64 high-income nations join effort to expand global access to Covid-19 vaccines

Countries representing about 64% of the world population have signed up to expand global access to Covid-19 vaccines by funding a purchasing pool organized by the World Health Organization and other nonprofit groups, leaders of the effort announced Monday.

Not among the countries: the United States, which had previously said it is not taking part in the so-called COVAX Facility, or Russia nor China, both of which have already issued emergency use licenses for Covid-19 vaccines.

Still, a total of 156 countries have committed to joining the effort, which hopes to purchase 2 billion doses of vaccine by the end of 2021. Of participating countries, 64 are higher-income nations, whose participation is critical to ensuring the financial feasibility of the effort.

The initiative is being organized by Gavi, the Vaccine Alliance and the Coalition for Epidemic Preparedness Innovations, in addition to the WHO. The Trump administration cited the involvement of the WHO, which it plans to withdrawal from by next July, as its reason for not participating.

“Vaccine nationalism will only perpetuate the disease and prolong the global recovery,” WHO Director-General Tedros Adhanom Ghebreyesus said Monday. “Working together through the COVAX Facility is not charity, it’s in every country’s own best interests to control the pandemic and accelerate the global economic recovery.”

Tedros said the effort is at a critical point, with only $3 billion committed so far. Another $15 billion is needed immediately to ensure momentum continues.

The European Commission, representing 27 countries, along with the United Kingdom, Australia, Canada, and Japan are among the countries supporting the pool.

Gavi CEO Seth Berkley said another 38 countries are in discussions with the COVAX Facility and may yet join the vaccine pool.

A report issued by the WHO on Monday gave the first indications of how the facility will distribute vaccine doses, when they become available. The WHO estimates that an allocation of doses equal to 20% of a country’s population should be enough to vaccinate people at the highest priority. In the initial phases, when doses are expected to be in short supply, countries will receive doses in tranches until they have enough to vaccinate 3% of their populations.

“This volume would enable, for example, the vaccination of frontline workers in health and social care settings in most countries,” the report said.

The report suggests a first tier should include frontline workers in health and social care settings, followed by adults who are at high risk because of their age or because they have health conditions known to exacerbate Covid-19 infections. The 3% tranche should handle the former while the 20% allocation should be enough to vaccinate all within the first tier, the report said.

Responsibility for establishing who should be at the front of the line for vaccine rests with each country, the report noted, but it urged countries to consider the WHO’s recommendations. Countries should be transparent about how they are deciding on priority groups.

Later, as more vaccine becomes available, countries will receive enough supply to vaccinate a larger proportion of their populations. During the second phase, doses may be allocated with an eye to helping countries where transmission of the SARS-CoV-2 virus is most active.

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