How the COVAX vaccine program is faring, and what challenges developing nations still face

The Biden administration is ramping up plans for vaccine manufacturing for the coming year. But developing nations have been struggling with delays and short supplies for months and will not meet their vaccination goals for this year. Drug maker Moderna will reportedly supply 56 million more doses to those countries in the first half of 2021, but far more is needed. William Brangham reports.

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  • Judy Woodruff:

    As we reported, the Biden administration is ramping up plans for vaccine manufacturing for the coming year.

    But developing nations have been struggling with delays and shortages for months. Moderna reportedly will supply 56 million more doses to the global vaccine initiative known as COVAX. But far more is still needed.

    William Brangham is back with that story.

  • William Brangham:

    While the U.S. and the European Union have gotten doses to roughly 70 percent of their populations, the rest of the world lags far behind.

    Across the African continent, just over 6 percent have been vaccinated. In developing nations, it's even lower. Just around 4 percent of people have received their first shot.

    Joining me now is someone whose job is dedicated to writing that imbalance. Dr. Seth Berkley is the CEO of the Gavi Vaccine Alliance, one of the key partners in COVAX.

    Dr. Berkley, great to have you back on the "NewsHour."

    Broadly speaking, help understand why this imbalance exists. I mean, you have gotten hundreds of millions of doses out the door to nations, but it's still less than you had hoped thus far. Why is that?

  • Dr. Seth Berkley, CEO, Gavi, The Vaccine Alliance:

    Well, it's a really interesting question.

    When a pandemic occurs, of course, there's a number of things you need to have happen. First, you have to figure out whether you have a countermeasure, in this case, vaccines. And we're really lucky. We have vaccines. Most of them have worked. We saw the first vaccine 327 days after it started, in terms of it being made available.

    So, that was the good news. The challenge was, wealthy countries, of course, bought up all of the doses at the beginning. And when we started COVAX, of course, we had no money for purchasing these doses and had no staff. So we had to build those efforts, as well as set up things like the no-fault compensation schemes, the regulatory approvals for countries.

    But, of course, right now, it is really picking up. We have delivered more than a half-a-billion doses. And, by the end of the year, we expect to have a little — around a billion doses that are in delivery.

  • William Brangham:

    There is some reporting that Moderna is about to have another announcement that they will get several millions of doses out the door.

    Broadly speaking also, what role do you place on pharmaceutical companies to do their part getting doses free or at low cost to the developing world?

  • Dr. Seth Berkley:

    Well, what's critical is we expect that companies will honor their commitments.

    And, sometimes, that hasn't been the case. Now, when you scale from nothing — if we look at the world, the world normally produces between 3.5 and five billion doses and, this year, maybe 12 billion doses of COVID vaccine. So it's been an incredible scale-up, and that means there have been many manufacturing problems.

    The critical issue for us is, if you promise to make doses for COVAX, if you are not able to do that, are you sharing that problem with your other paying customers? Or are you specifically not providing doses for low-income countries while you're continuing to provide doses for your high-income customers?

    And that's the type of transparency we need.

  • William Brangham:

    Do you think, going forward, God forbid, we have another one of these pandemics, but it's likely that we will, then when governments make contracts with these companies, especially when taxpayer money is involved, that it ought to have tighter restrictions to say, if this vaccine is successful, you must give X-percent to the developing world, you must share your intellectual property to help other nations build and distribute these vaccines as well?

    Should we do a better job of that?

  • Dr. Seth Berkley:

    Well, first of all, it is evolutionarily certain we will have other outbreaks. Whether they will be vaccine-preventable or not is, of course, unknown.

    But I think the critical thing here is not that the companies have to give. We made a decision that we would work with for-profit companies to develop our products. But what we want to make sure is, there's access. And that's what happened at the beginning. There was no access whatsoever. Of course, since we didn't know which vaccines would work, every country wanted to buy not one vaccine, two, three, four, five, if they could.

    And that's why we ended up with countries with lots of excess doses. And when we didn't have any doses, we called on those countries to say, please, if you have excess doses, make them available now.

  • William Brangham:

    Given all of these issues, going forward, what does 2022 look like for the developing world? Are we still talking about a very small minority of people getting the doses that they so desperately need now?

  • Dr. Seth Berkley:

    No, it's quite the opposite.

    I believe, by the end of this year, 2021, we should get close to the goal that we had originally had, which was to cover not only all the high-risk people, so, health care workers, elderly, those with comorbidities, something around 20 percent of the population, but the goal that President Biden put on the table was to try to get to 70 percent of the global population by the U.N. General Assembly next year.

    Now, that's a very tough goal. I'm not going to say we're going to hit it everywhere, but we are planning towards it. We actually have visibility towards 4.5 billion doses, which is what it would take to get us there. We will need some more money. We will need some more help on delivery.

    But it is plausible to get to a situation very soon where countries have the doses they want. The challenge is going to be, will they want to take it all the way up? And how do we deal with vaccine hesitancy and demand-related issues, which is an important challenge?

  • William Brangham:

    Dr. Seth Berkley, CEO of the Gavi Vaccine Alliance, thank you so much for being here.

  • Dr. Seth Berkley:

    Thank you for having me.

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