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8 Ensuring Equity in COVID-19 Vaccine Allocation Globally
Pages 203-216

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From page 203...
... emerged in late 2019 and began spreading across the world, the global community mobilized rapidly to start developing and massproducing effective vaccines. As some high-income countries start securing vaccine allotments through bilateral agreements with pharmaceutical companies, it is clear that an inequitable distribution of vaccines at the global level will ultimately fail to eliminate the risk of new outbreaks in the future.
From page 204...
... GLOBAL PREPAREDNESS AND RESPONSE TO THE COVID-19 PANDEMIC Global Preparedness Monitoring Board The 2014–2016 Ebola outbreak in West Africa uncovered important gaps in the global community's capacities to effectively prepare, detect, respond to and recover from emerging and re-emerging infectious disease outbreaks. In the wake of this unprecedented crisis and in response to recommendations by the United Nations Secretary-General's Global Health Crises Task Force, the Global Preparedness Monitoring Board (GPMB)
From page 205...
... . Many high-income countries, including the United States, the United Kingdom, and those in the European Commission, have sought to quickly secure reservations of scarce capacities for vaccine production for their domestic deployment, often in return for sizeable investments in research and development or at-risk scaling of vaccine manufacturing capacity (HHS, 2020a,b; Rockoff and Hopkins, 2020)
From page 206...
... Finally, if successful vaccines are developed in high-income countries and not equitably shared with low- and middle-income countries, we will continue to see differential morbidity and mortality, as well as economic and social shocks that will further increase global inequities -- and with them global instability, displacement, large-scale migration, and, ultimately, insecurity. ACCESS TO COVID-19 TOOLS ACCELERATOR AND THE COVAX FACILITY Access to COVID-19 Tools Accelerator On April 24, 2020, the president of the European Commission, Ursula van der Leyen, and President Macron of France, together with the director general of WHO and a host of other development partners and heads of states issued a Call to Action for the Access to COVID-19 Tools (ACT)
From page 207...
... Gavi, the Vaccine Alliance's Global Vaccine Procurement Strategy Gavi, the Vaccine Alliance has developed a financing approach through the COVAX Facility for the global procurement of COVID-19 vaccines (Gavi, the Vaccine Alliance, 2020b)
From page 208...
... Gavi, the Vaccine Alliance would use these combined financing streams to issue contingent volume guarantees to specific countries to scale vaccine production, as well as to provide a strong demand signal to the vaccine industry in general. These types of market-shaping interventions have proven successful as part of Gavi, the Vaccine Alliance's innovative financing for other vaccines needed by low- and middle-income countries over the past 20 years (e.g., the successful pneumococcal conjugate vaccine AMC [Gavi, the Vaccine Alliance, 2019]
From page 209...
... In the context of OWS, a modest investment in the COVAX Facility would be a reasonable hedge, a sort of insurance policy, to ensure access to any successful COVID-19 vaccine as soon as possible, at least for the highest-risk Americans. A Disease Threat Anywhere Is a Threat Everywhere Shaping the global allocation of COVID-19 vaccines should be of strong interest to the United States, given its global trade interests, foreign military deployments, and vital diplomatic alliances.
From page 210...
... Most recently, the United States has played an important role in supporting the global response to the Ebola outbreak in West Africa in 2014–2015, where hundreds of Centers for Disease Control and Prevention assignees and many American volunteers joined in a historic response to a global health crisis. Similarly, as effective medical countermeasures (MCMs)
From page 211...
... The COVAX Facility will expand Gavi, the Vaccine Alliance's innovative financing model to additional geographic regions (the Gavi, the Vaccine Alliance Board just approved the expanded eligibility for COVAX AMC financing to 92 countries) , which provides an opportunity to expand the influence of one of the largest U.S.
From page 212...
... 21) Even a comparatively modest investment in the ACT-A and COVAX Facility might allow the United States to quickly and most effectively meet key national security goals laid out in the 2018 National Biodefense strategy, while still pursuing separate bilateral partnerships with vaccine developers.
From page 213...
... It is possible that several vaccines may succeed in achieving technical and regulatory success, including some that may not be included in the COVAX portfolio. It should be a matter of global health and national security that the United States embrace its longheld leadership role on the international stage and support ongoing global vaccine access strategies, such as the ACT-A and the COVAX Facility.
From page 214...
... 2019. Global health security index.
From page 215...
... 2020e. Fair allocation mechanism for COVID-19 vaccines through the COVAX Facility.


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