The global vaccine-sharing initiative known as the COVAX Facility will close at the end of the year, its four host organizations announced.
The multilateral effort to deliver COVID-19 vaccines to low-income and developing countries fell short of its ambitious targets but still managed to save an estimated 2.7 million lives, the World Health Organization said on Tuesday.
“Millions of people are alive today who would not have been here without COVAX," said Jane Halton, board chair of the Coalition for Epidemic Preparedness Innovations, or CEPI, which has been co-leading the Geneva-based COVAX along with WHO, UNICEF and Gavi, the Vaccine Alliance. "It should take its place in history and be proud of what it was able to accomplish – but also serve as a reminder to us all that we can and must do better next time.”
COVAX will wind down with at least US$2.7 billion in unspent grant money, according to Sept. 2023 report by medical journal The Lancet. That includes US$1.9 billion freed up last year after Gavi renegotiated contracts with drugmakers.
“COVID-19 is no longer a public health emergency of international concern and country demand for COVID-19 vaccines has slowed greatly," the report said. "As a result, Gavi, which raised resources for COVAX, might end up with more than US$3 billion in unspent donor grants."
Gavi has several options to "repurpose" the unspent funds, according to the Center for Global Development. Those ranged from catching up on routine immunizations to financing a proposed African Vaccine Manufacturing Accelerator, or AVMA.
Earlier this month, Gavi's board said it approved the creation of AVMA, which will help prepare the continent for future pandemics, outbreaks and other health emergencies by making up to US$1 billion available to drugmakers to help offset the high initial production costs of vaccines, the board said.
Just one dose for people in the poorest countries
COVAX, which had agreements with several drugmakers and also worked with the World Bank, delivered almost 2 billion doses of vaccines and safe injection devices to 146 economies, the groups said. That accounted for just under 15% of the total number of vaccine shots administered.
Some 70.6% of the world's 8 billion population received at least one dose of a COVID-19 vaccine, according to Our World in Data figures, which show the global inequities that COVAX tried to address since its launch three years ago.
More than 13.5 billion doses were administered around the world since the pandemic began in early 2020 – but just 32.9% of the people living among lower-income countries got at least one dose.
Starting next year, 92 lower-income economies that were eligible to participate in a program supported by Gavi's funding mechanism known as the COVAX AMC will still be able to receive COVID-19 vaccine doses and delivery support.
'Valuable lessons'
So far, the organization said, 58 lower-income economies have requested 83 million doses in 2024, with "plans to focus on the continued protection of priority groups, including health care workers, community workers and older adults."
As an emergency solution launched in the midst of the pandemic, COVAX faced many challenges, the organizations said, noting the lack of any cash reserves up front meant it had only limited ability to sign early contracts with manufacturers.
"While COVAX was unable to completely overcome the tragic vaccine inequity that characterized the global response," they said, "it made a significant contribution to alleviating the suffering caused by COVID-19 in the Global South."
The organizations said the experience shows a clear need for the world to be better prepared the next time a viral threat with pandemic potential emerges.
"We knew that market forces alone would not deliver equitable access to vaccines and other tools," said WHO's Director-General Tedros Adhanom Ghebreyesus. "COVAX has taught us valuable lessons that will help us to be better prepared for future epidemics and pandemics."
