COVAX Facility governance explained
How will the COVAX Facility ensure equitable access to COVID-19 vaccines is indeed equitable? By Aurélia Nguyen, Managing Director, Office of the COVAX Facility
- 13 November 2020
- 6 min read
- by Aurélia Nguyen
With more than 180 countries now involved, representing nearly 90% of the global population, we now have a viable solution to the COVID-19 pandemic, the worst global crisis of our time. COVAX is the only truly global solution and our best hope of bringing the acute phase of this pandemic to a swift end. Because it is the only effort to ensure rapid, fair and equitable access to COVID-19 vaccines once they are available for people in all corners of the world, regardless of their wealth.
Coordinated by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO), COVAX has an initial goal of making at least 2 billion doses of safe and effective COVID-19 vaccines available by the end of 2021. This should be enough to protect high-risk individuals, including health care workers and vulnerable people.
But how exactly will COVAX ensure that these vaccines are appropriately and equitably distributed? The answer is a bespoke governance system, building on existing management bodies rather than creating new management – designed with equity and transparency at the core of every policy and process.
The COVAX Facility
The COVAX Facility is the global procurement mechanism of COVAX. Coordinated and legally administered by Gavi, the COVAX Facility is making investments across a broad portfolio of promising vaccine candidates (including those being supported by CEPI) to make sure at-risk investment in manufacturing happens now. By pooling purchasing power from all countries that participate, the COVAX Facility will have rapid access to COVID-19 vaccine doses as soon as they receive regulatory approval. Guided by a fair allocation framework developed by WHO, the COVAX Facility will equitably distribute these doses to help protect the most at-risk groups in all participating countries. And ensuring all participating economies’ perspectives are part of the solution will be critical to shaping and implementing a COVAX Facility that works for everyone, everywhere.
Who’s who in the COVAX Facility
The COVAX Facility has brought together some of the world’s leading experts in public health, international development, finance, global governance and from civil society to solve one of the biggest challenges the modern world has faced. The governance structure is complex for a reason: to ensure accountability and transparency, and diversity of geographic and thematic representation. Read on to learn more about the key groups that have been established to manage, govern, advise, represent their constituencies and support the operations of the COVAX Facility.
- Office of the COVAX Facility: As the legal administrator of the COVAX Facility, Gavi has established the Office of the COVAX Facility within the Gavi Secretariat as a dedicated team to support Facility operations. It will comprise several new teams, including: design and operations; deal making and vaccine portfolio management; country engagement; and finance. The Office of the COVAX Facility will also establish Advance Purchase Agreements and propose them to the Market-Sensitive Decisions Committee (MSDC) for approval.
- Gavi Board: The Board of Gavi, the Vaccine Alliance is responsible for overseeing the role of the Gavi Secretariat and the Alliance in the COVAX Facility, and will have ultimate responsibility for decisions and effective implementation of the Facility. The Gavi Board established the Audit and Finance Committee (AFC) to support the Board in fulfilling its oversight responsibilities in a timely manner, in respect of the Vaccine Alliance’s financial management; risk and control framework, including internal and external audit; and adherence to appropriate standards of good practices and ethics. The AFC will undertake this function in relation to Gavi’s role as the legal administrator of the COVAX Facility. Also, the Gavi Board established the Market-Sensitive Decisions Committee (MSDC) to provide oversight and make decisions that are market and/or commercially sensitive. The MSDC is responsible for reviewing business terms of proposed agreements with manufacturers to ensure: (i) reasonableness of terms and acceptable level of reputational risks; and (ii) availability of resources to back proposed agreements.
- COVAX Shareholders Council: In the governance of the COVAX Facility, the COVAX Shareholders Council represents the 90+ higher-income economies that have agreed to self-finance their COVID-19 vaccines. The Council is a self-organising body that will support real-time information exchange, and provide strategic guidance and advice, to the Office of the COVAX Facility on operational aspects of the COVAX Facility.
- AMC Engagement Group: The AMC Engagement Group is open to representatives from implementing economies, donors and other parties engaged in the financing and operation of the Gavi COVAX Advance Market Commitment (AMC). This self-organising group will support real-time information exchange, and provide strategic guidance and advice, to the Office of the COVAX Facility on the operational aspects of the COVAX Facility – particularly as it relates to implementation in AMC-eligible countries. Within this body, an AMC Investors Group will convene representatives from AMC donors; procurement organisations such as UNICEF and the Pan American Health Organization (PAHO); and representatives of multilateral development banks or regional banks involved in the financing of the AMC. It will discuss its investments in the AMC; options for additional financing; and receive specific reporting on progress achieved against the objectives of the AMC.
- COVAX Consensus Group: The COVAX Consensus Group will be established to support effective operation of the COVAX Facility through consensus-based decision-making between various governing bodies, particularly in areas where disagreement may arise.
Technical and advisory bodies
- Independent Product Group (IPG): Considering priority vaccine candidates and portfolio balance, the IPG makes recommendations to the Office of the COVAX Facility on the inclusion of vaccines in the COVAX Facility. The IPG regularly reviews the portfolio for balance; reviews updates on timing and availability of doses; and considers any implications for the COVAX Facility portfolio.
- Procurement Reference Group (PRG): Once vaccine candidates have been selected to be funded by the COVAX Facility, the PRG ensures an appropriately risk-managed COVAX portfolio from a commercial perspective, considering the timeline for supply delivery of vaccine candidates. The PRG provides independent advice to the Facility on its procurement strategy.
- Joint Allocation Taskforce (JAT): Comprised of Gavi, via the Office of the COVAX Facility, and WHO, the JAT will, based on a data-driven allocation model, prepare a Vaccine Allocation Decision (VAD) proposal for review and validation.
- Independent Allocation of Vaccines Group (IAVG): The IAVG will be established as an independent body to validate VAD proposals put forward by the JAT. Composed of technical experts, the IAVG will validate that the proposed VADs are technically informed, transparent and free from conflicts of interest. They may also request clarifications from the JAT, and for the model to be rerun if needed, before making their final determination. Once validated by the IAVG, the VAD is passed to the Office of the COVAX Facility for implementation, with support from procurement organisations, such as UNICEF and PAHO.
Operational bodies (e.g. working groups)
The COVAX Coordination Meeting (CCM) is the high-level body that meets to coordinate efforts across the different elements of COVAX. The CCM is chaired by the Board Chairs of CEPI and Gavi, representatives of civil society and industry, and includes the institutional leads of CEPI, Gavi and WHO – providing a link to the established governance of each organisation. It meets to help coordinate, guide and resolve issues across COVAX.
For more on the CCM and other operational bodies (e.g. working groups), click here for COVAX: Structure and Principles.