► Is the Covax mechanism now fully operational?
With the delivery of 1.1 million doses of vaccine against Covid-19 to Rwanda on January 15, the global solidarity mechanism Covax has now passed the symbolic bar of one billion doses delivered.
Covax had a hard time getting off the ground. This mechanism co-managed by UNICEF, the Global Vaccine Alliance (Gavi) and the Coalition for Epidemic Preparedness Innovations (Cepi) provided its first batch of vaccines in February 2021 in Ghana. It was then only able to deliver 91 million doses on July 1 and 428 million at the end of November, for lack of doses available in sufficient numbers.
At the end of 2021, Covax remained far from its initial ambition, which was to provide more than 1.8 billion doses to 92 poor countries to vaccinate 20% of the population there. However, the mechanism is indeed taking off, having provided as many vaccines in the last six weeks as in the first ten months of its existence. Covax indicated on January 19 that it needed an additional 4.6 billion euros to continue the effort. The sum should make it possible to buy 600 million doses.
► Where are we in terms of vaccine inequality in the world?
Despite the progress made at the very end of 2021, the gap between countries remains abysmal in terms of vaccination coverage. The World Health Organization reported in mid-January that although 10 billion doses have been produced, 98 countries have not been able to reach 40% of their population vaccinated, including 41 who are still under 10%. More than half of these are in Africa. Chad, the DRC and Burundi are even under 1% of the vaccinated population…
Commenting on these figures, the director of the World Health Organization, Tedros Adhanom Ghebreyesus, warned of the risk of the appearance of a new variant, estimating that “the next one could be worse” than Omicron.
What hinders vaccination, however, is no longer the lack of doses, but the poor state of health systems in a number of countries and the lack of confidence of the populations. The acceleration of vaccination campaigns therefore requires support for the health systems of developing countries.
► Would the lifting of patents on vaccines make it possible to accelerate?
The lifting of intellectual property rights for treatments and vaccines remains a request from non-governmental organizations. At the end of 2020, South Africa and India proposed it to the World Trade Organization (WTO). But this request did not succeed when the major laboratories, supported by European governments, opposed it.
They argue that the brake on the production of vaccines in developing countries is mainly due to the lack of industrial capacities and know-how. They put forward the possibility of granting voluntary licenses instead, within the framework of a cooperation agreement.
Thus, on Tuesday January 18, the Institut Pasteur in Dakar announced an agreement with Cepi to create a factory in Senegal that will produce 300 million doses of vaccine per year, exclusively for the African continent.
On January 20, 27 generic manufacturers signed an agreement with the Medicines Patent Pool (MPP), a United Nations organization. They will be able to manufacture molnupiravir, a still experimental oral treatment against Covid-19 developed by the American pharmaceutical group Merck. The latter had granted the MPP a voluntary license last October to facilitate global access at an affordable price to his treatment. Thanks to this, 105 countries will be able to have access to this treatment.
Last November, the pharmaceutical giant Pfizer had concluded a similar agreement to supply under the same conditions its new oral treatment against Covid, Paxlovid, to 95 countries. These treatments are easier to manufacture than vaccines because they do not require a cold chain.