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A Race to Safety: Millions still waiting for vaccines as political and economic obstacles endure

Israel is world-leading in its vaccination rates but has blocked doses promised to Palestinians. Millions of global citizens are facing diplomatic, financial and logistical hurdles to their vaccine procurement. Over 91 vulnerable nations have opted to take part in a World Health Organisation (WHO)-backed scheme called COVAX.

What does this look like and how does it plan to work?

Run by the Gavi Vaccine Alliance and a coalition for epidemic preparedness, it is geared towards securing vaccine supplies for poorer countries. Dependency on the initiative is high – many participating states have not been able to secure deals for alternative supply sources.

The $27bn scheme recognises a global problem requires a global solution. This sounds like a welcome breath of humanity in a dark time, right? But a long list of caveats casts shadows over the long list of participants and ambitious supply forecasts.

As of December 2020, rich nations constituting 14% of the global population had purchased over 50% of available vaccines, according to the People’s Vaccine Alliance.

Contracts used in COVAX projections are not all finalised. Manufacturing has not reached full capacity in most cases. Dose delivery is made difficult by logistical complexities – especially in unstable political areas such as Palestine.

Country preparedness is another issue – it is unclear how fragile, stateless or economically weak populations will be supported in terms of being ready to receive and administer doses.

Funding is another big dark cloud over the complex operation.

An Advanced Market Commitment (AMC) mechanism within COVAX is set to leverage participation from wealthy countries and secure demand for manufacturers across the market to support and accelerate manufacturing.

If a country has already secured their supply, why would they join this initiative?  Gavi say the incentive for economic powers to join is the possibility of a safety net. If their bilateral deals fail to generate a safe supply, COVAX offers a back -up.

Chamber of Commerce research shows it is more economical to fund COVAX than to allow the global economy to continue to suffer under the pandemic.

Higher-income participants will only need to pay for the doses they receive. So, where does this leave payment for the doses going elsewhere?

AMC-sourced doses for poor countries will be funded by Official Development Assistance (ODA). However, they may still need to pay up to $2 per dose.

Thousands of lives are reliant on private companies and non-regulated prices. The British Medical Journal writes that drug industry practices have resulted in poorer nations paying more than their wealthier peers.

South African health officials recently revealed they paid $5.25 per dose for 1.5 million doses of the Astra Zeneca and Oxford vaccines – meanwhile, the EU is paying just $2.15.

While some nations have acquired up to 4 times what they need to vaccinate their entire populations, developing countries and politically isolated territories like Palestine will face a continued wait for doses.

As of the 18th February 2021, low-income countries are still faring far worse off in terms of doses per 100 people, according to Our World in Data. Western tourists may be waiting longer than they thought for their tropical holidays.

The economic cost of allowing the pandemic to fester in the global south is astronomical. But only time will tell whether wealthy countries will continue to be enthusiastic in their support for COVAX even after their own vaccination needs are met.

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