25 December 2020
One organization leading the effort to get COVID-19 vaccines to poorer countries says in a report that the plan faces a "very high" risk of failure.
Reuters news agency examined documents from the report, which has not been made public. The report was prepared for high-level officials at Gavi, an alliance of governments, drug companies, aid groups and international organizations.
Gavi leads the COVAX vaccine campaign along with the World Health Organization, or WHO, and the Coalition for Epidemic Preparedness Innovations.
COVAX is the main plan to vaccinate people in poor and middle-income countries against COVID-19. It aims to give out at least two billion vaccine doses by the end of 2021. That would cover 20 percent of people most at risk in 91 of the countries, which are mostly in Africa, Asia and Latin America.
But Gavi's internal report says the COVAX program is struggling from a lack of money. The plan also faces supply risks and complex contract agreements that could make it impossible to reach its goals.
"The risk of failure to establish a successful COVAX facility is very high," the internal report says. The report and other documents prepared by Gavi were discussed at recent meetings attended by Gavi's leadership, Reuters reports.
The failure of the facility could leave people in poor nations without COVID-19 vaccines until 2024, one document says. The risk of failure is higher because the plan was set up so quickly, it notes.
Gavi hired financial services company Citigroup last month to provide advice on how to avoid financial risks. In one document, Citi advisors said the biggest risk was from parts of contracts that permit countries not to buy vaccines through COVAX.
Asked about the documents, a Gavi spokesman said the group remains sure it can reach its goals.
The WHO did not respond to a request for comment. In the past, it has let Gavi take the lead in public comments about the COVAX program.
Supply deals
COVAX's plans depend on less costly vaccines that have not yet been approved.
It has so far reached non-binding supply agreements with AstraZeneca, Novavax and Sanofi for a total of 400 million doses. And it may be able to order several hundred million more shots, one of the Gavi documents says.
But the three companies have faced difficulties in their trials that could delay some possible approvals to the second half of 2021 or later.
This could also increase COVAX's financial needs. Its current plan is based on an average cost of $5.20 per dose, one document says.
A top WHO official said the agency was in talks with Pfizer and Moderna to include their COVID-19 vaccines. That would be part of an early worldwide release program that may provide the vaccines to poor countries at a lower cost than current market prices.
Other shots are being developed worldwide and COVAX wants to expand its possibilities to include vaccines from other companies.
Rich countries have ordered most of the current supply of COVID-19 vaccines. They are also planning to donate some extra doses to poor countries. But it is not clear whether that effort would involve COVAX.
Financial pressure
COVAX says it needs $4.9 billion more to meet its target of vaccinating at least 20 percent of people in poor countries in the next year. It has already raised $2.1 billion.
The facility faces the chance of failure if vaccine prices are higher than expected. It could also fail if the supply is delayed or if the additional money is not fully raised, the documents say.
So far, Britain and European Union countries are the main donors to COVAX. The United States and China have offered no financial support. The World Bank and other multi-party financial groups are offering poor countries low-cost loans to buy and deploy vaccines through COVAX.
The facility is issuing vaccine bonds that could raise as much as $1.5 billion next year if donors agreed to buy them, a Gavi document says. COVAX is also getting money from private donors, mainly the Bill and Melinda Gates Foundation.
But even under the best financial conditions, COVAX could still face failure. The problem lies in financial risks caused by its complex deal-making process.
COVAX signs advance purchase contracts with companies for vaccine supplies. Donors or countries who can buy them must pay for them.
But under COVAX contracts, countries could still refuse to buy pre-ordered supplies if they favor other vaccines. They can also refuse if they are able to get vaccines through other means, either faster or at better prices.
The facility could also face losses if countries were not able to pay for their orders, or even if herd immunity happened too quickly. This would make the vaccines unnecessary, the Citigroup report said. Citigroup proposed a method to avoid these risks, including through changes to supply contracts.
I'm Alice Bryant.
The Reuters news agency wrote this story. Alice Bryant adapted it for Learning English. Bryan Lynn was the editor.
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Words in This Story
dose – n. the amount of a medicine, drug, or vitamin that is taken at one time
internal – adj. existing or occurring within an organization, such as a company or business
facility – n. something that makes an action, operation, or activity easier
non-binding (agreement) – n. an agreement that is not legally enforceable
bond – n. an official document in which a government or company promises to pay back an amount of money that it has borrowed
advance – adj. made, sent, or provided at an early time
herd immunity – n. a form of protection from infectious disease that happens when a large percentage of people have become immune, whether through previous infections or vaccination