MSF study shows COVAX vaccine donation scheme a broken promise

January 24, 2022: An MSF study shows why the COVAX donation scheme to distribute vaccines to low-income countries has fallen short of its promises for global vaccine equity. As of November 2021, more than 73% of people in high-income countries (HICs) had received at least one dose of a COVID-19 vaccine, compared with less than 6% of people in low-income countries. COVAX only raised half of its target of $2billion by the end of 2021, its main sponsors have not supported proposals to share vaccine knowledge through waiving monopolies on vaccines to increase global production .

COVAX involves pharmaceutical companies, governments, philanthropic organisations like the Gates Foundation and the World Health Organisation, and mainly relies on donations from governments and charities to buy vaccines from pharmaceutical companies and distribute them. The study measures what COVAX has delivered against its promised targets, and also uses information from interviews with those involved in the scheme.

The study shows the decision-making structure of COVAX is dominated by pharmaceutical companies which have monopoly patents and high-income countries, with little representation of low-income countries or civil society groups (p. 5). This meant that high-income countries prioritised their own populations, while making promises of donations which were not met.

Despite warnings from civil society groups, over-reliance on one supplier also contributed to delays in distribution early in 2021. However, COVAX’s renewed promises after this delay in June 2021 to increase distribution were not met. The report notes that “Africa is the second largest continent by size and population, it has received just 3% of global doses administered as of 28 November 2021.” (p.7).

The report summarises the flaws in the COVAX model:

“Overreliance on donations has created a seemingly haphazard and piecemeal approach to dose allocation …Countries are receiving multiple types of vaccines and given little notice on when to expect shipments. Receiving doses close to their expiration dates is a much-cited problem, as well as receiving small quantities. Though donated doses are urgently needed, it is a short term, unsustainable solution... Beyond the logistical issues, there is a more insidious consequence of the overreliance on donations: it reinforces neo-colonial power dynamics and an outdated charity model, leaving low-income countries’ ability to vaccinate their populations dependent on the “generosity” of wealthy countries.” P. 8

The report concludes that “COVAX relies too heavily on traditional market dynamics and voluntary actions from pharmaceutical companies and HIC governments” (p. 10). These flaws that were predicted by civil society organisations, and “should not be replicated in future pandemic responses.”

The report makes a series of detailed recommendations to change the COVAX structure. These include “technology transfer and sharing of know-how” for expanded global production of vaccines, and that “manufacturers should not pursue patents or enforce them in areas where patents have already been granted” (p. 11.)

  • Read the full report here