Brazil and Indonesia, for example, have agreements to buy millions of doses of vaccines that are undergoing phase III trials in their countries (see ‘Best and worst supplied’). Some low- and middle-income countries have struck advance-purchase deals themselves. “Their experiment of trying to convince rich countries to join to hedge their bets has gotten very few takers,” says Brook Baker, who studies access to medicines at Northeastern University in Boston, Massachusetts.
Some wealthier countries, such as the United Kingdom, have expressed interest in joining COVAX, but few have committed to it. But it’s far short of raising the roughly $18 billion that it estimates will be needed from donors to help manufacturers scale up production and to procure and deliver the 2 billion doses.
The other billion are for up to 75 wealthier countries, who will pay for their own vaccines.ĬOVAX has made a few orders already - such as a deal to buy 300 million doses of a vaccine being developed by the University of Oxford, UK, and UK pharmaceutical company AstraZeneca. The vaccines will cost these regions little or nothing. One billion are for 92 low- and middle-income countries and economies (LMICS), which encompass half the world’s population. It aims to secure 2 billion vaccine doses. The main international effort to secure vaccine supplies is a joint fund called the COVAX facility, spearheaded by Gavi, a Geneva-based funder of vaccines for low-income countries, along with CEPI and the World Health Organization. “If COVID-19 vaccines are misallocated in the way they were in 2009, the pandemic will last longer, more people will die and the disruption will be greater than it needs to be,” Hatchett says. The 2009 pandemic was far milder than COVID-19, but the hoarding meant that relatively few people who stood to benefit from the vaccine got it in time to make a difference. The situation is reminiscent of the 2009 H1N1 influenza outbreak, when a handful of wealthy countries secured most of the supplies of a vaccine, says Richard Hatchett, head of the Coalition for Epidemic Preparedness Innovations (CEPI), a fund based in Oslo that was created to finance and coordinate vaccines for outbreaks, and which has supported the development of nine vaccines for COVID-19. “We need to prevent vaccine nationalism,” said Tedros Adhanom Ghebreyesus, the director of the World Health Organization (WHO), at an 18 August briefing. “We’re not going to get rid of the pandemic until we get rid of it everywhere,” says Mark Feinberg, head of the International AIDS Vaccine Initiative in New York City, which is developing a COVID-19 vaccine with US drug company Merck. The rush is dispiriting for public-health experts who have urged that vaccines be equitably distributed across the world. Source: data from Airfinity, up to 21 August / Nature tabulations The European Union nations - which are buying vaccines as a group - and Japan have locked down hundreds of millions of doses of vaccines for themselves (see ‘Vaccine capacity and pre-orders’). The United Kingdom was the world’s highest per-capita buyer, with 340 million purchased: around 5 doses for each citizen. By mid-August, the United States had secured 800 million doses of at least 6 vaccines in development, with an option to purchase around one billion more. (Russia has approved a vaccine for limited use, but it hasn’t completed phase III trials.)īut pre-orders are rolling in. Most experts say that late 2020 or early 2021 is the soonest vaccines could be approved and rolled out they must first undergo large-scale phase III clinical trials to assess their effectiveness and safety. Meanwhile, an international effort to acquire vaccines for low- and middle-income countries is struggling to gain traction.
Wealthy countries have struck deals to buy more than two billion doses of coronavirus vaccine in a scramble that could leave limited supplies in the coming year.
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