Aurélia Nguyen, the Managing Director of the Office of the COVAX Facility, is optimistic that COVAX will achieve its “goal of delivering at least 2 billion doses to participating countries” in 2021, “including at least 1.3 billion donor-funded doses to the 92 lower-income Facility participants”. As of March 2021, roughly 431 million doses had been manufactured globally. To vaccinate 70 percent of the world’s population, considered the “threshold to achieving herd immunity,” it is estimated 11 billion doses will be needed.
Although the development and global deployment of vaccines is unprecedented, more funding is needed to address the immediate health challenges of the Covid-19 pandemic and to protect against future health crises. As human activity has increased the likelihood of future pandemics, more investments will be needed in pandemic preparedness and health system resilience. Although governments have supported private vaccine development – by directly funding or decreasing risk to investment – public sector participation will be critical to protecting against future pandemics going forward, as Nguyen explains in an interview with the International Monetary Fund (IMF) on the first day of its spring meetings.
On all of these points, and in particular on the Covid-19 vaccine rollout, “We are very much at the beginning of this [effort],” said Nguyen.
So far, COVAX has mobilized $6 billion in donations for Covid-19 vaccineprocurement, but in order for it to compete against individual countries to secure vaccines, more funding is needed. Global vaccine production must also be ramped up: “there’s an extreme shortage of supply,” according to Nguyen.
Vaccine supply and access, however, are only part of the equation. More investments must be made to the Access to Covid-19 Tools (ACT) Accelerator – of which COVAX is a part – to ensure vaccines can be deployed to where they would “have the greatest impact”: to the “most vulnerable and at-risk populations”. This entails investments in logistics, such as vaccine delivery and storage, and training for healthcare workers.
A cause for optimism, says Nguyen, is Secretary of State Antony Blinken’s spearheading the “2021 COVAX Investment Opportunity” on April 15, for which a variety of stakeholders including world leaders, the private sector, civil society, and technical experts will meet to “advance the equitable global access to COVID-19 vaccines.” The U.S., through USAID, has already committed $2 billion to GAVI, the Vaccine Alliance for the purchase and distribution of vaccines.
“COVAX is an investment for all of us,” said Nguyen as achieving global herd immunity is essential to pandemic recovery – for any country. As vaccine variants spread across the world and countries continue to suffer disruptions to trade, “delivering the right vaccines to the right people,” is therefore critical. More funding is needed to develop new vaccines to “stay ahead of the epidemiology.”
“One nation can be protected, but it will only be so long before more cases are imported,” said Nguyen. She added that administration of vaccines at a broader scale would better inform on their effectiveness against new variants and the development of new vaccines.
More funding is needed to increase supply, delivery, and development of vaccines, but what about future pandemic preparedness?
To start, Nguyen made clear that had the world made investments in “the right infrastructure,” its pandemic response would have been “faster and more effective.” The goal, then, is for countries to achieve “a basic level of preparedness” and strengthen global systems of disease surveillance, especially as land-use practices and climate change have increased the pandemic risk.
The COVAX coalition, which was organized in response to Covid-19, has been key to global vaccination, but a more “durable” system for vaccine development and distribution would better serve pandemic response efforts – GAVI, for its part, has worked for 20 years on global immunization. Such a system could also prevent against market failures for vaccine development and production, in part by incentivizing companies to invest in vaccines for emerging diseases.
Along with pandemic preparedness, more investments are needed in national healthcare sectors, particularly those in low-income countries that are chronically “underfunded,” and immunization programs for other diseases so that countries can better manage multiple health crises while providing routine and primary healthcare.
All this talk of global and national investment begs the question of what an international financial institution (IFI) such as the IMF can do going forward. The Covid-19 pandemic has made clear the linkage of public health and the economy. Therefore, one role for the IMF could be to promote national healthcare spending, especially in countries that underinvest in healthcare. In the near term, the IMF could also use its “voice” to coax countries with vaccine surpluses into sharing their extra doses with COVAX.