What is COVAX?

October 11, 2021 by Hannah Kettler

Five key questions and answers on the global initiative to deliver COVID-19 vaccines to billions of people.

A COVID-19 testing center in Madagascar. Photo: World Bank / Henitsoa Rafalia.

A COVID-19 testing center in Madagascar, where the pandemic has exacerbated hunger and economic instability. Madagascar is one of 92 countries that will be supported by the COVAX Advance Market Commitment. Photo: World Bank / Henitsoa Rafalia.

The COVID-19 pandemic ushered in unprecedented challenges for people and governments around the world. But the global community has responded in kind with COVAX—a collaborative, global initiative unlike any other.

What is COVAX?

In responding to a pandemic like this one, speed is everything. We need to develop vaccines, scale up manufacturing capacity, and deliver vaccines around the world as quickly as possible.

The Access to COVID-19 Tools (ACT) Accelerator is a global public-private-philanthropic collaboration to accelerate the development, production, and equitable rollout of COVID-19 tests, treatments, and vaccines. COVAX is the vaccines pillar of the ACT Accelerator.

COVAX brings together experts from around the world to collaborate on the research and development of a wide range of COVID-19 vaccine candidates and the manufacturing, procurement, and delivery of the vaccines once approved.

Through a mechanism known as the COVAX Facility, the partnership aims to secure and equitably allocate 2 billion doses of COVID-19 vaccines in the first quarter of 2022 according to the latest Supply Forecast. The adjustment is the result of supply disruptions that have resulted in COVAX having fewer doses in 2021 than planned. Distribution is based on WHO's Fair Allocation Framework for equitable COVID-19 vaccine access.

Who is involved?

Gavi, the Vaccine Alliance (Gavi), the Coalition for Epidemic Preparedness Innovations, and WHO co-lead COVAX. Gavi coordinates the COVAX Facility.

These organizations are global nonprofit and multilateral leaders in vaccine development and distribution, but they can’t do it alone. Success depends upon governments participating and vaccine manufacturers agreeing to make vaccines available.

So far, 190 countries are participating in the COVAX Facility. This includes most of the 92 countries that are eligible for donor-funded doses through the COVAX Advance Market Commitment (AMC)—an innovative financing mechanism through which the world’s poorest countries can gain access to COVID-19 vaccines.

The ability to gain timely, equitable access to vaccines is clearly beneficial for lower-income countries. The benefit to higher-income countries is the protection that COVAX can provide by investing in a broad portfolio of vaccines as well as competitive prices.

At PATH, we’re contributing toward and complementing COVAX by mobilizing our staff, networks, and partnerships to anticipate and address country needs. Through our expertise in vaccine financing, procurement, and partnerships, we’re assisting the COVAX Facility with program design and operationalization. And with our manufacturing expertise, we’re helping evaluate production capacity and offering strategies for scale-up. We’re also advancing new COVID-19 vaccine development and providing technical assistance to support COVID-19 vaccine trial-site and vaccination delivery readiness in Africa and Asia.

Learn more about PATH's work around the world

Why do we need COVAX?

The race to produce vaccines for billions of people at once is uncharted territory. And with a disease like COVID-19, it’s critical to ensure broad coverage and equitable access.

Equitable vaccine distribution isn't just ethical—it’s essential for controlling the spread. COVID-19 doesn’t respect borders, and its variants are adding additional urgency and uncertainty. No one is safe until everyone is safe.

Developing a vaccine requires that the best minds work together. A number of vaccines have been approved for emergency use by national governments and have or are in the process of securing WHO approval, which will allow for broader distribution.

Even as these COVID-19 vaccines begin to roll out, demand still outpaces supply. The percentage of people in low- and lower-middle-income countries that have received a first dose of vaccine is still far lower than in high- and upper-middle income countries. Factors like export bans, bilateral deal prioritization by manufacturers and countries, production scale up challenges, and regulatory approval hurdles are all issues that still need to be overcome as COVAX works to narrow the gap.

Equitable vaccine distribution isn’t just ethical—it’s essential for controlling the spread.

Collaboration reduces risk for everyone involved. Vaccine research and development is expensive, and the risk of failure is high and even once vaccine is approved there are many obstacles to scaling and distributing the vaccines to all who need them. By investing in a diverse portfolio of vaccine candidates, COVAX can hedge risk on behalf of all members.

How does the COVAX Facility work?

Governments and philanthropists have provided vaccine developers with significant funding to support and help mitigate the risks of product development. But what about incentives to scale up manufacturing to meet global demand, including for the poorest economies?

To address this, the COVAX Facility has been negotiating advance deals across a broad portfolio of COVID-19 vaccines, including, in a few cases, pre-payments to increase manufacturing capacity. The facility depends on its ability to bring both self-financing participant resources (from higher-income countries) and donor funding (through the AMC) to the table, to create enough demand to secure its share of doses. In essence, the facility must have sufficient buying power to compete with countries independently seeking bilateral deals with manufacturers.

So far, COVAX has raised over US$10 billion. These funds are paying for doses for the 92 most resource-limited economies. Overall, the facility has delivered over 311 million doses to 143 participants and counting. It is also working to coordinate and collaborate with other donors and funders, such as the World Bank, that have made money available to countries to support vaccine introduction and delivery in these locations.

How is COVAX helping countries prepare for COVID-19 vaccine delivery?

In short, COVAX’s success hinges on country readiness to deliver COVID-19 vaccines. Along with COVAX, Gavi, USAID, US Centers for Disease Control and Prevention, Word Bank, and others are making resources available for planning, logistics, training, human resource capacity building, surveillance, and other critical system strengthening support. At the same time, countries are modifying policies to accelerate regulatory processes and vaccine introduction. At the community level, local agencies and NGOs are implementing community mobilization strategies and to raise COVID-19 vaccine awareness and acceptance in communities.

To boost these efforts, COVAX is providing essential resources for technical assistance and cold chain expansion to AMC-eligible countries.