LONDON — A new funding mechanism to help ensure a future coronavirus vaccine is accessible to lower-income countries was announced by Gavi, The Vaccine Alliance, at the organization's replenishment summit on Thursday.
The Advance Market Commitment for COVID-19 Vaccines, or Covax AMC, will be the first “building block towards a global mechanism to ensure equitable access to future COVID-19 vaccines,” according to a statement by Gavi.
The Gavi replenishment secured a record $8.8 billion in funding for 2021 to 2025, serving as a “real injection of confidence into the multilateral system."
The record $8.8 billion raised at the organization's replenishment is intended to support routine immunizations and health systems, and will not cover the costs of supplying vaccines developed to fight the coronavirus pandemic. However, the new funding mechanism aims to make a coronavirus vaccine accessible in the global south.
Ngozi Okonjo-Iweala, chair of the Gavi Board, said the mechanism “moves us one step closer to the essential vision of equitable access for all.”
Covax AMC has so far raised $567 million from 12 donors out of a $2 billion target. The effort is based on Gavi’s Advance Market Commitment for Pneumococcal Conjugate Vaccines, which incentivizes vaccine manufacturers to produce affordable vaccines. Some of its donors, including Italy, the U.K., Norway, Canada and the Bill & Melinda Gates Foundation, will now sponsor the Covax AMC, too, using unused funds from the PCV AMC.
It is designed to “accelerate equitable access to appropriate, safe and efficacious COVID-19 vaccines globally,” according to Dr. Seth Berkley, CEO at Gavi, who added that the “specific technical details of this are being discussed over the next few weeks.”
Explaining the concept, Berkley said: “All countries who wish to participate are encouraged to do so by making a commitment to purchase doses and a contribution to the facility. Participating countries will receive access to a portfolio of vaccines secured by the facility and based upon an allocation framework and at a negotiated price.”
High-income countries will pay using domestic financing, and Gavi-supported countries “will use ODA resources,” according to Berkley, referring to official development assistance.
“Even countries who have already done bilateral deals with a company will be able to mitigate the risk of not backing a winning vaccine by joining the facility, which will then back a portfolio of vaccines increasing the likelihood of success, when they get their fair share alongside all other countries,” he continued.
The large number of COVID-19 vaccine candidates currently being developed, and the high failure rate in creating new vaccines, means it remains highly uncertain where a successful specimen will be created — if at all. Okonjo-Iweala said: “By de-risking the cost of investing in high volumes of manufacturing against an unknown outcome — and making sure those investments are made now — the Gavi Covax AMC increases the likelihood that when we have a successful vaccine or vaccines, it will be available in sufficient quantities and affordable to developing countries.”
“If a COVID-19 vaccine is going to be a global public good, governments cannot sidestep their responsibility to intervene.”— Heidi Chow, senior campaigns manager, Global Justice Now
Pharmaceutical company AstraZeneca has already signed up to the Covax AMC to guarantee 300 million doses of a COVID-19 vaccine it is developing with the University of Oxford. Discussions with other vaccine manufacturers are ongoing, according to Berkley.
But the announcement was not met with universal support. Health equity campaigners warned that Gavi and governments should be taking measures to reduce the stronghold of the pharmaceutical industry on vaccines to ensure equal access.
"There was no plan [at the replenishment] today for how equitable allocation would happen and no mention of the patent-barriers and pharmaceutical monopolies that keep prices high and restrict supplies,” said Heidi Chow, senior campaigns manager at Global Justice Now.
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“If a COVID-19 vaccine is going to be a global public good, governments cannot sidestep their responsibility to intervene and impose conditions to ensure any vaccine researched or purchased with public funds is openly licensed, sold at cost-price and the know-how shared,” she continued.
Oxfam health policy manager Anna Marriott said the project needs to avoid “costly mistakes of the past” when Gavi and donors “sought to subsidize the high prices charged by the pharmaceutical industry rather than seeking to bring them down, which ignored the needs of middle-income countries” which receive fewer subsidies.
“Governments should stand up to the pharmaceutical industry and insist that taxpayers’ money is only invested in vaccines that are patent-free and available for all,” Marriott added.