Since at least the 1980s, private actors and market-based mechanisms have played an increasingly important role in the provision of public goods and services and the pursuit of public policy ...objectives in general. A market approach is also widely used in the field of public health. In effect, the PPP approach, as illustrated by COVAX, can work to structurally protect the interests of (a majority) of the high-income countries. While PPPs in global health may do a lot of good things, their private law, contractualist nature and structures safeguard formal state sovereignty and voluntarism, predominantly benefitting high-income donor countries
As the world has a history of vaccine nationalism, especially during the 2009 Swine flu pandemic, the COVAX alliance, a globally collaborated mechanism, was created by World Health Organization ...(WHO), GAVI, and UNICEF to address the inequity of COVID‐19 vaccines. One of the primary aims of this alliance was to deliver vaccines to low‐ and middle‐income countries (LMICs), which otherwise have less or no capacity to access vaccines from the open market. It is crucial to explore the contribution of COVAX in bridging the gap in equity, accessibility, and affordability of COVID‐19 vaccines between high‐ and low‐income countries (LICs). We selected Group 20 (G20) COVAX participants and the African Union (AU) as case studies to estimate these gaps. The bilateral purchase data shows that by December 2021, the G20 countries had vaccines more than double their population, whereas the AU could procure only about one fifth (19%) of their population. Out of 52 AU countries whose data was available, only 21 of them could strike a bilateral deal with vaccine manufacturers. Even after COVAX delivery, the share of the population that could be vaccinated in AU was just 36.8%, less than the target of WHO (40%) for December 2021. It was found that the COVAX alliance worked better than the open market competition for LMICs and LICs. The cost of vaccinating 20% of the population was 0.7% of the current health expenditure for G20 countries, whereas AU countries had to spend 5.5%. COVAX bears more cost (1%–3%) for AU countries than G20 countries (less than 1%). COVAX made COVID‐19 vaccines more affordable and accessible to these countries. However, LICs were disproportionately affected even with the COVAX Facility mechanism owing to their lack of vaccine deployment infrastructure.
COVAX delivery to African Union states was inadequate to achieve the WHO target of 40% coverage along with its own target of 20% by December 2021. However, the alliance was a better alternative for LMICs and LICs than open vaccine market. Moreover, COVAX has made the COVID‐19 vaccines more affordable to AFU than G20.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
3.
World-System of Vaccine Distribution Philipp Köncke; Stefan Schmalz
Journal of world-systems research,
04/2024, Volume:
30, Issue:
1
Journal Article
Peer reviewed
Open access
This article analyzes spatial hierarchies and geopolitical conflicts during the COVID-19 pandemic from a world-systems perspective. Drawing on data on global vaccine production and distribution, we ...argue that the trimodal structure of the capitalist world-system—core, semi-periphery, and periphery—has been reproduced through unequal access to vaccines, constituting hierarchically structured “vaccine worlds”. These vaccine worlds are geopolitically contested, as Chinese companies compete with American and European corporations for influence and markets. Against this background, we outline the Chinese state-led vaccine internationalization strategy with its focus on the global South, and discuss its achievements and contradictions.
During the first weeks of the Covid-19 pandemic, European Union (EU) member states competed over scarce countermeasures. Regarding vaccines, a few member states launched exclusive joint endeavours, ...yet eventually, the EU centralised vaccine provisioning. The EU's external vaccine diplomacy proceeded almost inversely. After stepping into the breach in global health governance, European leadership faltered and global collaboration progressed more slowly. This article explores Europe's diverging trajectories in the regional and global provisioning of Covid-19 vaccines. Focussing on the European Commission's leadership, we investigate to what extent it promoted regional and international cooperation and with what success. We also explain which factors enabled and constrained Commission leadership. Employing a controlled comparison and process tracing, we find that Commission leadership was more extensive and impactful in regional than in global vaccine provisioning. Member state support was the main enabling condition. Without support, institutional capacity and resources were insufficient for impactful leadership.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Despite the advent of safe and effective coronavirus disease 2019 vaccines, pervasive inequities in global vaccination persist.
We projected health benefits and donor costs of delivering vaccines for ...up to 60% of the population in 91 low- and middle-income countries (LMICs). We modeled a highly contagious (Re at model start, 1.7), low-virulence (infection fatality ratio IFR, 0.32%) "Omicron-like" variant and a similarly contagious "severe" variant (IFR, 0.59%) over 360 days, accounting for country-specific age structure and healthcare capacity. Costs included vaccination startup (US$630 million) and per-person procurement and delivery (US$12.46/person vaccinated).
In the Omicron-like scenario, increasing current vaccination coverage to achieve at least 15% in each of the 91 LMICs would prevent 11 million new infections and 120 000 deaths, at a cost of US$0.95 billion, for an incremental cost-effectiveness ratio (ICER) of US$670/year of life saved (YLS). Increases in vaccination coverage to 60% would additionally prevent up to 68 million infections and 160 000 deaths, with ICERs <US$8000/YLS. ICERs were <US$4000/YLS under the more severe variant scenario and generally robust to assumptions about vaccine effectiveness, uptake, and costs.
Funding expanded COVID-19 vaccine delivery in LMICs would save hundreds of thousands of lives, be similarly or more cost-effective than other donor-funded global aid programs, and improve health equity.
The development of COVID-19 vaccines was a landmark in the current efforts to contain the global pandemic caused by the novel SARS-CoV-2. Consequently, vaccine rollout and inoculation campaigns ...continue to progress steadily across the globe. However, “skewed” rollout, or the inequitable or delayed access to the vaccines encountered particularly by low-income countries in Africa, remains a source of great concern. This may negatively affect the continent and could lead to increased transmission, travel restrictions, further economic disruptions, and increased morbidity and mortality. Ultimately, these negative consequences could directly or indirectly hamper global efforts to defeat the pandemic. Access to COVID-19 vaccines is a global priority and provides a source of hope to bring the pandemic under control. High-income nations, national governments, donor agencies, and other relevant stakeholders must support the World Health Organization's COVAX initiative to ensure fair, rapid and equitable distribution of the vaccines to countries, irrespective of income level. This effort will rapidly bring the pandemic under control and impact the recovery of the global economy. Low-income nations in Africa must significantly invest in research, health care, vaccines, and drug development and must remain proactive in preparing against future pandemics. This review examines the rollout of the COVID-19 vaccines with a focus on Africa.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
There has been increasing recognition of vaccine access challenges in middle-income countries and the need for increased action, particularly in countries that are not eligible for or have ...transitioned out of Gavi, the Vaccine Alliance support. These countries’ immunization systems are more vulnerable than ever as the COVID-19 pandemic exacerbates existing programme challenges, increasing the risk of delayed vaccine introductions, backsliding immunization coverage rates, and increased coverage inequity. The potential health and equity impact of improving immunization outcomes in middle-income countries is substantial. Modelling suggests that the introduction of pneumococcal conjugate vaccine and vaccines for rotavirus and human papillomavirus in this set of Gavi-transitioned and non-Gavieligible middle-income countries in 2020 could have saved an estimated 70,000 lives if 90 % coverage had been reached. Further, increasing coverage for already-introduced vaccines to 90 % could have saved an additional estimated 16,000 lives. Over the past decade, stakeholders have made considerable efforts to identify immunization challenges in middle-income countries as documented in the 2015 SAGE-endorsed Shared Partner Middle-Income Country Strategy. In the coming decade, new global platforms like Gavi 5.0 and the Immunization Agenda 2030 provide opportunities to align on MIC strategies and provide coordinated global support to middle-income countries. The international COVID-19 pandemic response has the potential to lay the foundation for long term support beyond the scope of COVID-19 to non-Gavi eligible middle-income countries. Meanwhile regional mechanisms to address immunization barriers in middle-income countries have grown in number and strength, offering sustainable platforms for cross-country collaboration and the provision of tailored technical support. To ensure that these opportunities are successfully acted upon and that middle-income countries achieve the Immunization Agenda 2030 goals, comprehensive, multi-stakeholder consultations were conducted to identify areas of action with the greatest potential to accelerate immunization progress. Stakeholders should work together to put these findings, highlighted in this paper, into action, adapting their approaches to specific country contexts and learning from and building on existing efforts.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The world is in dire need of safe, effective coronavirus disease 2019 (COVID-19) vaccine strategies. Since its emergence in November 2019, it has spread to 188 countries and 25 territories around the ...globe, despite elaborate efforts by World Health Organization (WHO) and governments to contain the infection, primarily owing to the highly infectious nature of this virus. Present article reviews various aspects in process of vaccine designing, vaccine platforms and current efforts and progress of COVID-19 vaccine candidates. The founding of the COVID-19 vaccines global access (COVAX) facility by Gavi, the coalition for epidemic preparedness innovations (CEPI) and the WHO is an attempt to garner resources and unite higher- and lower-income countries for the coordinated, rapid, transparent and equitable access to COVID-19 vaccines worldwide.
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