A quest for equitable and accelerated vaccine distribution led to the creation of the Covax facility, a joint effort of GAVI, the Vaccine Alliance; the Coalition for Epidemic Preparedness Innovations; and the World Health Organization, joined by UNICEF. An early target was to acquire and distribute 2 billion doses by the end of this year. As of now, 522 million doses have been delivered to 144 countries, most of it to the poorer nations. That’s certainly millions of people helped, but it has been slower than expected, and the wait agonizing.
Why the lag? In the face of a catastrophic emergency, Covax began from zero — no money, no people. Once vaccines were developed and started being manufactured, a mad scramble took place for scarce supply. Wealthy countries, not sure which vaccine would work, ordered quantities far greater than their populations. The U.S. government with Operation Warp Speed made enormous investments, especially in mRNA vaccines, so had reason to make first claim. Russia and China, seeking influence, added to the scramble, offering their own vaccines in a spate of bilateral deals. By the time Covax had raised money, it faced limited supplies and tough negotiations with manufacturers. A lesson: In the future, some kind of contingent funds, ready to go early in a crisis, would be a huge head start.
Covax opted for the AstraZeneca vaccine, in part because it did not have to be kept at super-cold temperatures, making it better suited for difficult conditions, and was being sold at cost. Covax was counting on the Serum Institute of India to produce millions of doses. Then the delta variant exploded in India, leading to a suspension of exports, a huge setback to Covax and the poorer nations. Another lesson: A global network of sustainable, quality vaccine manufacturing facilities — and thus an assured source of vaccines — is essential to fight a pandemic. It does not yet exist. The Biden administration has just announced plans to encourage a major boost in vaccine manufacturing, a good idea that should have been launched sooner.
Covax has had better luck obtaining donations. Seth Berkley, chief executive of GAVI, says a bit more than 1 billion doses are now allocated to Covax. Without Covax, the situation would have been far worse — imagine 195 nations jostling for vaccine candidates in a free-for-all. Still, the Covax experience has exposed how the haves took care of themselves, and the have nots have been forced to wait. Absorbing the lessons of this pandemic should lead to a renewed effort to prepare a rescue ship before the storm: financing, factories and know-how poised to go at a moment’s notice.
An earlier version of this editorial incorrectly stated the AstraZeneca vaccine was a single dose. It requires two doses. This version has been corrected.