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WHO Reveals Plan for Vaccine Distribution, US Not Included

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WHO Reveals Plan for Vaccine Distribution, US Not Included

2020-09-23 12:18:31

By Laura Tucker, Staff writer; Image: Health care professional giving a vaccine (Image source: Public domain)

With everyone wondering how and when a coronavirus vaccine will be distributed, the good news is that the World Health Organization has a plan. The bad news is that the United States won't be part of it.

More than 64 percent of the world's population, more than 150 countries, have agreed to take part in the COVID-19 Vaccines Global Access Facility, or Covax. Its goal is to develop and distribute $2 billion in doses of a vaccine by the end of this year.

Rich and poor countries alike will pool their money and give it to vaccine manufacturers with volume guarantees to give them many possible candidates. The hope is that this will discourage hoarding and focus on vaccinating the highest risk people first in every participating country.

There are 64 higher-income countries that have agreed to participate at this point, according to WHO officials. Thirty-eight more are expected to join. Conspicuously missing are Russia, China, and the United States.

China has not committed either way to whether it will join Covax. The White House said earlier this month that the U.S. would not be joining in, partially because the Trump administration no longer wants to work with the WHO. It will instead take on the effort on its own.

At a news briefing on Monday, WHO Director General Tedros Adhanom Ghebreyesus asked more countries to sign on. "The race for vaccines is a collaboration, not a contest," he said. "This is not charity. It's in every country's best interest. We sink or swim together."

In the first phase of the vaccine's release, doses will be distributed proportionately to each participating country. Each will get enough doses for 3 percent of its population, then up to 20 percent as the supply allows.

If the supply is limited after it has reached the 20 percent threshold, the manner in which it is being doled out will change. The risk level of each country will be considered. Countries at the highest risk will receive more doses.

Each country will be able to decide on its own who will receive the vaccine first. The expectation is that the initial doses will be given to medical workers and then other high-risk groups.

"Providing each country with enough doses to start protecting the health system and those at higher risk of dying is the best approach to maximize the impact of the small quantities of vaccines," said Mariângela Batista Galvāo Simāo, the assistant director general for access to medicines and health products for the WHO.

Health Analysts believe this plan shows the politics of this process. "It seems like a compromise position," said Thomas J. Bollyky, senior fellow at the Council on Foreign Relations and the director of its global health program. "It's not exactly what you would do if you were driven strictly by public health."

An alternate framework called the Fair Priority Model was mentioned by critics. They don't believe it makes sense to provide the same share to countries that have different needs and resources. One country that has been heavily entrenched in the pandemic would receive the same proportionate amount as a country that has remained relatively unscathed.

They would like distribution to rely instead on benefiting people, limiting harm, and placing priority on more disadvantaged people while showing equal concern for all.

The current framework is meant to encourage more to sign up. "It's a very pragmatic and expedient way of trying to put forward a simple plan and will not ignite a food fight among different member states in the first phase," said the Global Health Policy Center at the Center for Strategic and International Studies director J. Stephen Morrison.

"The real food fight," he continued, " will come later." That will happen in Phase 2 when individual risk will be assessed.

The Trump administration declined to work with Covax and is instead committed to its own plan, "Operation Warp Speed." Hundreds of millions of doses of vaccines have been ordered. The goal is to secure doses for more Americans, including people who are low risk, before anyone else in the world.

It's a risky strategy, as the U.S. could be left out if one of its many vaccine candidates doesn't pan out, but Covax does have a candidate that is provided to the participating countries. It's more likely, however, that the U.S. will have a vaccine and hoard its doses, while people in other countries go without, which could continue to limit international travel.

The additional problem is that despite the hopes for the vaccine, it's unlikely that all people will be protected. A portion of the people in the country will be left vulnerable. There is also a portion of the country that do not believe in the safety of such things, and this will continue to leave everyone vulnerable. 

"From what we've seen so far, political, industrial, and security interests will play a much larger role in determining global vaccine allocation than ethics or public health rationale," said Suerie Moon, co-director of the Global Health Center at the Graduate Institute of International and Development Studies in Geneva.

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