Thread by @WesElyMD

1/🧵COVAX was created to get #COVID19 #Vaccine to ALL countries. Hailed as a “heroic effort to transcend limits of human ingenuity,” it fell short globally because we “rich countries behaved worse than anyone’s worst nightmare.” @TheLancet
 
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#MedTwitter

2/ At COVAX’s pledging summit, it finally secured US $8B ask for procurement & delivery of #vaccines for 92 eligible low-middle-income countries (LMICs) this year. But even with full financing, the COVAX roll-out is moving too slowly compared to high-income countries.

3/ “Today, ten countries have administered 75% of all COVID-19 vaccines, but, in poor countries, health workers and people with underlying conditions cannot access them. This is not only manifestly unjust, it is also self-defeating”, UN secretary general António Guterres said.

4/ The poorest of the 92 countries were to receive them at no cost. Team Europe (led by Germany) & USA have provided US $5B to COVAX AMC, Japan has given US $1B, and UK, US $735M. Most of these funds have been pledged only in the past few months. Some LMICs are self-financing.

5/ The grand idea of COVAX was that the combination of self-financed and aid-financed pieces would give COVAX a way to invest in R&D for promising vaccine candidates. COVAX would be a lifeline for self-financing countries that had not made bilateral deals w vaccine makers.

6/ But US, EU, and UK all made huge deals bypassing COVAX’s plan. “Everyone knew rich countries would enter into bilateral vaccine deals, but it was hoped that they would also buy into COVAX as insurance.” That didn’t happen, and luckily the vaccines worked. BUT…

7/fin
The process left the shelves empty at COVAX and the poorer countries without a safety net until major outbreaks had already occurred, leaving the #COVID19 virus happily spreading around the globe in the most vulnerable countries – LMICs.