'Countless batches' of Covid vaccine at risk of being thrown away in low income countries

·5-min read
The international community is not currently living up to promises "to vaccinate the world” - AP Photo/Brian Inganga
The international community is not currently living up to promises "to vaccinate the world” - AP Photo/Brian Inganga

“Countless batches” of coronavirus vaccine will go to waste in lower income countries every month without a concerted effort to tackle gaps in the rollout readiness, according to the Global Health Security Consortium (GHSC).

In a report published on Wednesday, the group warned that “capacity absorption” - the infrastructure needed to use doses once deliveries arrive - will be a growing challenge in the coming months, with the potential to scupper efforts to vaccinate the world.

As it stands, the 92 AMC (Advance Market Commitment) countries - those who can access vaccines through Covax for free - have the capacity to distribute 170 million doses a month, according to the GHSC.

This needs to more than double - to 410m doses a month by the end of 2021 - to absorb the anticipated surge in supply as deliveries through Covax and bilateral donations finally ramp up.

If not, there is a risk the international community will forfeit “the opportunity to vaccinate the world” and rectify increasingly unequal access to jabs, researchers warned.

In particular, there are mounting concerns that countless batches of vaccine will expire before countries have an opportunity to use them - a scenario that has already unfolded in several nations.

In May, Malawi was forced to incinerate 20,000 doses of the AstraZeneca jab, while the Democratic Republic of Congo and South Sudan have sent shipments to nearby countries because they could not administer them before they expired.

Researchers also warn that full vaccination campaigns will not be complete until the end of 2023 in several AMC regions - including Africa and the Eastern Mediterranean - if absorption capacity is maintained at the current rate.

But that timeline could be cut by at least 18 months if capacity doubles.

“Up until this point, I think what we’ve been predominantly hearing is discourse around the supply of vaccines,” said Dr Gabriel Seidman, director of policy for the Ellison Institute for Transformative Medicine - a founder of the GHSC alongside the Tony Blair Institute for Global Change and the University of Oxford.

“But that’s only half the equation… without the political attention on absorption capacity, on the financing and the surge of resources, we’re not going to see the progress we need and we’ll miss this opportunity to vaccinate the world,” Dr Seidman told The Telegraph.

“So it’s a massive call to action… There’s going to be all this supply, but distributing vaccines is going to be a huge challenge - wastage is going to be a huge challenge,” he said.

The paper calls for a new G20 taskforce to drive forward and centralise efforts to boost absorption capacity, with planning focused around ‘four Ss’: settings (to host vaccination drives), staffing, systematisation (data) and strategic communication.

“Without urgent action to meet this challenge, the timeline to vaccinate the world will slip further. Worse still, countless batches of vaccine will go to waste,” Tony Blair, the UK’s former prime minister, wrote in the Financial Times on Wednesday.

More funding is also required. According to the International Monetary Fund, $6 billion is needed to distribute jabs; the logistics of vaccination cost roughly $3.40 for every person given two doses. But Dr Seidman said little of this money has been committed - or spent.

And according to records seen by the New York Times, bureaucratic barriers have already held up the disbursement of $220m to help countries administer vaccines. The Biden administration has also redirected some funds promised for vaccination drives in poorer countries to purchase $3.5bn worth of Pfizer shots.

The GHSC paper comes at a potential turning point in efforts to roll out vaccines worldwide. To date, the Covax scheme has delivered just 163m jabs, compared to initial estimates suggesting 640m would have been available by this point.

But that is set to change in the coming months, as purchases made by Covax - which had been bumped to the back of the queue in the scramble for supply - finally arrive, and donations from wealthy countries begin to trickle out.

On Tuesday the United States said it has so far sent 110 million vaccines to 60 countries, while the UK last week started to deliver an initial tranche of nine million jabs to countries including Indonesia and Kenya - though the bulk of these have short expiry dates, complicating efforts to distribute them.

Gian Gandhi, Covax coordinator at Unicef’s Supply Division, told The Telegraph that the threat of wasting jabs - be it due to vaccine hesitancy, limited absorption capacity, bumpy supply or short expiration dates - will “continue to hang over us for the foreseeable future”.

“Because of the focus on what I call the upstream issues [developing, manufacturing and buying the jabs], there’s been relatively and significantly less funding set aside for system strengthening and delivery, and so it left countries and Unicef, the World Health Organization and Gavi scrambling now to raise and deploy the resources,” he said.

But Mr Gandhi added that a surge in supply over the coming months could actually help efforts to boost rollout readiness, as vaccine deliveries will become less sporadic and governments forced to prepare.

“The upside to the challenge that we see right now with so many more doses expected in the latter part of this year now, is that, hopefully, there will be more confidence in supply materialising,” Mr Gandhi said.

“It’s sort of counter-intuitive, but an analogy is that the cogs on an engine in a car work best when there’s consistent fuel - you get that kind of juddering noise and the engine bangs when the fuel becomes inconsistent and runs dry.

“Insecurity in supply has had a self-defeating effect in some countries as, when money is tight, they don’t want to invest in something that might not be needed for another six months,” Mr Gandhi said.

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