The heads of the International Monetary Fund, World Bank Group, World Health Organization and World Trade Organization held high-level consultations with Gavi and UNICEF on 17 December, 2021 aimed at increasing the use of COVID-19 vaccines and other critical medical countermeasures in low-income (LIC) and lower middle-income (LMIC) countries and supporting countries to be better prepared, resourced, and ready to roll out vaccines.
We agreed on the urgency to accelerate vaccinations in LICs, where under 5% of the population is fully vaccinated, as well as in LMICs, where around 30% of the population is fully vaccinated. We agreed to work with countries to support and strengthen their national vaccination goals consistent with the global target to vaccinate 70% of the populations in all countries by mid-2022. The emergence of the Omicron variant underscores the vital need for fair and broad access to vaccines as well as testing, sequencing, and treatments to end the pandemic.
Addressing vaccine inequity, particularly in LICs, requires increasing the supplies of vaccines to COVAX and AVAT, encouraging LICs and LMICs to purchase additional vaccine doses, and enhancing country readiness to deploy vaccines. Furthermore, to facilitate trade flows to support the manufacturing and distribution of vaccines and other COVID tools, export restrictions must be rolled back and trade-facilitating measures must be put in place. Fully funding the ACT-A Accelerator’s Financing Framework would play an important role in narrowing these gaps and reaching the global target.
Some LICs and LMICs are facing serious challenges in vaccine deployment. Constraints related to storage, cold chain capacity, and trained vaccinators are exacerbated in some cases by doses arriving with short shelf lives and without adequate lead time and shortages in ancillary supplies (such as syringes, safety boxes, and dilutants), with challenges to plan and finance vaccination campaigns in a timely manner. As in wealthier countries, vaccine hesitancy is also an issue in some LICs and LMICs.
To address such challenges, we call on governments that have already achieved high coverage to:
- fulfill their donation pledges as quickly as possible to accelerate near-term deliveries to COVAX;
- release manufacturers from contracts and options and implement delivery swaps, so they can prioritize supply to COVAX, AVAT, and low-coverage countries.
We urge governments that have yet to achieve high vaccination coverage to:
- contract additional doses immediately through AVAT, COVAX, or bilaterally;
- establish in-country surge capacity to increase the rate of vaccine utilization as supplies increase; and
- coordinate between health and finance authorities for making increased use of multilateral development banks’ resources that are readily available for both vaccine purchase and deployment.
We call for better coordination among vaccine manufacturers, dose donating countries, COVAX, AVAT, and other partners to improve visibility on vaccine supply schedules and quality of supply for LICs and LMICs, to support country-level planning and preparedness for turning vaccines into vaccinations. Visibility on schedules along with adequate lead times and shelf lives of vaccines are critical for both equitable distribution as well as for recipient countries and their partners to prepare for in-country deployment.
Growing volumes of COVID-19 vaccines are forecast to arrive in LICs and LMICs in the coming months. Close coordination amongst all stakeholders will be crucial to help provide countries with the assistance and necessary resources to increase their capacity to administer those doses. In this regard, we welcome the recent appointment by UNICEF and WHO, in partnership with Gavi, of the Global Lead Coordinator for COVID Vaccine Country Readiness and Delivery, who will play an important key role in strengthening in-country vaccine deployment.