International equitable vaccine effort ships 32 million shots to 61 countries

“COVAX works” the head of the World Health Organization (WHO) said on Friday, informing journalists that the UN-backed vaccine initiative has distributed more than 32 million vaccines to 61 countries in just one month.  

At the beginning of the year, WHO chief Tedros Adhanom Ghebreyesus had called for countries to work together, so that all States could begin vaccinating within the first 100 days of 2021. 

“177 countries and economies have started vaccination”, he said at a regular press briefing, adding that with just 15 days left before the 100 days are up, 36 countries are still waiting for vaccines so they can start inoculating health workers and older people. 

Of those countries, 16 are scheduled to receive their first doses from COVAX within the next 15 days, leaving 20 nations waiting. 

“COVAX is ready to deliver, but we can’t deliver vaccines we don’t have”, said Tedros, pointing to the distorting effect of export bans and vaccine diplomacy, which have caused “gross inequities in supply and demand”. 

Moreover, increased demand for shots, and changes of national strategy, have led to delays in securing tens of millions of doses that COVAX was counting on. 

Noting that getting all countries up and running by day 100, is “a solvable problem”, the UN official asked countries with shots cleared for WHO “Emergency Use”, to donate as many as they can as “an urgent stop-gap measure”, so the 20 additional countries can begin vaccinating their healthcare workers and elderly within the next two weeks. 

“COVAX needs 10 million doses immediately”, he said. While acknowledging that contributing doses is “a tough political choice”, he asserted that “there are plenty of countries who can afford to donate doses with little disruption to their own vaccination plans”.  

Currently, many countries who had invested in COVAX in good faith have become frustrated with bilateral deals that have left the vaccine initiative short, said Tedros. 

“WHO and our partners are continuing to work around the clock to find ways to increase production and secure doses”, he added, saying that four more inoculations were being assessed for WHO Emergency Use Listing – at least one of which may be approved by the end of April. 

WHO, UNICEF and Partners Receive First Batch of Billion Dollars Project of COVID-19 Vaccines

By Isaac Unisa Kamara.

Sierra Leone country representatives of WHO, unicef, and other partners receive the first batch of 96,000 doses of Astra Seneca COVID-19 vaccines under the COVAX Facility.

 The consignment according to WHO Country Chief is donor driven, and has it main supporters from USA with $2.5 bill, Germany – $1.097bill, £735 mill, European Union $485 mill, Japan $200mill, and among others.

The consignment consist of the first batch of 528,000 of the vaccine that was produced by Serum Institute of India and approved by the World Health Organization for emergency response on COVID-19 virus.

Country Representative of WHO, Dr. Steven Velabo Shongwe, on the 8th March, 2021, at the Lungi International Airport, while receiving the consignment said the moment was a historic one. 

“We gather here to witness the arrival of this first batch out of the 528,000 allocated for Sierra Leone,” Dr. Shongwe said, continuing that, the COVAX Facility through a very strong collaboration is supporting low and middle-income countries including Sierra Leone under its Advance Market Commitment (AMC). “The global COVAX Facility partnership brings together Coalition for Epidemic  Preparedness Innovation (CEPI), Gavi, UNICEF and WHO,” he added. 

Further, he said the arrival of the first consignment provides the country with an additional public health tool in the fight against the COVID-19 pandemic. This initial batch and immediat subsequent shipment will prioritize critical target groups like frontline health professionals, vulnerable groups like the age and people with underlying health conditions informed the WHO Boss

Shongwe assured that, the vaccines are safe and efficacious, will help to save lives, reduce the severity of the viruses and improve the quality of life for individuals. “The deployment of the vaccine should be one of the critical measures that have to be taken in addition to the strict adherence to other public health measures,” he cautioned, while commending the government for providing leadership in the development of national COVID-19 vaccine deployment plan with the support of implementing partners.

Country Representative of UNICEF, Dr. Suliaman Braimoh congratulated the government for its leadership and commitment in signing up to the COVAX Facility. He said through this global collaboration, the vaccine would be accessible to everyone regardless of ones economic status. He noted that, for the fact that they have come together to complement government effort on the fight, their collective strides towards tackling the virus will prove worthy results.”UNICEF hereby reiterate its commitment to support the COVAX vaccine deployment in the country through ensuring that the population is well informed of the vaccination,” he disclosed, while commending the conserted efforts of frontline health workers and the Ministry of Health and Sanitation, which he said has helped to slowdown the transmission of the disease.

Minister of Health and Sanitation said the arrival of the vaccines will switch on the vaccination of 20% of the country’s 8,000,000 population. “Our health facilities throughout 2020 have been challenged by the task of responding to the pandemic while trying to balance our roles towards our normal health services,”  he said, adding that Sierra Leone is delighted to receive its first COVAX vaccine doses as it looks forward to the launching of the vaccination campaign in the coming days.

 “This arrival of the vaccine is a testimony of global solidarity in response to a global health and development  crises,” said Mr. Babatunde Ahons, United Nations Resident Coordinator in Sierra Leone.

COVID-19 vaccination ‘wildly uneven and unfair’: UN Secretary-General

International partners working to achieve equitable distribution of COVID-19 vaccines appealed on Wednesday for the UN Security Council to ensure people caught in conflict have access to these lifesaving treatments.  

Addressing the virtual meeting, UN Secretary-General António Guterres described the goal of providing vaccines to all as “the biggest moral test before the global community”, underlining that everyone, everywhere must be included.

“Defeating COVID-19, now that we have begun to have the scientific capacity to do so, is more important than ever”, he said. 

“Yet progress on vaccinations has been wildly uneven and unfair. Just 10 countries have administered 75 per cent of all COVID-19 vaccines.  Meanwhile, more than 130 countries have not received a single dose. Those affected by conflict and insecurity are at particular risk of being left behind”. 

The UN and partners have established the COVAX Facility so that all countries will have access to vaccines, regardless of their wealth.  The global mechanism must be fully funded, the Secretary-General said.  

“But we must do even more”, he added. “The world urgently needs a Global Vaccination Plan to bring together all those with the required power, scientific expertise and production and financial capacities”. 

Mr. Guterres proposed that the world’s richest countries, the G20 nations, form an Emergency Task Force to prepare the plan and coordinate its implementation and financing. 

The task force would work to mobilize pharmaceutical companies and key industry and logistics actors, he said, underlining the UN’s readiness to support this effort. 

WHO lists two additional COVID-19 vaccines for emergency use and COVAX roll-out

The World Health Organization (WHO) on Monday listed two versions of the AstraZeneca/Oxford COVID-19 vaccine for emergency use, giving the green light for these vaccines to be rolled out globally through COVAX. The vaccines are produced by AstraZeneca-SKBio (Republic of Korea) and the Serum Institute of India.

WHO’s Emergency Use Listing (EUL) assesses the quality, safety and efficacy of COVID-19 vaccines and is a prerequisite for COVAX Facility vaccine supply. It also allows countries to expedite their own regulatory approval to import and administer COVID-19 vaccines.

“Countries with no access to vaccines to date will finally be able to start vaccinating their health workers and populations at risk, contributing to the COVAX Facility’s goal of equitable vaccine distribution,” said Dr Mariângela Simão, WHO Assistant-Director General for Access to Medicines and Health Products.

‘But we must keep up the pressure to meet the needs of priority populations everywhere and facilitate global access. To do that, we need two things – a scale-up of manufacturing capacity, and developers’ early submission of their vaccines for WHO review.”

The WHO EUL process can be carried out quickly when vaccine developers submit the full data required by WHO in a timely manner. Once those data are submitted, WHO can rapidly assemble its evaluation team and regulators from around the world to assess the information and, when necessary, carry out inspections of manufacturing sites.

In the case of the two AstraZeneca/Oxford vaccines, WHO assessed the quality, safety and efficacy data, risk management plans and programmatic suitability, such as cold chain requirements. The process took under four weeks.

The vaccine was reviewed on 8 February by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE), which makes recommendations for vaccines’ use in populations (i.e. recommended age groups, intervals between shots, advice for specific groups such as pregnant and lactating women). The SAGE recommended the vaccine for all age groups 18 and above. 

The AstraZeneca/Oxford product is a viral vectored vaccine called ChAdOx1-S [recombinant]. It is being produced at several manufacturing sites, as well as in the Republic of Korea and India. ChAdOx1-S has been found to have 63.09% efficacy and is suitable for low- and middle-income countries due to easy storage requirements

COVAX warns SARS-CoV-2 is reminder viruses by their very nature mutate

The emergence of variants of SARS-CoV-2, the virus that causes COVID-19,  serve as a powerful reminder that viruses by their very nature mutate, and that the scientific response may need to adapt to remain effective against them, according to COVAX statement on new variants of SARS-CoV-2.

In light of recent news stories regarding the preliminary data on minimal effectiveness of the AstraZeneca/Oxford vaccine at preventing mild to moderate COVID-19 disease caused by the viral variant B.1.351, it is important to note that primary analysis of data from Phase III trials has so far shown – in the context of viral settings without this variant – that the AstraZeneca/Oxford vaccine offers protection against severe disease, hospitalisation and death. This means it is vitally important now to determine the vaccine’s effectiveness when it comes to preventing more severe illness caused by the B.1.351 variant. 

Additional studies will also allow us to confirm the optimal vaccination schedule and its impact on vaccine efficacy. CEPI has announced funding for additional clinical research to optimize and extend the use of existing vaccines, which could include “mix-and-match” studies of different vaccines used in combinations that may improve the quality and strength of the immune response.  Such studies could be useful in optimizing the use of available vaccines, including the AstraZeneca/Oxford vaccine.

The WHO Strategic Advisory Group of Experts on Immunization (SAGE) convened today to review evidence on the AstraZeneca/Oxford vaccine, including emerging evidence on performance against viral variants, and to consider the demonstrated impact of the product and the risk-benefit assessment for use cases with limited data.  These recommendations for use of the AstraZeneca product are being finalised and will be presented to the WHO Director-General on 9 Feb 2021.    

Even though this recent news on effectiveness of the AstraZeneca/Oxford vaccine against the B.1.351 variant is based on a limited study size which focused on low-risk participants and used interval doses that were not optimized for immunogenicity, these results confirm we must do everything possible to reduce the circulation of the virus, prevent infections and reduce the opportunities for the SARS-CoV-2 to evolve resulting in mutations that may reduce the efficacy of existing vaccines

Joint statement by UNICEF Executive Director Henrietta Fore and WHO Director-General Dr. Tedros Adhanom Ghebreyesus

Of the 128 million vaccine doses administered so far, more than three quarters of those vaccinations are in just 10 countries that account for 60% of global GDP.

As of today, almost 130 countries, with 2.5 billion people, are yet to administer a single dose.

This self-defeating strategy will cost lives and livelihoods, give the virus further opportunity to mutate and evade vaccines and will undermine a global economic recovery.

Today, UNICEF and WHO – partners for more than 70 years – call on leaders to look beyond their borders and employ a vaccine strategy that can actually end the pandemic and limit variants.

Health workers have been on the frontlines of the pandemic in lower- and middle-income settings and should be protected first so they can protect us.

COVAX participating countries are preparing to receive and use vaccines. Health workers have been trained, cold chain systems primed. What’s missing is the equitable supply of vaccines. 

To ensure that vaccine rollouts begin in all countries in the first 100 days of 2021, it is imperative that:  

• Governments that have vaccinated their own health workers and populations at highest risk of severe disease share vaccines through COVAX so other countries can do the same.
• The Access to COVID-19 Tools (ACT) Accelerator, and its vaccines pillar COVAX, is fully funded so that financing and technical support is available to lower- and middle-income countries for deploying and administering vaccines. If fully funded, the ACT Accelerator could return up to US$ 166 for every dollar invested.
• Vaccine manufacturers allocate the limited vaccine supply equitably; share safety, efficacy and manufacturing data as a priority with WHO for regulatory and policy review; step up and maximize production; and transfer technology to other manufacturers who can help scale the global supply.

We need global leadership to scale up vaccine production and achieve vaccine equity.

COVID-19 has shown that our fates are inextricably linked. Whether we win or lose, we will do so together.”

Ghana faces hurdles to achieve targets set for COVID-19 vaccine rollout

Nana Kofi Quakyi, New York University

Ghana, like many of its counterparts on the continent, is contending with the fallout from the rapid spread of SARS-CoV-2 variants. Of particular concern is the B.1.1.7 variant first identified in the UK. It is estimated to be up to 70% more infectious and 65% more lethal than the ancestral strain.

Scientists at the West African Centre for Cell Biology of Infectious Pathogens have confirmed that B.1.1.7 is now the dominant variant in Ghana based on nationwide genomic surveillance. And that it is responsible for 88% of cases in the capital city.

The ongoing surge in new infections, hospital admissions and deaths has refocused public attention on a situation that the Ghana Medical Association describes as “dire”. Intensive care units are operating at the limits of their staff and space constraints. And more young people appear to be developing severe forms of the illness.

This means that the rollout of COVID-19 vaccines in Ghana cannot come quickly enough. But what is the country’s COVID-19 vaccination strategy? And how well advanced are plans to execute it?

Potential pitfalls

At least 60% of Ghana’s 31 million residents will need to be vaccinated for the population to attain herd immunity. The goal of the president, Nana Akufo Addo, is that every Ghanaian will be vaccinated. But a timeline for this remains elusive as no plan has been made public.

The president has promised to procure and administer 17.6 million COVID-19 vaccine doses in the first half of 2021 as part of an initial push. But there is uncertainty even around this target.

Firstly, how the country will secure this number of doses is not yet clear.

Secondly, there are questions around how the doses will be stored and distributed, as well as the capacity of the country’s existing cold chain infrastructure.

And there will be a final major hurdle to clear – convincing many sceptical Ghanaians that the vaccines on offer are safe and effective.

Constraining factors

A number of external factors are hampering Ghana’s efforts to secure the doses it needs to reach its mid-year target.

Unlike developed nations, countries like Ghana have limited bargaining power to negotiate directly with manufacturers. As a result, it is principally relying on two multilateral initiatives to procure COVID-19 vaccines – the COVAX facility and the African Vaccine Acquisition Task Team. Combined, they have secured 1.27 billion vaccine doses for African nations.

COVAX is a global initiative co-led by the World Health Organisation, Gavi and the Coalition for Epidemic Preparedness Innovations. It aims to develop, manufacture and distribute COVID-19 vaccines to all nations on a fair and equitable basis. It operates as a funding mechanism that uses the collective purchasing power of participating nations to obtain competitive prices.

Nevertheless, participating low- and middle-income countries will only receive enough vaccines to cover up to 20% of their populations.

Ghana expects to take delivery of up to 968,000 doses of the Oxford-AstraZeneca vaccine by the end of March 2021 as part of an initial batch from COVAX. These first doses have been earmarked for the nation’s healthcare workforce of about 108,000.

COVAX aims to deliver the remainder of this initial tranche of 2.4 million doses by June 2021. This should be enough to protect about 1.2 million Ghanaians with the two-jab Oxford-AstraZeneca vaccine. But reaching the president’s target will require about four times that amount.

This means that Ghana will have to lean heavily on vaccine supplies from the African Vaccine Acquisition Task Team – an initiative being driven by the African Union. It aims to bridge the gap between the 20% population coverage promised by COVAX to participating African countries and the 60% coverage they need to attain herd immunity.

The African Export-Import Bank and the World Bank are supporting the strategy with about $7 billion in cash advancements to vaccine manufacturers on behalf of AU member states. The African Vaccine Acquisition Task Team has so far secured 270 million doses of the Pfizer, Oxford-AstraZeneca and Johnson & Johnson vaccines. Deliveries are scheduled to begin later this month.

In early February the sirector of the Africa Centers for Disease Control announced that 16 African nations had applied to the task team for vaccine supplies totalling 114 million doses. While the final allocations are yet to be published, Zambia, Kenya and Nigeria are set to receive 42.7 million.

It is not yet known if Ghana is one of the remaining 13, nor how many doses it intends to order from the African Vaccine Acquisition Task Team.

Ghana’s Presidential Advisor on Health, Anthony Nsiah-Asare, recently hinted that the country was also procuring vaccines through bilateral deals with some of its development partners. But these supplies are likely to be a negligible fraction of the 15.2 million additional doses required to meet the June target.

This means that Ghana’s supplies from the African Union initiative is likely to determine the nation’s ability to reach its mid-year goal of 17.6 million doses.

The groundwork

Ghana’s COVID-19 vaccination drive will face other challenges that ought to be addressed urgently.

One is a storage and distribution plan that prioritises speed and minimises waste. Public health authorities have assured Ghanaians that a comprehensive plan exists – it has not yet been made public – to make use of the country’s existing cold chain infrastructure for vaccine distribution.

This infrastructure supports Ghana’s enviable record in immunisation coverage that has helped reduce infant mortality and the incidence of vaccine-preventable diseases such as measles. In 2019, immunisation coverage for essential vaccines was in excess of 90%. Ghana has not recorded a single death from measles since 2003. In addition, it was certified as having eliminated maternal and neonatal tetanus in 2011.

But there are gaps. Ghana’s current cold storage facilities lack the capacity to house vaccines like those manufactured by Pfizer and Moderna because of the arctic temperatures required to store them. Both use a technology known as mRNA.

This limits the COVID-19 vaccine options available to Ghana. It also matters because these vaccines can be adapted to target new SARS-CoV-2 variants relatively quickly compared with other vaccine technologies. Having access to them could therefore determine how fast nations are able to respond to the emergence of new variants.

Ghana faces a potentially bigger stumbling block: public scepticism about COVID-19 vaccines.

Anxieties and uncertainties about their safety underlies considerable hesitancy in Ghana towards the COVID-19 vaccines. The proliferation of fake news and misinformation on social media and in certain quarters of the popular press are fanning those embers.

To meet this challenge public health authorities will have to be laser-focused on identifying and addressing both legitimate apprehensions and conspiracy theories. They will also have to be proactive in monitoring digital platforms because of the dynamic and viral nature of vaccine misinformation.

It will also be important to measure progress towards public acceptance of the vaccines. One route would be to conduct a series of public surveys to assess the evolving landscape of knowledge and attitudes. This would enable the government to identify specific misinformation that allows for more focused communication about vaccine safety and efficacy.

Much of that will also depend on media coverage. It is therefore crucial to engage the media on its role in combating misinformation

Nana Kofi Quakyi, Research Fellow, New York University

This article is republished from The Conversation under a Creative Commons license. Read the original article.