Geneva, 29 September 2021 – The Gavi Board met yesterday to receive an overview of the key issues shaping the Vaccine Alliance’s push to expand routine immunisation in its fifth strategic period and, as part of a wider consultative process in advance of finalising 2022 strategy, to discuss COVAX’s role in supporting countries to help them end the acute phase of the COVID-19 pandemic.
Routine immunisation programmes were hit hard by the pandemic, with Gavi-supported countries seeing a 4-percentage point drop in vaccine coverage in 2020 – the first drop since Gavi was established in 2000 – and a 3.1 million increase in the number of zero-dose children. The Gavi Board discussed solutions to help boost the resilience of health systems to weather the secondary impacts of COVID-19.
On COVAX, the Board considered progress and the lessons learned since the mechanism was first designed in mid-2020, in the middle of the first wave of the pandemic. It also discussed how today, with more and more safe and effective vaccines coming available, yet in light of continued constrained global supply and the continued emergence of dangerous new variants, COVAX can remain responsive to countries’ needs and best support countries in the effort to ensure equitable access to COVID-19 vaccines.
“Gavi’s ambitions have never been greater than they are today: in 2022, the Vaccine Alliance will not only seek to extend its core work on routine immunisation, including reaching millions of zero-dose children, but also play a lead role in COVAX, the largest and most complex roll out of vaccines in history”, said José Manuel Barroso, Chair of the Gavi Board. “This Board meeting provided an invaluable opportunity to take stock on both areas of activities as they increasingly converge on the same goal: ensuring that the most vulnerable are able to access life-saving vaccines and the benefits they bring.”
The Board’s first session discussed the impact of the COVID-19 pandemic on routine immunisation. In July the annual WHO/UNICEF Estimates of National Immunization Coverage (WUENIC) showed a significant drop in vaccine coverage, with a 4 percentage-point drop in Gavi-supported countries. This was accompanied by a significant increase in zero-dose children, who receive no doses of the basic diphtheria, tetanus and pertussis vaccine (DTP). Since 2000, DTP3 coverage in lower-income countries had increased from 59% to 82% in 2019, close to the global average of 85%, with the Vaccine Alliance playing a key role in this progress. With coverage slipping to 79% in 2020, Gavi also has an important role to play in helping countries to weather the pandemic storm.
“Despite some decrease in vaccine coverage, we saw unprecedented effort from governments and partners to protect immunisation programmes from the worst effects of the pandemic”, said Anuradha Gupta, Deputy CEO of Gavi, the Vaccine Alliance. “However, disparities remain with an increased number of zero-dose children not reached with basic vaccines. This is why we need to focus our efforts on catch-up immunisation and reaching more of the most hard-to-reach children in years to come”.
The Board stressed the important role of the Vaccine Alliance in integrating COVID-19 vaccines into routine immunisation programmes moving forward. This will require making sure that processes, tools, guidelines, delivery innovations and lessons learned are leveraged for the wider immunisation agenda with a focus on reaching marginalised communities and zero-dose children while strengthening the links between routine immunisation and pandemic preparedness.
Yesterday’s Board meeting saw the participation of the Co-chairs of the AMC Engagement Group and the COVAX Shareholders’ Council, who expressed their overwhelming support of the COVAX mechanism, including from the constituents they represent. With their active engagement the Board discussed the critical challenges COVAX is experiencing. The Co-chairs, alongside Board members, supported COVAX’s urgent call for action – for the lifting of all export restrictions; for manufacturers to deliver on their commitments to COVAX and provide transparency on delivery schedules and queues; for countries that have already achieved high coverage to give up their place in the queue to COVAX and the low and middle-income participants it supports; and for the expansion, acceleration and systemization of dose donations.
COVAX has so far delivered over 313 million doses of COVID-19 vaccines and with vaccine supply now increasing significantly, the Board emphasized the importance of pivoting to a more intense focus on delivery. Here, the Board highlighted the importance of partnerships and continued collaboration in the effort to provide adequate support for countries in the rollout of COVID-19 vaccines. The Board has also highlighted the importance of COVAX’s Humanitarian Buffer and the critical need to ensure indemnity and liability provisions are in place in order to be able to protect the most vulnerable populations in humanitarian settings.
Gavi and its Alliance partners UNICEF and WHO continue to help prepare countries for this rapid scale up. At its June meeting the Gavi Board approved new funding of US$ 799 million to support the delivery of COVAX-funded doses in lower income economies and humanitarian zones over the next two years. The funding comes in addition to a previously approved envelope of US$ 150 million in delivery support. A significant portion of this funding is being distributed rapidly and on an accelerated timeline to meet countries’ urgent vaccine rollout-related needs, for example rolling out ultra-cold chain infrastructure in time for the arrival of mRNA vaccines.
“As the global solution designed around equitable access to COVID-19 vaccines, COVAX’s strategy will continue to adapt as the pandemic evolves.” said Dr Seth Berkley, CEO of Gavi. “For many countries, COVAX is one of the primary sources of supply of COVID-19 vaccines, and we must ensure we best serve their needs. As we embark on our most intense period for deliveries yet, COVAX will also continue to focus on strengthening in-country vaccine deployment and even closer coordination with partners such as the African Union. COVAX will also need to focus further on protecting routine immunisation programmes and explore opportunities for integration with Gavi’s core strategy, with its particular focus on marginalised and missed communities”.
Finally, the Gavi Board gave a warm send-off to Orin Levine, the Director of Global Development Program for Vaccine Delivery at the Bill & Melinda Gates Foundation. Mr Levine has been a member of the Gavi Board since January 2013 and has used his extensive experience and knowledge to accelerate the introduction of new vaccines and improve routine immunisation systems.
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