GAVI’s new drive for COVID-19 vaccine access in LMIC countries includes India

The international vaccine alliance GAVI has facilitated a new drive aimed at securing doses of COVID-19 vaccines for 92 low and middle-income countries and economies, including India, at the same time as wealthier nations.

The COVAX Advance Market Commitment (AMC) forms part of the COVAX Facility, a mechanism hosted by Gavi, the Vaccine Alliance, to guarantee rapid, fair and equitable access to COVID-19 vaccines for every country in the world.

“These countries will have limited resources to access future COVID-19 vaccines: it is our duty to support them. Without this support, the majority of the world’s population will continue to suffer from this disease even after we’ve developed a tool to tackle it. We now can stop this from happening,” said Dr Ngozi Okonjo-Iweala, Chair of the Gavi Board in a statement released in Geneva.

The list of 92 AMC-eligible economies includes all economies with Gross National Income (GNI) per capita under $4,000 plus other World Bank International Development Association (IDA) eligible economies.

While close to $600 million has already been raised for the AMC, the “innovative financing mechanism” requires seed funding of $2 billion before the end of the year to secure and guarantee doses for the 92 AMC-eligible economies. India falls under the lower-middle income category.

A minimum of an additional $3.4 billion is estimated to be required to procure around one billion doses by the end of 2021.

“We now have the framework in place to ensure that every economy, particularly the poorest nations, don’t get left behind in the race for a COVID-19 vaccine,” said Dr Seth Berkley, CEO of Gavi, the Vaccine Alliance.

“Gavi will work with governments, international organisations, manufacturers and civil society organisations to ensure doses get to those who need them,” Berkley said.

The 92 low and middle-income countries and economies approved by the Gavi Board will be able to access vaccines through the COVAX AMC, which will also cover at least part of the cost. The COVAX AMC was launched last month at the Global Vaccine Summit hosted virtually by the UK.

At that summit, Prime Minister Narendra Modi had pledged $15-million as India’s contribution to Gavi, the Vaccine Alliance.

Gavi hopes that COVAX will enable countries to have access to the world’s largest and most diverse COVID-19 vaccine portfolio. This means that, even if separate bilateral deals with vaccine manufacturers exist, through the facility countries stand a far better chance of getting access to the vaccine or vaccines that prove to be most effective.

The high and middle-income economies that have already submitted expressions of interest in the COVAX Facility will need now to enter into a legally binding agreement to purchase doses through the Facility. This commitment will need to be confirmed in the next month by making upfront financial contributions, enabling the Facility to enter into manufacturer agreements for future vaccine supply.

The goal is by the end of 2021 to deliver two billion doses of safe, effective vaccines to all participating countries including the 92 AMC-eligible economies.

Once a vaccine has been approved by regulatory agencies and/or prequalified by the WHO, the COVAX Facility will then purchase these vaccines with a goal to try and initially provide doses for an average of 20 per cent of each country’s population, focusing on health care workers and the most vulnerable groups.

Further doses will be made available based on financing, country need, vulnerability and potential threat, and a buffer of doses will also be maintained for emergency and humanitarian use.