WHO, partners unveil ambitious plan to deliver 2 billion doses of Covid-19 vaccine to high-risk populations

The World Health Organization and key partners unveiled a plan Friday to purchase 2 billion doses of Covid-19 vaccines for the highest risk populations of the world.

The plan anticipates that by the end of 2021, the doses could be delivered to countries to vaccinate high risk individuals, likely including health care workers, people over the age of 65, and other adults who suffer from conditions like diabetes.

The WHO and its partners — the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi, the Vaccine Alliance — estimate it will cost $18.1 billion to deliver on the plan. The effort is one pillar of the WHO’s effort to ensure all countries have access to Covid-19 vaccines, therapeutics, and diagnostics, called the ACT Accelerator, short for Access to Covid-19 Tools.

In addition to the funding — $11.3 billion of which must be raised in the next six months — the project would also need commitments from high- and upper-middle income countries to purchase up to 950 million doses of vaccine.

Countries will be offered “shares” of the nine candidate vaccines that CEPI is supporting, as well as other vaccines the consortium may end up purchasing. The idea is that because it is not known which vaccines will be successful, purchasing shares in a pool — to be called the Covax facility — will broaden a country’s chances of having access to vaccines. It is expected that charitable donors will help support shares for low- and middle-income countries.

Individual countries that can afford to do so are negotiating advance direct purchase agreements with various manufacturers — and are even helping to pay upfront for the cost of making vaccine before it has been shown to be effective. But should a country make a big investment in one vaccine, only to see it fail, it could find itself with limited alternatives in the early days of vaccine availability, when demand will be huge and supply scarce.

“It’s risky for them to do that and it’s also not ethically the right approach, because it leaves the rest of the world without vaccine doses,” said Soumya Swaminathan, WHO’s chief scientist.

That risk is real. Vaccines are difficult to make and historically more vaccine projects fail than succeed. Seth Berkley, CEO of Gavi, said about 7% of vaccines make it through preclinical development, and maybe 15% to 20% that enter the clinic are successful.

“The vast majority will fail, but by having a large portfolio this will move forward,” Berkley said. He noted the facility has signed a memorandum of understanding for 300 million doses with AstraZeneca, which is partnering with Oxford University on a vaccine that has already begun a Phase 3 clinical trial.

Richard Hatchett, CEPI’s chief executive officer, said production support of a number of vaccine candidates gives Covax a right of first refusal to vaccine doses where the program has provided financial support for the manufacturing of the vaccine.

“The advantage of the facility is that it is the ‘first customer in line’ for those projects where access agreements exist but it can also go out to the market and buy any vaccine. And the large volume guarantees will be very attractive to companies,” Hatchett said.

According to the WHO, there are currently 16 Covid-19 vaccines in clinical trials already, and at least another 125 in earlier stages of development.

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