Gavi – The Vaccine Alliance, that legally administers the COVAX Facility, has had to do some serious stock-taking in rethinking its role in the international response to COVID-19. This week the Gavi Board approved proposals, among others, to redefine the way the COVAX Facility engages with Self-Financing Countries and the way it plans to service low- and middle-income countries in the future.
It is also an acknowledgement of the limitations faced by the structure that has been set up and constrained by the donors of the COVAX Facility.
According to Gavi, over 80 million doses from COVAX have been delivered to 129 participants of which 53 million doses have gone to 78 low and middle-income countries supported by the financial instrument called Advance Market Commitment. This is far less than the more 350 million doses envisioned in February 2021.
Apart from severe supply constraints, letting paying countries – Self-Financing Participants in the COVAX Facility – also donors to Gavi, to have greater latitude in accessing doses and setting the rules, undoubtedly had an impact on the availability of doses in low-income countries dependent on this international mechanism.
Coming months will see whether and how Gavi will rectify these in-built inequities, including in the governance structure of the COVAX Facility, where donor countries have a seat at the table.
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