Following months of conversations between Venezuelan officials and representatives from COVAX, the country’s vice president announced last weekend that Venezuela had paid COVAX $64 million — which will finally allow the country to receive shipments from the global consortium that promises equitable access to COVID-19 vaccines.
The amount accounts for over half of the $124 million COVAX is requiring of Venezuela in exchange for over 11 million doses — enough to fully vaccinate 20% of the population. A day later, President Nicolás Maduro indicated Venezuela has secured the funds required for the full payment.
The surprise announcements came as good news for the South American country with a population of 28 million, which currently has one of the lowest vaccination rates in the world. Venezuela, which has vaccinated less than 0.4% of its population, ranks last in Latin America in doses administered per 100 people. At this pace, it would take the country over 2,603 days, or seven years, to achieve herd immunity, according to the Time to Herd project.
Despite landing the deal with COVAX, Venezuelans are “still waiting for the details of a national vaccination plan to emerge,” said Geoff Ramsey, the director for Venezuela at the Washington Office for Latin America.
“This is a government that systematically hides information from the public,” Ramsey said. “They're very cautious about any kind of transparency or accountability. They’ve systematically undercounted COVID cases.”
Venezuela’s efforts to obtain vaccines and release a vaccination plan have been caught in a power struggle between the government and the opposition. In February, COVAX forecast that up to 1,425,600 doses would be distributed in the country in the first two quarters of 2021, although none have been allocated so far due to the payment delay.
The agreement, made official by Venezuela’s payment after months in the making, brought Maduro and opposition leader Juan Guaidó face-to-face for the first time in over a year. In March, the two political foes agreed to use over $30 million in offshore funds frozen under U.S. sanctions to buy vaccines through the World Health Organization initiative.
On that occasion, Guaidó, who is recognized by the U.S. as the legitimate president of Venezuela, also vowed to request Washington’s permission to use more than $340 million in frozen funds for vaccine acquisition and distribution.
But a few days later, Maduro announced that Venezuela would not authorize the import of around 2 million doses of the Oxford-AstraZeneca vaccine — COVAX’s vaccine of choice and which is not yet approved for use in Venezuela — due to concerns over blood clots.
Citing “vaccine sovereignty,” Maduro said that the country would not acquire any vaccines that are “causing damage in the world,” and said Venezuela would ask COVAX for doses of Johnson & Johnson vaccine instead, despite COVAX not allocating J&J doses yet for countries. But an agreement between J&J and Gavi, the Vaccine Alliance, has been set.
Currently, administering doses of J&J vaccine has been paused in the U.S., EU, and South Africa.
As Venezuelan officials confirmed the COVAX payment last weekend, however, they did not express concerns about either vaccine. Though it’s unclear how Venezuela paid, Maduro claimed that Caracas was able to access the funds that had been “kidnapped” by Washington.
Signing the deal with COVAX does not prohibit Venezuela from acquiring other vaccines on its own for other segments of its population, said Richard Marlink, director of the Rutgers Global Health Institute.
Vaccine access amid political turmoil
Guaranteeing access to coronavirus vaccines amid a long-standing political and economic crisis has been a challenge for Venezuela. In December, Maduro promised the country would have access to 10 million doses of the Russian and Chinese vaccines by the first quarter of 2021. So far, the country has only received around 500,000 doses of China’s Sinopharm and 250,000 doses of Russia’s Sputnik V.
To score more vaccines, Maduro even considered offering his allies, as well as COVAX, oil in exchange for shots. “But the Russians and the Chinese are more interested in cash than in crude oil from Venezuela, which they already receive in large quantities,” Ramsey said.
With new variants in neighboring Brazil and the corrosion of the health care system that preceded the pandemic, Venezuela is currently experiencing the worst moment of the pandemic, with doctors running against the clock to maximize their scarce resources. The country’s National Academy of Medicine has called the limited vaccine availability a “worst-case scenario.”
Asked about the lack of reliable COVID-19-related data coming out of the country, a Gavi spokesperson explained that during the first phase of COVAX distribution, doses are allocated proportionally to all participant countries “until 20% of total population coverage is achieved.”
“We must assume that all participants are at significant risk, and a lack of COVID-related data from a participant will not factor into allocation decisions during this first phase,” the spokesperson said.
Ensuring a fair rollout
“We've got to get the virus under control in all countries. ... In the end, we’re all on one planet.”— Richard Marlink, director, Rutgers Global Health Institute.
Venezuela’s political turmoil has extended to its vaccine rollout, with the Maduro administration recently accused of restricting shots to loyalists. Last year, it was accused of seizing control of around 340,000 COVID-19 antigen tests that arrived in the country.
Experts say international organizations can play a key role in guaranteeing that the vaccine rollout proceeds effectively.
“The reality is that the only authority in Venezuela with the ability to oversee vaccination with any kind of accountability is UNICEF and the Pan American Health Organization, and both already have extensive experience in vaccination campaigns in the country,” Ramsey said, referring to the agencies’ role in measles and tuberculosis vaccination campaigns in past years.
At this point, PAHO has been focusing its efforts in convincing the Venezuelan health ministry, through scientific evidence, that the Oxford-AstraZeneca vaccines offered through COVAX are safe and “can save lives,” PAHO Assistant Director Jarbas Barbosa said at a press conference Wednesday.
“The important part now is to guarantee countries have access to vaccines as soon as possible,” he added. PAHO and UNICEF helped mediate the deal to secure the COVAX vaccines — and under the terms, the two agencies will oversee the rollout.
In March, Ciro Ugarte, PAHO’s director of health emergencies, also highlighted the importance of strengthening the country’s food and fuel chains “as part of a common effort to be made by everyone” to guarantee the doses reach different sections of the country.
The country also needs to strengthen its cold chain procedures, logistics, training, and access to essential services, Ugarte said then.
Due to Venezuela’s chronic fuel and power shortages, establishing the cold chains required for vaccine transportation has already proven to be a challenge. And the longstanding exodus of health care workers is now being reflected in the operational obstacles faced in the vaccine rollout, as well as in the overall response to the virus.
Initiatives such as COVAX, said Marlink, are created to guarantee that the whole world is “completing the race” the race against the coronavirus. Despite Venezuela’s political instability, making sure that the population is timely and effectively vaccinated is key to ending the pandemic.
“If we don’t stop this virus from replicating, we will not be able to stop the emergence of new variants of the virus that are showing to be both more contagious and, in the situation in Brazil, more deadly,” Marlink said. “We've got to get the virus under control in all countries. ... In the end, we’re all on one planet.”
About the vice president’s announcement last weekend, Guaidó’s interim government said in a statement that “getting the vaccine is the first step, but the important thing is to vaccinate” and called for a distribution plan that meets “humanitarian principles.”