Devex CheckUp: Is COVAX still relevant as a vaccine sharing initiative?

With the help of Germany, COVAX is hoping to raise at least $3.8 billion from donors, out of a $5.2 billion investment package from the Break COVID Now summit on Friday, to help increase COVID-19 immunization rates in low-income countries. But the vaccine sharing mechanism, which has been criticized for falling short of its promises, could face challenges in obtaining the resources needed to do this.

• The call for this funding was launched back in January 2022, but COVAX has only secured $192 million, along with a €350 million ($385 million) pledge from Germany, which will be hosting the virtual event. A Gavi spokesperson tells Jenny that while no country has been affected yet because of the limited resources, “many lower-income countries have reached the limits of their capacity to absorb doses.”

• The Gavi spokesperson says “Gavi’s existing COVID-19 Delivery Support is already over-subscribed and we expect additional requests from AMC-eligible economies.” However, demand from eligible economies to the COVAX Advance Market Commitment “remains dynamic and highly specific to each country’s unique context and national health priorities,” although COVAX now has enough supply to meet and go beyond countries’ vaccination targets. On Thursday, Gavi also announced a new partnership with MedAccess and the Open Society Foundations for a $200 million risk-sharing facility to allow COVAX to procure additional vaccine doses if needed.

• While COVAX’s work remains important, especially in helping countries reach the goal of vaccinating 70% of their populations, it has created an “environment of distrust,” says Fifa Rahman, a civil society representative with the Access to COVID-19 Tools Accelerator. “How long it’s taken for vaccines to get through to countries unfortunately has resulted in a loss of momentum” as nations, including those in the global south, now seek to focus on economic recovery, she tells Jenny.

• The funding is meant to ensure that COVAX will have the money to deliver the vaccines, cover for syringes and other ancillary costs for donated doses, and contingent financing on hand in case there’s a need to procure additional vaccine doses. But Rahman says COVAX needs to also consider paying health workers salaries and investing in media campaigns to build people’s confidence in the vaccines.

• More than a year since immunization campaigns started, about 15% of people in low-income countries have received at least one dose of a COVID-19 vaccine. That figure is significantly lower than the percentages for other country groupings, with lower-middle-income nations at 60%, high-income nations at 79%, and upper-middle-income nations at 81%.

• Back in January, Gavi CEO Seth Berkley called for funding for COVAX’s operations, saying that “we right now are basically out of money.” But in a recent letter to the editor for The Washington Post, he writes that COVAX’s work “goes on” to help countries “administer more doses before a new [COVID-19] wave strikes.”

• Amid the criticism, a recent study by researchers from the World Bank and the Johns Hopkins Bloomberg School of Public Health’s International Vaccine Access Center concluded that COVAX “is helping to balance global inequities in the allocation and distribution of COVID-19 vaccines” — although the mechanism alone “has not been enough to reverse the inequality of total COVID-19 vaccine distribution.”

+ Catch up on all our coverage of COVAX, including our exclusive report on COVAX’s canceled vaccine delivery to refugees in Thailand.

WLA what?

For years, approvals by countries on WHO’s list of so-called stringent regulatory authorities have been important criteria in many international organizations’ procurement policies. The quality assurance policy of the Global Fund, for example, requires that medical products procured using Global Fund grants be prequalified by WHO or approved by an SRA.

But in recent years, many countries not on the list have been clamoring to be part of a regulatory reference list so that they too can have this advantage.

Now, WHO is developing a new list of “WHO-listed authorities” and a process for how countries can be part of it. Jenny speaks with Rogério Gaspar, director of regulation and prequalification at WHO, to learn about the process, the preconditions, and what benefits await countries that agree to be involved in the new WLA initiative.

Explainer: WHO’s new scheme to globally recognize regulatory authorities (Pro)

+ Devex Pro subscribers can also learn about an investment plan to bolster health manufacturing in Africa. Not gone Pro yet? Try it for free for 15 days.

Career alert

Thinking about launching a career in global health? Our colleague Justin Sablich has curated tips from global health professionals, recruiters, and other career experts on how to break into the sector. Here are a few of them:

Broaden your skills. Many roles in global health require expertise across a wide range of areas, from management systems to disease control and surveillance.

Consider a master’s. An advanced degree in public or global health would make the most sense for someone pursuing a career in the sector. It can help you prepare for a variety of roles while also fostering field-specific knowledge through project experience, according to Camlus Odhus, a health expert who oversees a UNICEF-funded program in Kenya.

Learn to communicate well. Because global health professionals work collaboratively, “it's really important for people to be good communicators, to be able to communicate complex information in a way that people can understand,” says Yvette Herrera-Greer, a senior global recruiter at PATH.

Career Account members can read the full list of tips.

+ A Career Account membership includes all the valuable tools you need to be successful in your globaldev job hunt. Sign up and start your 15-day free trial.

What $20 can do

In an effort to move beyond emergency cash distribution and toward a social protection system, an NGO consortium has registered over 20,000 pregnant people for regular mobile cash transfers in Somalia and Somaliland. They can use the money, worth $20 per month, for whatever they feel is essential — whether that’s diapers or paying the family water bill. The payments, which last for two years, are an incentive to get pregnant people in their third trimester to visit health clinics to monitor their pregnancy and "nudge" them toward having healthy habits.

And the program seems to work. However, $20 doesn’t buy much amid the current levels of inflation in the country. Across Somalia, the consumer price index in January and February saw a significant increase from the 2017-2021 average, exacerbated by the Russia-Ukraine war. A 55-pound (25 kilogram) bag of rice that used to cost $15 now sells at $22, according to

Aliow Mohamed, Islamic Relief’s country director in Somalia.

Despite this, health workers tell our colleague Sara Jerving that clinics involved in the cash program have seen an increase in attendance. And while the program is only a pilot, Abdihakim Farah, a social transfer adviser at a state ministry in Somalia, tells Sara that this may be a step on the road to the government eventually funding the program on its own.

"It is clear, at this time, Somalia cannot give its people social welfare,” Farah said. But, he added, “we cannot wait until we have a longer-term social protection system in place while drought and other emergencies are ravaging our people.”

Explore our visual story: Building up a social protection system in Somalia and Somaliland

The truth is …

Panjabi recently spoke with our colleague Michael Igoe about the latest thinking within the U.S. government on preparing for and responding to future disease outbreaks globally.

Read: ‘The vision is to transform global health security' (Pro)

What we’re reading

China has approved clinical trials for two messenger RNA vaccines. [South China Morning Post]

The U.S. Senate has agreed on $10 billion in COVID-19 aid but left out funding for global vaccine efforts. [Politico]

In the long term, fighting the pandemic will require $10 billion annually, IMF says. [Devex]