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The development of Covid-19 vaccines offers a potential pathway towards global recovery.

However, the purchasing and administration of vaccines has been dominated by richer economies. As of 31 July 2021, only 1.1 percent of people in low income countries have had at least one vaccine dose, compared to 53.9 percent in high income states. The UK, Canada and the USA are amongst those states who have also secured agreements for vaccine doses several times their population need.

The Covax initiative was established in April 2020 by the World Health Organization (WHO), Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations. It aims to ensure fair access to Covid-19 vaccines, and to accelerate their production. For 92 low-income economies, Covax intends to donate sufficient doses to vaccinate around 30 percent of their populations in 2021-2022. Funding for Covax is the primary support the UK gives to vaccination campaigns overseas, though it has also said it will donate 100 million Covid-19 vaccines by June 2022.

This briefing sets out how the Covax scheme works, the challenges faced in administrating vaccine campaigns in Africa, Asia and the Middle East, and the contributions of the UK and other high and upper-middle income economies to Covax and the distribution of vaccines.

How does Covax work?

The Covax scheme uses funding from donors and self-financing members to support the research, manufacture, and distribution of Covid-19 vaccines. It currently has agreements to offer eight types of vaccine and to potentially purchase up to 4.5 billion doses. Around 701 million vaccines have also been donated to Covax.

While its paying members, such as Canada, Saudi Arabia and South Africa are required to pay for the vaccines procured via Covax, eligible low and lower-middle income economies are eligible to receive doses for free. This includes Ethiopia, Nepal, Sudan, Syria and Yemen.

To ensure fairness, all states will first receive doses in proportion to their population until 20 percent of the population are received.

Vaccine procurement and the pandemic in India

In March 2021, the rollout of Covax vaccines began. Despite the goal to distribute 170 million doses by 31 May, only 76 million were delivered. By 29 July 2021, 153.6 million doses were delivered to 137 participants.

Delays were due to increased domestic demand and the Indian Government halting the export of vaccines as the pandemic worsened in that country. The Indian Serum Institute is one the largest global manufactures of vaccines and was due to provide 1.1 billion to Covax.

Calls to share vaccines

India is not expected to resume exports of vaccines until October 2021. While Covax has secured additional agreements, these will not result in vaccine deliveries until later in 2021.

The WHO has called upon higher-income countries to delay child vaccines and share doses with Covax. UNICEF has argued that G7 and EU member states should share 20 percent of their supply (153 million doses) from June to August to compensate for the shortfall. China, the United Arab Emirates and India have previously donated vaccines to other states.

The organisation hopes that by September 2021, 10 percent of the population of every country is vaccinated, and 40 percent by December. In July, the WHO’s Director General said the world “remains way off” achieving this target.

G7 and other pledges to donate vaccines

Several countries including the USA and UK have now pledged to share doses, primarily via Covax. In June 2021, G7 members pledged to share 1 billion doses by June 2022, half of which will come from the United States. It includes 870 million via Covax, of which half will be delivered by the end of 2021.

This includes a UK commitment to donate 100 million doses by June 2022. 80 percent will be distributed via Covax. Since April 2020, the UK has committed £548 million to the Covax scheme (this does not include the value of the donated doses).

In July, the UK Government said 5 million doses had been released to Covax and that it had come to agreements to share 4 million vaccines with countries in Africa, Asia and the Americas. These included Indonesia, Kenya, Antigua and Barbuda, and Thailand. 

While the WHO has welcomed the G7’s pledge, its Director Tedros Adhanom Ghebreyesus has said the doses are needed “now” rather than next year, and reported that currently the virus “is moving faster the global distribution of vaccines.”

Update log 

9 July: Added information on financial pledges to Covax and vaccine rollout in Africa and the Eastern Mediterranean. 

2 August: Added information on UK donation of vaccines and data on Covax. 

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