THE WORLD HEALTH Organization’s director-general, Dr. Tedros Adhanom Ghebreyesus, warned in August that no country could afford to go it alone in fighting the pandemic. Nations already depend on global supply chains for everything from diagnostic testing to personal protective equipment, he said, and they must avoid “vaccine nationalism” when it comes to the most powerful tool to fight covid-19. When the Group of 20 leaders held their virtual summit meeting last weekend, they again declared their intent not to hoard lifesaving vaccines, saying, “We will spare no effort to ensure their affordable and equitable access for all people.”

But as vaccines come closer to reality, wealthy nations of the world have already taken care of their own needs and signed contracts to buy up hundreds of millions of vaccine doses. And the poor? A global risk-sharing procurement initiative to ensure fair and equitable access to vaccines, the Covax Facility, could bring them protection, but only if it can get sufficient funding in 2021. This is the world’s best chance to help the poorest populations confront the pandemic, being led by the WHO, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance.

As it currently stands, 92 lower-income economies will be supported by the financing mechanism in Covax, the Advanced Market Commitment (AMC). Ninety-seven higher-income economies have signed up as self-financing members of the Covax Facility. The idea is to pool vaccine buying power and ensure distribution for all countries, including the less developed nations, with a goal of obtaining 2 billion doses to protect 20 percent of their populations by the end of 2021, enough to cover front-line health-care workers and the most vulnerable. Negotiations for the shots are underway with manufacturers. To make this initiative work, according to the WHO, there is an urgent need for $7.8 billion next year from international donors, including $5 billion for the 92 lower-income countries, and additional funds to help them set up distribution systems, a demanding task. All of that funding remains to be raised.

China and Russia are developing vaccines, too. They have their own national regulatory process, but for their vaccines to be used globally through the Covax Facility they would have to meet international standards through WHO review of quality, safety and impact on disease. They could distribute the vaccines on their own. China has joined Covax as a participant, allowing it to procure doses from the facility, but Russia has not.

Among the big donors to the AMC are the United Kingdom, Canada, Germany and Saudi Arabia. President-elect Joe Biden should commit the United States, too. A $200 million donation would amount to only 2 percent of spending on Operation Warp Speed. And we hope Mr. Biden will rapidly return the United States to the WHO.

The world’s wealthiest countries are on the verge of a science triumph with the arrival of an effective vaccine in less than a year. But in this moment of need, the haves should also extend a hand to the have-nots. As Dr. Tedros said in August, “No one is safe until everyone is safe.”

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