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COVID-19 Vaccines Global Access, abbreviated as COVAX, is a global initiative aimed at equitable access to COVID-19 vaccines led by UNICEF, Gavi, the Vaccine Alliance (formerly the Global Alliance for Vaccines and Immunization, or GAVI), the World Health Organization (WHO), the Coalition for Epidemic Preparedness Innovations (CEPI), and others. It is one of the three pillars of the Access to COVID-19 Tools Accelerator, an initiative begun in April 2020 by the World Health Organization (WHO), the European Commission, and the government of France as a response to the COVID-19 pandemic. COVAX aims to coordinate international resources to enable the equitable access of COVID-19 diagnostics, treatments, and COVID-19 vaccines.[1]

By 15 July 2020, 165 countries – representing 60% of the human population – had joined COVAX.[2]

Contents

Vaccine candidates

Many of the countries that will benefit from COVAX, have “limited regulatory capacity” and depend on WHO’s authorisations. By early 2021, WHO was reviewing 11 potential COVID-19 vaccines for its Emergency Use Listing (EUL).[3] The first WHO authorised for its EUL on 31 December 2020, was the Pfizer–BioNTech COVID-19 vaccine—an RNA vaccine developed by BioNTech in cooperation with Pfizer, and sold under the brand name Comirnaty.[4][5]

The WHO stated in a press release on 24 August 2020 that COVAX had nine CEPI-supported vaccine candidates and nine candidates undergoing trials, giving it the largest selection of COVID-19 vaccinations in the world.[6] By December, COVAX had finalized negotiations with other manufacturers that gave it access to two billion vaccine doses.[7]

Distribution (recipients)

COVAX provides vaccines to the developing world.[8] A total of 92 low- and middle-income countries are eligible to receive COVID-19 vaccines through the COVAX mechanism[9] through the COVAX Vaccines Advance Market Commitment (AMC) financing instrument.[9][10] COVAX AMC is funded by donor contributions.[10] COVAX AMC funds the COVAX Facility, the vaccine procurement platform.[10]

On 3 February 2021, GAVI, the WHO, and UNICEF published the country-by-country distribution of the Pfizer-BioNTech and Oxford–AstraZeneca vaccines forecast for first half of 2021.[11] The early projection includes 1.2 million doses of the Pfizer–BioNTech vaccine in Q1 2021 and 336 million doses of the Oxford–AstraZeneca vaccine in first half 2021 to the 145 COVAX facility participants.[12][13] It is expected that health care workers and the most vulnerable will receive the first doses, which are anticipated to reach approximately 3.3% of the total population of each participating country by the end of the first half of 2021.[13]

In February 2021, the WHO and Chubb Limited announced the roll out of a no-fault compensation scheme for COVID-19 vaccinations for low and middle-income countries which would be financed initially through Gavi COVAX AMC donor funding.[14]

On 24 February 2021, Ghana became the first country in the world to receive vaccines through COVAX when 600,000 doses of the Oxford–AstraZeneca vaccine were delivered to Accra.[8][15]

On 1 March 2021, frontline workers and public officials from the Ivory Coast became the first persons to be inoculated with COVID-19 vaccines shipped from the COVAX Facility. More than 500,000 doses of the Oxford–AstraZeneca COVID-19 vaccine manufactured by the Serum Institute of India were shipped to the city of Abidjan the week before. The vaccines were flown in by UNICEF from Mumbai.[16]

On 5 March 2021, Moldova received 14,400 Oxford–AstraZeneca COVID-19 vaccine units through COVAX, becoming the first European country to do so. The country had already been donated 21,600 doses of the same vaccine by Romania some days earlier.[17]

ParticipantSFP/AMCAstraZeneca
SII
AstraZeneca
SK Bioscience
Pfizer-BioNTechTotal
 IndiaAMC97,164,00097,164,000
 PakistanAMC17,160,00017,160,000
 NigeriaAMC16,008,00016,008,000
 IndonesiaAMC13,708,80013,708,800
 BangladeshAMC12,792,00012,792,000
 BrazilSFP10,672,80010,672,800
 EthiopiaAMC8,928,0008,928,000
 Congo, Dem. Rep.AMC6,948,0006,948,000
 MexicoSFP6,472,8006,472,800
 PhilippinesAMC5,500,800117,0005,617,800
 EgyptAMC5,138,4005,138,400
 VietnamAMC4,886,4004,886,400
 MyanmarAMC4,224,0004,224,000
 IranSFP4,216,8004,216,800
 KenyaAMC4,176,0004,176,000
 UgandaAMC3,552,0003,552,000
 SudanAMC3,396,0003,396,000
 South AfricaSFP2,976,000117,0003,093,000
 AfghanistanAMC3,024,0003,024,000
 South KoreaSFP2,596,800117,0002,713,800
 ColombiaSFP2,553,600117,0002,670,600
 UzbekistanAMC2,640,0002,640,000
 AngolaAMC2,544,0002,544,000
 MozambiqueAMC2,424,0002,424,000
 GhanaAMC2,412,0002,412,000
 UkraineAMC2,215,200117,0002,332,200
 YemenAMC2,316,0002,316,000
 ArgentinaSFP2,275,2002,275,200
   NepalAMC2,256,0002,256,000
 AlgeriaAMC2,200,8002,200,800
 CameroonAMC2,052,0002,052,000
 Cote d’IvoireAMC2,040,0002,040,000
 IraqSFP2,018,4002,018,400
 North KoreaAMC1,992,0001,992,000
 CanadaSFP1,903,2001,903,200
 MoroccoAMC1,881,6001,881,600
 NigerAMC1,872,0001,872,000
 PeruSFP1,653,600117,0001,770,600
 Saudi ArabiaSFP1,747,2001,747,200
 Sri LankaAMC1,692,0001,692,000
 MalaysiaSFP1,624,8001,624,800
 Burkina FasoAMC1,620,0001,620,000
 MaliAMC1,572,0001,572,000
 MalawiAMC1,476,0001,476,000
 ZambiaAMC1,428,0001,428,000
 VenezuelaSFP1,425,6001,425,600
Non-UN Member StatesN/A1,303,2001,303,200
 CambodiaAMC1,296,0001,296,000
 SenegalAMC1,296,0001,296,000
 ChadAMC1,272,0001,272,000
 SomaliaAMC1,224,0001,224,000
 ZimbabweAMC1,152,0001,152,000
 GuineaAMC1,020,0001,020,000
 Syrian Arab RepublicAMC1,020,0001,020,000
 BoliviaAMC900,00092,430992,430
 ChileSFP957,600957,600
 BeninAMC936,000936,000
 RwandaAMC996,000-102,960893,040
 EcuadorSFP885,600885,600
 HaitiAMC876,000876,000
 South SudanAMC864,000864,000
 GuatemalaSFP847,200847,200
 TajikistanAMC732,000732,000
 TunisiaAMC592,80093,600686,400
 Papua New GuineaAMC684,000684,000
 TogoAMC636,000636,000
 Sierra LeoneAMC612,000612,000
 LaosAMC564,000564,000
 Dominican RepublicSFP542,400542,400
 JordanSFP511,200511,200
 AzerbaijanSFP506,400506,400
 Kyrgyz RepublicAMC504,000504,000
 NicaraguaAMC504,000504,000
 HondurasAMC496,800496,800
 Congo, Rep.AMC420,000420,000
 LiberiaAMC384,000384,000
 El SalvadorAMC324,00051,480375,480
 Central African RepublicAMC372,000372,000
 MauritaniaAMC360,000360,000
 ParaguaySFP357,600357,600
 SerbiaSFP345,600345,600
 LibyaSFP343,200343,200
 LebanonSFP340,800340,800
 SingaporeSFP288,000288,000
 West Bank and GazaAMC240,00037,440277,440
 Costa RicaSFP254,400254,400
 OmanSFP254,400254,400
 New ZealandSFP249,600249,600
 PanamaSFP216,000216,000
 GeorgiaSFP184,80029,250214,050
 MongoliaAMC163,20025,740188,940
 MoldovaAMC156,00024,570180,570
 Gambia, TheAMC180,000180,000
 Bosnia and HerzegovinaSFP153,60023,400177,000
 UruguaySFP172,800172,800
 LesothoAMC156,000156,000
 ArmeniaSFP146,400146,400
 JamaicaSFP146,400146,400
 GuineaAMC144,000144,000
 QatarSFP144,000144,000
 AlbaniaSFP141,600141,600
 NamibiaSFP127,200127,200
 BotswanaSFP117,600117,600
 BhutanAMC108,0005,850113,850
 Cabo VerdeAMC108,0005,850113,850
 ComorosAMC108,000108,000
 DjiboutiAMC108,000108,000
 EswatiniAMC108,000108,000
 Solomon IslandsAMC108,000108,000
 North MacedoniaSFP103,200103,200
 MaldivesAMC108,000-5,850102,150
 BahamasSFP100,800100,800
 BahrainSFP100,800100,800
 BarbadosSFP100,800100,800
 BelizeSFP100,800100,800
 Brunei DarussalamSFP100,800100,800
 FijiAMC100,800100,800
 GuyanaAMC100,800100,800
 KosovoAMC100,800100,800
 MauritiusSFP100,800100,800
 Timor-LesteAMC100,800100,800
 Trinidad and TobagoSFP100,800100,800
 VanuatuAMC100,800100,800
 Sao Tome and PrincipeAMC96,00096,000
 MontenegroSFP84,00084,000
 SamoaAMC79,20079,200
 SurinameSFP79,20079,200
 St. LuciaAMC74,40074,400
 KiribatiAMC48,00048,000
 Micronesia, Fed. Sts.AMC48,00048,000
 GrenadaAMC45,60045,600
 St. Vincent and the GrenadinesAMC45,60045,600
 TongaAMC43,20043,200
 Antigua and BarbudaSFP40,80040,800
 DominicaAMC28,80028,800
 AndorraSFP26,40026,400
 Marshall IslandsAMC24,00024,000
 St. Kitts and NevisSFP21,60021,600
 MonacoSFP7,2007,200
 NauruSFP7,2007,200
 TuvaluAMC4,8004,800

Participants (donors)

COVAX is principally funded by rich Western countries.[8] As of 19 February 2021, 30 countries have signed commitment agreements to the COVAX Facility as well as the European Union.

Although mainly funded by governments (“Official Development Assistance“), the COVAX scheme is also funded by private-sector and philanthropic contributions, and recipient countries may share some costs for vaccines and delivery.[10]

DonorContributions
 United States2,500
 Germany1,093
 United Kingdom735
European Commission489
 Japan200
 Canada181
Bill & Melinda Gates Foundation156
 Saudi Arabia153
 Norway141
 France122
 Italy104
 Australia61
 Spain61
 Netherlands37
 Austria32
Reed Hastings and Patty Quillin30
 Sweden24
Anonymous Foundation22
  Switzerland22
 New Zealand12
 Kuwait10
 Qatar10
Shell10
 South Korea10
TikTok10
 Denmark8
 Belgium5
 Ireland5
 Singapore5
Wise5
Soccer Aid4
Thistledown Foundation4
 Greece2
 Iceland2
 Colombia1
KSRelief1
 Luxembourg1
Mastercard1
 Estonia0.1
 Monaco0.1
Nikkei, Inc.1
Medline International0.02
 Bhutan0.01
Total6,268

European Union

As of November 2020, the European Union (EU) and EU members have pledged €870 million to COVAX.[19] The European Commission (EC) brought the EU into COVAX on 31 August 2020 and pledged €400 million in guarantees,[20] but did not state how this money would be paid out or its conditions.[21] The EC pledged a further €100 million from the 11th European Development Fund to COVAX via a grant to GAVI on 12 November. Individual EU member states have also made additional pledges; France donated an additional €100 million, Spain an additional €50 million, and Finland an additional €2 million.[19]

According to the Foreign Office of the Federal Republic of Germany, Germany has joined COVAX through the European Union and has pledged €300 million for the treatment of COVID-19 in developing nations.[22]

United Kingdom

The United Kingdom has provided £548 million to COVAX.[23] The United Kingdom was the biggest single donor to COVAX-AMC until being overtaken by Germany and the United States.[24]

United States

As part of its isolationist America First policy,[25] the Trump administration stated on 1 September 2020 that it would not join COVAX because of its association with the WHO,[26][27] from which it had begun a year-long withdrawal process on 6 July 2020.[28]

Joe Biden defeated Trump in the 2020 election; on his first day in office, on January 20, 2021, the Biden administration announced that the United States would remain in the WHO and would join COVAX. This reversal of American policy (announced by Anthony Fauci, Chief Medical Advisor to the President) was welcomed globally.[29][30] On 19 February, the US pledged $4 billion, making it the single largest contributor to the fund.[31]

China

China has joined COVAX on October 9 2020. [32]On June 4 2020, China has decided to increase its donation to GAVI for 2020-2025 to $20 million compare to $5 million for 2016-2020.[33] China has declared that it will provide 10 million vaccine doses to COVAX on Febuary 3 2021.[34]

References

“COVAX explained”. gavi.org. GAVI. Retrieved February 25, 2021. World Health Organization (15 July 2020). “More than 150 countries engaged in COVID-19 vaccine global access facility”. Retrieved 3 February 2021. Widianto, Stanley (January 29, 2021). “COVAX to ship enough shots for 3% of poor countries’ populations in H1 – WHO”. Reuters. Jakarta. Retrieved February 3, 2021. “Comirnaty EPAR”. European Medicines Agency (EMA). Retrieved 23 December 2020. “WHO issues its first emergency use validation for a COVID-19 vaccine and emphasizes need for equitable global access”. World Health Organization (WHO) (Press release). 31 December 2020. Retrieved 6 January 2021. World Health Organization (24 August 2020). “172 countries and multiple candidate vaccines engaged in COVID-19 vaccine Global Access Facility” (Press release). Retrieved 4 February 2021. World Health Organization (18 December 2020). “COVAX Announces additional deals to access promising COVID-19 vaccine candidates; plans global rollout starting Q1 2021” (Press release). Retrieved 4 February 2021. Gabriele Steinhauser, Ghana Is First Nation to Get Free Covid-19 Vaccines Under Covax Plan, Wall Street Journal (February 24, 2021). 92 low- and middle-income economies eligible to get access to COVID-19 vaccines through Gavi COVAX AMC, Gavi, the Vaccine Alliance (31 July 2020). Seth Berkley. “The Gavi COVAX AMC Explained”. Gavi, the Vaccine Alliance. Jerving, Sara (3 February 2021). “COVAX releases country-by-country of vaccine distribution figures”. Devex. Retrieved 3 February 2021. “COVAX publishes first interim distribution forecast”. Gavi. 3 February 2021. “The Covax Facility: Interim Distribution Forecast – latest as of 3 February 2021” (PDF). COVAX. 3 February 2021. “World’s first COVID-19 vaccination compensation scheme launched”. Health Europa. Retrieved 24 February 2021. “Covid: WHO scheme Covax delivers first vaccines”. BBC. Retrieved 24 February 2021. Ducharme, Jamie (MARCH 1, 2021). “The First COVID-19 Vaccines Shipped Through COVAX Were Administered in the Ivory Coast”. time.com. Retrieved 1 March 2021. “Moldova becomes first European country to receive COVID-19 vaccines under COVAX scheme”. Radio Free Europe/Radio Liberty. 5 March 2021. “Key Outcomes: COVAX AMC 2021” (PDF). Gavi. European Commission (12 November 2020). “EU increases its contribution to COVAX to €500 million to secure COVID-19 vaccines for low and middle-income countries” (Press release). Retrieved 3 February 2021. European Commission (31 August 2020). “Coronavirus Global Response: Commission joins the COVID-19 Vaccine Global Access Facility (COVAX)” (Press release). Retrieved 4 February 2021. Guarascio, Francesco; Nebehay, Stephanie (31 August 2020). “EU offers 400 million euros to WHO-led COVID-19 vaccine initiative”. Reuters. Retrieved 4 February 2021. “Corona-Impfstoff weltweit fair verteilen: GAVI kündigt erste Lieferung von Impfdosen über COVAX an”. Federal Foreign Office (in German). Federal Republic of Germany. 3 February 2021. Retrieved 3 February 2021. “Corona-Covax: How will Covid vaccines be shared with poorer countries? an”. BBC News. BBC. 26 January 2021. Retrieved 4 February 2021. “Key Outcomes: COVAX AMC” (PDF). Gavi. Williams, Abigail (3 September 2020). “U.S. opts out of WHO-linked global COVID-19 vaccine effort”. NBC News. Retrieved 3 February 2021. Beer, Thomas (1 September 2020). “U.S. Won’t Join Global Coronavirus Vaccine Effort Because It’s Led By The WHO”. Forbes. Retrieved 15 November 2020. Rauhala, Emily; Abutaleb, Yasmeen (1 September 2020). “U.S. says it won’t join WHO-linked effort to develop, distribute coronavirus vaccine”. The Washington Post. Retrieved 4 February 2021. Smith, Allan; Perlmutter-Gumbiner, Elyse (7 July 2020). “Trump administration gives formal notice of withdrawal from WHO”. NBC News. Retrieved 3 February 2021. Nebehay, Stephanie (21 January 2021). “U.S., staying in WHO, to join COVID vaccine push for poor nations: Fauci”. Reuters. Retrieved 3 February 2021. Donato Paolo Mancini (21 January 2021). “US joins global vaccine efforts on Biden’s first day”. Financial Times. “Covid vaccines: G7 increase support for Covax scheme”. BBC News. 19 February 2021. Retrieved 19 February 2021. Nebehay, Colin Qian, Stephanie (2020-10-09). “China joins WHO-backed vaccine programme COVAX rejected by Trump”. Reuters. Retrieved 2021-03-10. “China”. www.gavi.org. Retrieved 2021-03-10. Staff, Reuters (2021-02-03). “China to provide 10 million vaccine doses to COVAX initiative”. Reuters. Retrieved 2021-03-10.

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