COVAX Aims to Send Poor Countries Their Fair Share of COVID-19 Vaccines



Key Takeaways

  • The WHO and several other organizations have banded together to promote vaccine equity.
  • The resulting initiative, COVAX, aims to provide low- to middle-income countries with vaccine doses, in many cases free of charge. Almost 200 countries have already pledged to support COVAX’s mission. 
  • Healthcare workers and high-risk individuals will be prioritized. The first shipments of doses were issued in late February. 

In an effort to keep vaccine distribution and administration efforts from fracturing along socioeconomic lines, the World Health Organization (WHO) has called on its members to work together to ensure that healthcare workers and high-risk individuals in every country have access to a vaccine within the first 100 days of 2021.

To achieve this objective, the WHO issued a Vaccine Equity Declaration (VED) and partnered with the Coalition for Epidemic Preparedness Innovations and the Vaccine Alliance to spearhead the COVID-19 Vaccines Global Access (COVAX) initiative.

Nearly 7,000 individuals and hundreds of organizations have signed the VED, which implores political and commercial entities to support COVAX by safely and effectively accelerating manufacture, approval, and allocation processes. Currently, 190 countries and economies are backing COVAX.

In “an interconnected world, no one is safe until everyone is,” WHO spokesperson Tarik Jašarević tells Verywell.

In the race to achieve widespread immunity to COVID-19, poorer countries are falling behind richer countries as the latter leverage their considerable social, political, and economic power to secure doses and cut deals with pharmaceutical companies. In practice, this means that billions of people worldwide—90% of the population of 67 nations—stand little to no chance of vaccination in 2021, according to The British Medical Journal.

Two weeks ago, “the United Nations criticized such inequity [by pointing] out at the time, 10 nations had already claimed 75% of available vaccines," Chunhuei Chi, MPH, director of the Center for Global Health at Oregon State University’s College of Public Health and Human Sciences, tells Verywell. "Several nations, including Canada, the USA, and the UK, all procured way more doses than their entire population needed."

COVAX rejects such “vaccine nationalism” by providing 92 poorer countries with necessary medical tools and treatments in the name of promoting equity in COVID-19 medicine and health care. It is essentially a storage and production facility for vaccine doses of a variety of brands, including Novavax, Moderna, Pfizer-BioNTech, AstraZeneca, and Johnson & Johnson, and has already accrued over two billion doses. The majority will be distributed free of charge to regions in need, including sub-Saharan Africa, Latin America, the Caribbean, Southeast Asia, and the Middle East.

What This Means For You

Increasing vaccine access and reaching herd immunity globally is important for curbing the COVID-19 pandemic. If you live in one of the 92 countries that are eligible for COVAX shipments, you can expect to be vaccinated earlier than initially planned.

COVAX Rollout

The COVAX vaccine rollout began last month. By February 26, Ghana and the Ivory Coast received 600,000 and 504,000 doses, respectively, with distribution beginning this week. Nigeria and Colombia have also received their first shipments. The remainder will continue to be shipped by the end of 2021.

“In Phase One of the allocation from the COVAX Facility, all countries will receive an initial tranche of doses until they cover 3% of the population," Jašarević says. "This will allow for the vaccination of the highest priority populations; additional tranches will follow gradually as more supply becomes available until 20% of the population is covered (to allow for the vaccination of most of the at-risk groups in countries)."

Per the terms of the VED, healthcare workers and high-risk individuals such as older adults and people with underlying conditions will receive priority. The VED does not specify what demographics come next, but, Jašarević says, countries will “have discretion on how to use their allocated doses based upon their own epidemiologic situation and guidance from national policymaking bodies'' once the 20% target has been met.

Barriers to the Program

As with any ambitious, large-scale project, COVAX faces significant financial and logistical barriers to success. The initiative is seeking $2.8 billion on top of the $6 billion it has already raised to fund further research, development, and acquisition efforts, and its main distributor, the UN Children’s Fund, is scrambling to meet demand.

The U.S. has donated $2 billion to COVAX and pledges to donate another $2 billion over the next two years.

But by far the most daunting barrier is the inherent tension between public health and the free market, Chi says. That is, the need to immunize as many of the world’s seven billion people against COVID-19 as fast as possible runs counter to the need for companies to benefit from the sales of a product. 

The “free market...limits the ability of COVAX to achieve its goal of equitably allocating vaccines, for the COVAX regime does not have a monopoly on allocating all vaccines," Chi says. "What we need is a global governing body on the global public goods that monopolize the allocation of those public goods (such as vaccines and critical drugs for the pandemic), and also restrict the individual company’s sale."

That said, COVAX’s stated goal—to distribute every single one of its more than 2.1 billion doses of the vaccine by the end of 2021—is in reach. As Chi sees it, success is conditional upon three factors: 

  • Approval of additional candidate vaccines, which will increase the pool from which COVAX can draw 
  • Approval of an emergency patent waiver, which will enable lower-income nations to manufacture patented vaccines in order to increase the rate of production 
  • Public pressure from world leaders and national governments to commit to vaccine equity. (World leaders such as WHO Director-General and French Prime Minister Emmanuel Macron have already spoken out, Chi says.) 

In addition to reducing the incidence of COVDI-19 infection, illness, and death, COVAX is expected to catalyze economic recovery in recipient countries. Not only has the novel coronavirus killed over 2.5 million people worldwide, but it will also cost the global economy $28 trillion in lost output by 2025, Jašarević says.

"Global equitable access to a vaccine, particularly protecting health care workers and those most-at-risk is the only way to mitigate the public health and economic impact of the pandemic," the WHO writes.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. World Health Organization. Call to Action: Vaccine Equity Declaration. Updated January 18, 2021.

  2. World Health Organization. World waking up to vaccine equity. February 19, 2021.

  3. Dyer O. COVID-19: many poor countries will see almost no vaccine next year, aid groups warn. Br Med J. 2020. doi:10.1136/bmj.m4809

  4. World Health Organization. COVAX Announces Additional Deals to Access Promising COVID-19 Vaccine Candidates; Plans Global Rollout Starting Q1 2021. December 18, 2020.

  5. World Health Organization. First COVID-19 COVAX Vaccine Doses Administered in Africa. March 1, 2021.

By Caroline Tien
Caroline Tien is a journalist with degrees in English and biology. She has previously written for publications including Insider and Cancer Health.