04 Covax

For acting as the world’s conscience on global vaccine equity

Even before COVID-19, policymakers around the world had long struggled with the wicked problem of vaccine equity. Looking to change that, a rock star force of global nonprofits—the Coalition for Epidemic Preparedness Innovations, World Health Organization (WHO), UNICEF and Gavi, the Vaccine Alliance—mobilized around a singular goal: accelerate the development and manufacturing of vaccines, while guaranteeing access for the neediest people. 

The original vision behind the project was fairly straightforward: COVID-19 Vaccines Access Facility, or Covax, would use donations from the world’s richest countries to pre-purchase vaccines from major manufacturers, then distribute them so every country would get a fair share based on its population. But virus variants, supply competition and vaccine hoarding by wealthier countries have forced project leaders to execute pivot after pivot—and sometimes face sharp criticism. Tedros Adhanom Ghebreyesus, WHO director general, didn’t mince words at an address in April: “Vaccine equity is the challenge of our time. And we are failing.”

The team’s initial plan crumbled as Covax found itself competing against wealthy countries buying vaccines directly from drugmakers. Then one of Covax’s top suppliers, Serum Institute of India, stopped exporting its vaccines beyond India’s borders. During the resulting supply crunch, the team began asking wealthy countries for any and all surplus vaccines. Covax also secured project funding from at least 29 private organizations and individuals, including the Bill and Melinda Gates Foundation, Cisco, Mastercard, Visa Foundation and Shell.

The response: a slow but steady payoff. In the six months since starting vaccine rollout in February, Covax facilitated 240 million doses in 139 countries. And more help is on the way: In September, the United States pledged to donate 500 million doses of Pfizer vaccine to Covax. Days before that U.S. donation, the group projected that, by the end of 2021, Covax would make available 1.2 billion doses for lower-income countries in the program, enough to ensure shots for 40 percent of adults in 92 economies.