Against low expectations, two promising vaccines are in the final stages of development, in record time, giving hope of an effective vaccine. Yet, while WHO has made it clear that it welcomes the recent Moderna and Pfizer announcements on the efficacy of their vaccines, it has also made it clear that, for the time being, its alliance to secure vaccine supplies for the world's poorest countries is still suffering from a deep financial hole. During its World Health Assembly last week, WHO indicated for the first time that a lack of resources threatens the project to ensure global distribution of the vaccine. No announcement of any new donations happened at the Assembly. The organisation had to wait for the Peace Forum in Paris last Friday to receive the news that new resources will be allocated to the initiative. Still, they are not seen as enough.
The European Commission, France, Spain, The Republic of Korea and the Bill & Melinda Gates Foundation pledged US$ 360 million to COVAX, the Vaccines Pillar of the Access to COVID-19 Tools (ACT) Accelerator. New contributions bring the total committed to over US $5.1 billion—but an additional US$ 4.2 billion is needed urgently this year, with a further US$ 23.9 billion required in 2021, if tools are to be deployed across the world as they become available. A Unicef-Covax internal document also points out that the planned vaccine production in 2020-2021 will be tight when compared to aspirational demand. “It is also reasonable to assume that sufficient vaccine supply will be available for widespread global roll-out starting in late 2022; but also possible that annual vaccination or booster doses could be needed,” the Unicef-Covax document states. Careful dose allocation will be key to maximising impact. But WHO’s ability to control distribution and allocation is far from a given. The Pfizer vaccine, for example, is not currently part of the Covax facility vaccine portfolio, although the two are currently in talks. And there is always the question of whether countries will allow vaccine doses being produced on their territory to leave it before they have met their need (as we saw with export restrictions on PPE).