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As countries scramble to secure potential vaccine doses, there are fears that the WHO-led COVAX project is a few steps behind.
An ambitious humanitarian project to deliver coronavirus vaccines to the world’s poorest people faces a possible shortage of money, cargo planes, refrigeration and vaccines.
It is also drawing skepticism even from some of those it is most purported to help.
In one of the biggest hurdles, rich countries have blocked most of the world’s potential vaccine supply through 2021, and the United States and others have refused to join the project, called Covax.
Covax was envisioned as a way to give countries access to coronavirus vaccines regardless of their wealth.
It is run by the World Health Organization (WHO); Gavi, a public-private partnership, funded in part by the Bill and Melinda Gates Foundation; and the Coalition for Epidemic Preparedness Innovations (CEPI), another public-private partnership supported by Gates.
Covax’s goal is to purchase two billion doses by the end of 2021, although it is not yet clear whether the successful vaccine will require one or two doses for the world’s 7.8 billion people.
Countries participating in the project can purchase vaccines from Covax or get them free if needed.
An early problem that has arisen is that some of the richest nations in the world negotiated their own deals directly with drug companies, meaning they don’t need to be involved in the effort at all.
China, France, Germany, Russia and the US do not intend to join.
And so many rich countries bought vaccines from manufacturers, even before the injections were approved, that they have already used up most of the vaccine supply by 2021.
The European Union has contributed 400 million euros ($ 469 million) to support Covax, but the 27-country bloc will not use Covax to buy vaccines, in what some see as a vote of no confidence in the project’s ability to comply.
Instead, the EU has signed its own deals to buy more than 1 billion doses, depriving Covax of the bulk bargaining power to buy injections for the mainland.
Clemens Auer, who sits on the WHO executive board and was the EU’s main negotiator for its vaccine deals, said there is a worrying lack of transparency about how Covax will work.
“We would have no say in the vaccines, the price, the quality, the technical platform or the risks,” Auer said. “This is totally unacceptable.”
He said the WHO never consulted countries on its proposed vaccination strategy and called the health agency’s goal of vaccinating the world’s most vulnerable people before anyone else as a “noble notion” but politically naive.
As part of Covax, the WHO and Gavi have called on countries to prioritize front-line health workers first, then the elderly, with the goal of vaccinating 20 percent of the world’s population.
A costly hurdle is that many vaccine candidates must be kept cold from factory to patient, according to internal Gavi documents. “Air transport of COVID vaccines will be a major constraint” and a “significant and urgent increase in cold chain capacity may be needed,” it is said.
Many of the leading vaccine candidates require two doses. That will mean double the syringes, double the waste disposal, and the complications involved to ensure that patients in remote corners of the world receive the second dose on time and suffer no side effects.
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