WHO: Two-thirds of global population now participating in COVAX initiative

Countries representing nearly two thirds of the world’s population have now signed on to The World Health Organization’s COVID-19 vaccine development and manufacturing accelerator. In all, 64 higher income countries have joined the COVAX facility, with an additional 38 expected to join soon. The United States, Russia and China are not among the countries joining the multinational effort.
 
World Health Organization (WHO) director-general Tedros Ghebreyesus led a 21 September press conference, attended by other WHO leaders, that provided updates on global participation in COVAX and announced a global vaccine allocation framework. The initiative aims to have 2 billion doses of vaccine available for global distribution by the end of 2021.
 
The COVAX initiative is led by the World Health Organization (WHO), Gavi – the Vaccine Alliance -- and the Coalition for Epidemic Preparedness Initiatives (CEPI). COVAX’s aim is “to guarantee fair and equitable access for every country in the world,” according to the WHO COVAX webpage. The COVAX initiative fits under WHO’s Access to COVID-19 Tools Accelerator (ACT-Accelerator).
 
Thus far, the ACT Accelerator has raised just about 10% of the $35 billion it will need for “scale-up and impact,” said WHO in a press release, adding that $15 billion is needed immediately “to maintain momentum and stay on track for our ambitious timelines.”
 
“COVAX is now in business: governments from every continent have chosen to work together, not only to secure vaccines for their own populations, but also to help ensure that vaccines are available to the most vulnerable everywhere,” said Seth Berkley, MD, CEO of Gavi. “With the commitments we’re announcing today for the COVAX Facility, as well as the historic partnership we are forging with industry, we now stand a far better chance of ending the acute phase of this pandemic once safe, effective vaccines become available.”
 
Bruce Aylward, MD, senior advisor to the WHO director-general and lead staff for the ACT accelerator, added that a significant portion of the required funding will be dedicated to logistical and “last-mile” problems, with funding helping “to ensure that when these new products hit the countries, they can actually be utilized in the most efficient and effective way possible, so that part of the budget has been built in,” said Aylward. “So what you're seeing today in the new investment case, which will be fully revised and released later this week, will include the cost of what we call the “health systems connector.’”
 
WHO’s chief scientist, Soumya Swaminathan, MD, fleshed out what the “target product profiles” for a COVID-19 vaccine will be from WHO’s perspective. “Obviously,” she said,” these target product profiles are to help developers and funders to try to have some benchmarks for when they're developing the vaccine.
 
“We have two scenarios: a vaccine that's used mainly as a preventive, and also a vaccine that could be used in an outbreak setting to rapidly control outbreaks,” said Swaminathan, pointing out that the product profiles would differ slightly. Ideally, she said, a vaccine would have 70% or greater efficacy, but a point estimate of 50% efficacy would also be acceptable in the context of the pandemic.  
 
Swaminathan also noted that confidence intervals must be set appropriately: “In other words, if you do a clinical trial with small numbers of people, you could still prove a 50% efficacy but you may have confidence intervals that go all the way down to zero, which means that there's a chance that the vaccine actually doesn't have any efficacy or has very poor efficacy. So we also specify the lower boundary of these,” she said, to 30%.
Ideally, added Swaminathan, WHO would like to see “several months” of follow-up to assess adverse reactions from vaccines, especially since many leading candidates are novel platforms.
 
WHO