of the future choose as the tipping point of the pandemic, there will be little doubt that the creation and widespread adoption of the COVAX framework played an indispensable role in ending it.
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