COVAX has supplied nearly half of the vaccines administered by governments in humanitarian settings and, along with the UN’s Inter-Agency Standing Committee (IASC), set up the Humanitarian Buffer to address the hardest-to-fill gaps in fragile and conflict contexts.
Flood-displaced people on the DRC border want to access vaccines and other forms of preventive care, but scarcity and looming natural threats imperil their efforts.
In this photo essay photographer Guerchom Ndebo and the WHO’s Eugene Kabambi capture resilience and community effort in the DRC’s IDP camps.
The WHO has called for a scaling up of the response to the health and humanitarian emergency in Sudan, which is fast becoming a regional crisis.
Poverty, power cuts, medicine shortages and COVID-19. Learning new ways to communicate with the team of nurses she manages has helped Rita Akiki deal with multiple crises in the last few years.
Amid a crisis of malnutrition, children in Katsina state are desperately vulnerable. Community-based feeding centres offer them the chance to fight another day.
In northwest Nigeria, some health workers are facing down danger to care for embattled communities.
“We thought that the conflict will stop the vaccinations, but thankfully it is going on.”
An estimated 650,000 of the many millions displaced by Pakistan’s 2022 floods were pregnant women. VaccinesWork caught up with three of them, to hear their tales of loss, survival, and new life.
Services have ceased in more than 70 per cent of hospitals in areas hit by the clashes in a number of Sudanese states.
Sometimes to build demand for vaccines, just speaking the right language can be enough, especially in one of the world’s largest refugee camps.
Throughout the pandemic COVAX and humanitarian agencies – via the UN’s Inter-Agency Standing Committee (IASC) – set up the Humanitarian Buffer to address the most unpredictable and hardest-to-fill gaps in global COVID-19 vaccine access, supporting governments and non-governmental agencies to deliver to vulnerable groups regardless of COVAX participant status.
The COVAX Humanitarian Buffer also embarked on what was a global first: seeking to directly allocate Emergency Use Listed (EUL) vaccines to non-state actors and support delivery. Up until now, it remains the only mechanism to attempt this. This ambition recognized two key features of humanitarian delivery: (1) the centrality of non-state actors in vaccination in humanitarian settings; and (2) the need for delivery pathways across borders to reach marginalized populations.
Unprecedented collaboration: Design, operationalisation and implementation of the Humanitarian Buffer have been an unprecedented multistakeholder and multi-sectoral effort, involving COVAX co-leads Gavi, WHO and UNICEF and, through the IASC, the UN Office for the Coordination of Humanitarian Affairs (OCHA), the International Committee of the Red Cross (ICRC), Médecins Sans Frontières (MSF), and civil society platforms like the International Council of Voluntary Agencies (ICVA).
Securing access to vaccines: Gavi secured access to COVID-19 vaccines on behalf of the COVAX Facility, which dedicating up to 5% of the volume available for the Facility to the Humanitarian Buffer so that humanitarian agencies and/or governments could reach marginalized communities.
Addressing systemic barriers: During the COVID-19 pandemic manufacturers required those procuring and delivering vaccines to take on indemnification related to novel vaccines. Recognizing that humanitarian agencies, who are often best placed to reach vulnerable groups, could not take on this burden, Gavi negotiated indemnity and liability waivers with six manufacturers within the COVAX portfolio securing access to seven COVID-19 pandemic vaccines (Covishield, Covovax, J&J, Clover, Sinopharm, Sinovac, Novavax).
Delivering to humanitarian settings: COVAX has delivered nearly 50% of COVID-19 vaccines used by governments for immunization in humanitarian contexts. In addition, the Buffer has delivered nearly 2.5 million doses to support immunization of displaced persons and host communities in Iran and Uganda.
The nature of the challenge has shifted since the Buffer was first designed: COVID-19 vaccine supply is no longer constrained, global demand has slowed, countries and humanitarian contexts in particular are dealing with multiple competing priorities. With the main need now funding and supporting effective delivery of available doses to vulnerable groups, partners will work through existing programmes and platforms, leveraging available COVID-19 delivery funding, to integrate the delivery of COVID-19 vaccines with other critical services in humanitarian contexts.
A key takeaway from the Buffer is that access during a pandemic, in settings where governments play an active role and can access groups, is feasible despite political and other complexities. However, many global health unilateral and multilateral actors have long faced difficulties operating in humanitarian settings. These challenges were exacerbated working with non-governmental actors to import and deliver novel products in a pandemic environment, particularly outside state-based architecture, proved incredibly challenging due to a range of systemic, legal and regulatory factors.
To date, the COVAX Humanitarian Buffer has received nine applications, of which six were approved; of which three were withdrawn, one is on hold indefinitely, and two have been fulfilled.
Initial learnings and recommendations, such as contingency waivers for humanitarian import during a pandemic, are outlined in a Gavi Discussion Paper and in the COVAX: Key Learnings for Future Pandemic Preparedness and Response white paper published by COVAX partners. Partners will work together on further knowledge products and collaborate on a plan of action for future pandemics.
As of 31 December 2022, The COVAX Humanitarian Buffer is no longer accepting new applications. COVAX partners are working through existing programmes and platforms, leveraging available COVID-19 delivery funding, to integrate the delivery of COVID-19 vaccines with other services in humanitarian contexts.
*Participants will be required to complete and submit the Humanitarian Buffer Standard Reporting Form to Gavi. This reporting form must be completed and submitted within three months after the completion of the programme activities, or within nine months after the doses were received by the Participant, whichever date is earlier.
Co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, COVAX aims to accelerate the development and manufacture of COVID-19 vaccines while guaranteeing fair and equitable access for every country.