TThe World Health Organization and key partners on Friday unveiled a plan to buy 2 billion doses of Covid-19 vaccines for the world’s highest-risk populations.
The plan anticipates that by the end of 2021, doses could be administered to countries to vaccinate high-risk individuals, likely to include healthcare workers, people 65 and older, and other adults with conditions such as diabetes.
WHO and its partners, the Coalition for Outbreak Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance, estimate that it will cost $ 18.1 billion to comply with the plan. The effort is one of the pillars of the WHO effort to ensure that all countries have access to Covid-19 vaccines, therapies and diagnostics, called ACT Accelerator, short for Access to Covid-19 tools.
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In addition to financing, of which $ 11.3 billion is to be raised in the next six months, the project would also require commitments from high- and upper-middle-income countries to purchase up to 950 million doses of vaccine.
Countries will be offered “shares” of the nine candidate vaccines that CEPI is supporting, as well as other vaccines that the consortium could end up buying. The idea is that because it is not known which vaccines will be successful, the purchase of shares in a group, to be called the Covax facility, will expand a country’s chances of having access to vaccines. Charitable donors are expected to help support the actions of low- and middle-income countries.
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Individual countries that can afford it are negotiating advance direct purchase agreements with several manufacturers, and are even helping to prepay the cost of making the vaccine before it is proven to be effective. But if a country makes a big investment in a vaccine, just to see that it fails, it could find limited alternatives in the early days of vaccine availability, when demand will be huge and supply will be tight.
“It is risky for them to do that and it is not ethically the right approach either, because it leaves the rest of the world without a dose of vaccine,” said Soumya Swaminathan, WHO chief scientist.
That risk is real. Vaccines are difficult to manufacture and historically more vaccine projects fail than are successful. Seth Berkley, CEO of Gavi, said that approximately 7% of vaccines achieve preclinical development, and that between 15% and 20% entering the clinic are successful.
“The vast majority will fail, but having a large portfolio will move this forward,” Berkley said. He noted that the facility has signed a memorandum of understanding for 300 million doses with AstraZeneca, which is partnering with the University of Oxford on a vaccine that has already started a phase 3 clinical trial.
Richard Hatchett, executive director of CEPI, said that supporting the production of several vaccine candidates gives Covax a right of first refusal of vaccine doses when the program has provided financial support for the manufacture of the vaccine.
“The advantage of the facility is that it is the ‘first online customer’ for those projects where there are access agreements, but it can also go to the market and buy any vaccine. And high-volume guarantees will be very attractive to companies, “said Hatchett.
According to the WHO, there are currently 16 Covid-19 vaccines in clinical trials, and at least 125 others in earlier stages of development.
