The global scheme to deliver Covid-19 vaccines to poor countries faces a “very high” risk of failure, which could leave billions without people access to vaccines until 2024, documents show. inside saying.
A number of issues were raised on the Covax scheme, including a shortage of doses of approved vaccines, and a decision by the Serum Institute of India, which was initially identified to provide Covax, saying it would give priority to the -Indicate first.
The cheapest and easiest to carry vaccines offered by the scheme on banking, including the Oxford-AstraZeneca University vaccine, have been slower in testing and gaining regulatory approval.
The grim warning is part of a financial risk assessment commissioned by Gavi, an alliance of governments, drug companies, charities and international organizations that organize global vaccination campaigns and is a WHO partner in Covax scheme.
To meet its target of vaccinating at least 20% of people in poor countries next year, Covax says it needs $ 4.9bn more than the $ 2.1bn it has already raised.
That assessment is not shared by psychologists at the World Health Organization, which represents one of the three pillars of the Covax scheme, which shows that discussions with pharmaceutical companies to date have not been signing up to the scheme, as well as individual countries to supply too many doses are still going, with new announcements about the scheme expected soon.
The Covax program is the leading global scheme to vaccinate people in poor and middle-income countries against the coronavirus.
It aims to deliver at least 2bn vaccine doses by the end of 2021 to cover 20% of the most vulnerable in 91 countries, mostly in Africa, Asia and Latin America.
But in inside documents leaked to Reuters, Gavi says the program is struggling with a lack of funding, procurement risks and complex contractual arrangements, which could make it impossible. made to achieve its goals.
“The risk of a successful Covax facility being established is very high,” said a report into Gavi’s board.
The report and other documents prepared by Gavi are being considered at the board meetings on 15-17 December.
The failure of the facility could leave some people without access to vaccines until 2024, one of the documents says.
The risk of failure is higher because the scheme was set up so quickly, operating in “unregistered land”, the report says. He also warns that issues with contracts that allow countries to return from buying doses that they have promised to raise the cost of doses from the $ 5.20 criterion and ultimately make the further possible scheme.
“Considerable risk exposure outside of risk appetite is being considered to provide full clarity on the extent of risks and opportunities to mitigate them. Intensive mitigation efforts are therefore required to incorporate the risk into risk appetite. “
While some pharmaceutical companies working on vaccines, including AstraZeneca, have signed up to provide the vaccine at a cost, there are other manufacturers that may still be named. added to Covax. Wealthier countries, which have often invested in vaccine development, have retained many of the early vaccination groups.
Covax ‘s plans rely on cheaper vaccines that have not yet been licensed, rather than vaccines from Pfizer / BioNTech and Moderna starters that use new, more expensive mRNA technology.
The Pfizer vaccine has already been approved for emergency use in several countries and used in Britain and the US, and the Moderna vaccine is expected to be approved in the same way soon.
Covax has so far reached non-binding supply agreements with AstraZeneca, Novavax and Sanofi for 400m doses, with options for ordering several hundred additional shots, one of the Gavi documents says.
But all three companies have faced delays in their trials that could push back some potential regulatory licenses until the second half of 2021 or later.
Gavi hired Citigroup last month to offer advice on how you can mitigate financial risks. The question of the complexity of contracts for vaccines has been known for some time, with experts concerned by the lack of transparency about the detailed arrangements for vaccinations and timing of delivery.
Asked about the documents, Gavi said the group remains confident that they can achieve its goals.
“It would be irresponsible not to assess the risks involved in such a large and complex campaign, and to build policies and instruments to mitigate those risks,” he said.
Citibank said in a statement: “As a financial advisor, we have a responsibility to help Gavi plan for various situations related to the Covax facility and support their efforts to mitigate risks. could be discounted. “
On Tuesday, a WHO chief executive said the group was in talks with Pfizer and Moderna to introduce their Covid-19 vaccines as part of an early global rollout at a cost to poor countries possibly below normal prices a market of nearly $ 20 per dose.
Other shots are being developed worldwide and Covax wants to expand its portfolio to include vaccines from other companies.
Reuters contributed to this report.