February 2022 marks a year since Covax, the global vaccine-sharing initiative run by the World Health Organization (WHO) and others, made its first international shipment of Covid-19 vaccines.

A year later, only 6% of people in lower income countries are fully vaccinated against the virus, primarily in Africa and Asia. ‘Fully vaccinated’ means they have received two doses or a single dose of a one-dose vaccine.

Due to a combination of shortages, delays in deliveries and donations, and challenges in rolling out vaccines, Covax fell short of its 2021 goal.

While it aimed to deliver 1.8 billion doses to 92 low- and lower-middle- income economies, it had shipped only 1.1 billion doses by February 2022.

This Insight looks at the challenges for meeting the WHO’s target to vaccinate 70% of the world in 2022, and how it might be achieved.

Target to vaccinate 70% of the world in 2022

The WHO set a target for 70% of the global population to be vaccinated against Covid-19 by September 2022. This has already been achieved in most high-income states.

The G20, which includes the UK and US, has also backed the goal.

The world now has sufficient supply to meet need

In December 2021, the International Federation of Pharmaceutical Manufactures and Associations said 11.2 billion Covid-19 vaccines were manufactured in 2021.

This was sufficient to vaccinate 70% of the global population of 7.9 billion (excluding booster shots).

In late 2021, the WHO said its 70% target for 2022 is achievable, due to rising global production. It argues this is now “not a supply problem; it’s an allocation problem.”

Allocating vaccines fairly

As of December 2021, 80% of vaccines delivered to low-income countries have been via Covax.

Covax is funded by aid donors. It uses this funding to buy vaccines direct from manufacturers, in addition to those it receives as donations. In 2020 to 2021, the UK pledged £548 million to support its work.

Covax currently has sufficient funding and confirmed donations to deliver a total of 2.8 billion doses by mid-2022 (PDF). As of February 2022, 1.1 billion have been delivered. Delivering the rest will be partly dependent on the pace of delivery by manufactures and donors.

Pledges to donate vaccines

G7 countries, including the UK and US, together with “Team Europe” (the EU and neighbours including Norway), have pledged to donate one billion doses to other countries by June 2022.

Of this, Covax will allocate 870 million, including 80 million UK doses.

The Foreign Affairs Committee has argued the UK’s pledge falls “well short” of what is needed.

As of February 2022, around 500 million vaccines have been shipped, including 30 million from the UK.

Challenges in delivering vaccines

The WHO and African Union have raised concerns that doses are often donated at short notice, resulting in vaccine wastage as countries cannot distribute them before they expire.

While the Oxford-AstraZeneca jab has been important to low-income countries, the WHO says its short shelf-life has complicated vaccine rollouts.

Pfizer, now likely to be the main supplier for Covax, has its own challenge. While Oxford-AstraZeneca is stored at regular fridge temperature, Pfizer requires freezers. Many countries lack cold-storage capacity, delaying rollouts.

Other challenges include vaccine hesitancy, lack of data for identifying vulnerable populations, and few local manufacturers, especially in Africa.

Is vaccinating 70% of the world’s population achievable?

Whether there are sufficient vaccines is reliant on unknowns, such as the trajectory of the pandemic and any new variants of concern.

In January 2022, Covax said it had sufficient supplies to vaccinate 45% of the populations of eligible economies by mid-2022. However, it highlighted a lack of funding to purchase new doses—making donations even more important.

The WHO is now calling for the world to address the funding gap for national vaccine rollouts. It has requested US$ 6.8 billion to ensure countries can administer vaccines and diagnostic tests in 2022.

Oxford University’s Our World in Data publication estimates that at current rates, only two African countries will achieve the 70% target by mid-2022. Many in Eastern Europe and the Middle East will also miss the target.

The projection is based on several assumptions, including the supply and distribution of vaccines remaining the same as February 2022.

Many of these countries have successfully achieved population-wide coverage against other diseases, giving weight to the achievability of the 70% target.

For example, in the 73 low-income states supported by Gavi, the vaccine alliance, 78% to 80% of children completed a three-dose vaccine course against measles and other diseases from 2015 to 2019.

What steps might be taken in 2022?

The WHO Chief, Tedros Adhanom Ghebreyesus, has argued that by “end[ing] inequity, we end the pandemic.”

Discussions have been ongoing at the World Trade Organization since 2020 on waiving intellectual property rights on Covid-19 vaccines.

Supporters argue this would scale-up global manufacturing. The UK and EU remain opposed, encouraging instead the voluntary licencing of vaccine data to other manufacturers.

In March 2022 there will be two further opportunities to work towards the 70% target:

Further reading

About the author: Philip Loft is a researcher in the House of Commons Library, specialising in international affairs.

Photo by Mat Napo on Unsplash

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