GUARANTEE PORTFOLIO

COVID-19 vaccines through COVAX

We are working with Gavi, the Vaccine Alliance and the Open Society Foundations to help the world’s 92 lowest-income countries access more COVID-19 vaccines and protect their populations.

The partnership

COVAX is a global initiative that aims to ensure equitable distribution of vaccines against COVID-19.

Part of the Access to COVID Tools Accelerator (ACT Accelerator), it is coordinated by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), and the World Health Organization (WHO), alongside key delivery partner UNICEF.

Gavi is responsible for the procurement of vaccine doses which are then distributed by UNICEF.

A WHO employee stands in front of a COVAX shipment

There are two strands to COVAX:

  1. Advance Market Commitment (AMC): Vaccines that are funded by donor contributions are provided free of charge to AMC-eligible economies. COVAX aims to help countries towards the objectives set out in their national vaccination strategies.
  2. Cost-Sharing: AMC-eligible economies can build on the foundations of donated doses through the purchase of additional doses using non-COVAX funds, such as with support from multilateral development banks, to achieve higher vaccine coverage levels.

MedAccess and the Open Society Foundations, through the Soros Economic Development Fund, have provided a US$ 200 million Risk Sharing Facility to Gavi in support of the cost-sharing mechanism. This Facility provides a backstop for Gavi when it exercises COVID-19 vaccine options on behalf of countries using the cost-sharing mechanism. This will help Gavi to meet country demand.

The Risk Sharing Facility is comprised of a US$ 100 million guarantee from MedAccess and a guarantee of up to US$100 million from OSF.

Development impact

Our guarantee enables the COVAX Cost-Sharing mechanism to support AMC-eligible economies to purchase additional COVID-19 vaccine doses beyond donor-funded commitments.

The cost-sharing mechanism provides accelerated access to a large, diverse and actively managed portfolio of vaccine candidates, including second generation candidates that may have benefits on cost, ease of use or scalability; access to COVAX-negotiated prices; assurance of safety and efficacy; and logistical support via UNICEF to ensure smooth delivery.

This mechanism ensures low-and middle-income countries can have the ability to choose from a range of vaccine options and ensures equitable distribution of doses globally.

The product

This partnership covers any COVID-19 vaccine which has received WHO approval for use under either the WHO prequalification programme or the Emergency Use Listing procedure.

Why we acted

COVID-19 vaccine distribution has been fraught with inequity. Supply constraints, including a COVID-19 vaccine export ban in India, meant COVAX struggled to hit its initial target of distributing two billion doses by the end of 2021. As a result, while people in richer countries were receiving booster doses, 98 countries had not reached the target of vaccinating 40% of their populations by the end of 2021.

Since October 2021, the COVID-19 vaccine availability has improved substantially. Gavi predicts that 2.8 billion doses will be available for delivery by mid-2022 through a combination of contracted doses, dose-sharing and cost-sharing arrangements. MedAccess joined this partnership to help countries increase their COVID-19 immunisation rates in line with their national vaccination strategies. COVAX helps make this possible by enabling countries to secure doses earlier and at lower cost, with greater visibility of supply, helping countries to plan and implement their national strategies.

This partnership will also help to move COVID-19 procurement towards a more sustainable footing. In the long term, countries are likely to be required to contribute towards COVID-19 doses, as they do with other Gavi-supported vaccines. Cost-Sharing marks the first step towards a transition from emergency funding to more routine resourcing for COVID-19 vaccines.

Around 3.9 billion people live in COVAX-eligible countries. While the AMC aims to help countries towards the objectives set in their national vaccination strategies, countries can choose to protect more people by ordering additional doses through COVAX’s Cost-Sharing mechanism.

By providing this procurement guarantee to Gavi, more countries will be able to order additional doses more quickly. It also opens up vaccine supply choices for low- and middle-income country governments.