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Tom Bollyky Profile picture
@TomBollyky
Sep 24, 2021 • 11 tweets • 6 min read • Read on X
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Countries have pledged to donate 1.9B COVID vaccines but delivered 1.1B

@samckiernan @serena_tohme combed govt websites, COVAX docs & media reports to identify the 61 nations that have pledged, where doses are going & which nations have yet to deliver 1/
thinkglobalhealth.org/article/billio…
The US has most outstanding, but that is misleading as President Biden just this week added 500m to US total pledged donation by 1.1B COVID vaccine doses

Team Europe on the other hand...
2/
thinkglobalhealth.org/article/billio…
Team Europe (EU Norway + Iceland) added 50M to its total pledge of 500m COVID vaccine doses

While Team Europe has administered 561M doses at home, it's donated just 33.8M doses - 6.8% of total pledge

W/in Team Europe, Germany has most undelivered

UK hasn't been much better 3/
China has consumed the most COVID vaccine doses at home (2.2 billion!) and, yet, has pledged to donate considerably less (90M) than either the US (1.1B) or Team Europe (500M)

It has, however, been quicker to deliver on its modest promises 4/
Despite claims by donors that their donations are apolitical, donation patterns suggest otherwise

Donations have not tended to go to countries w/highest current or projected case burden, lowest vax rates, or biggest populations 5/
Asia-Pacific nations are receiving 50% of all donated doses, despite having just 22% of total global cases since Nov. 2020

Latin America, non-EU nations in East & Central Europe & Central Asia receive fewer donations than risk-based approach would suggest
thelancet.com/journals/lance…
To its credit, US has prioritized Latin American & African nations to greater extent than other donor nations

But US has sent 44% of its donated doses to 19 nations in Asia

10.3M went to Pakistan—the largest recipient of US vax donations—soon after US pulled out of Afghanistan
China has pledged to donate 90M COVID vaccine doses, earmarked 67.8M doses for 93 countries, of which 49 million doses have been delivered

All but six of the 93 nations to which China has pledged doses are participants in its Belt and Road Initiative 8/
thinkglobalhealth.org/article/billio…
Team Europe pledged 500M donated doses, earmarked 61.1M of those doses to 54 nations. 33.8M doses have been delivered

Germany favored Africa

Austria & Lithuania favored Eastern Europe

Portugal, Spain & France sent doses 1st to former colonies

EU hasn't prioritized Asia 9/
Japan pledged 59M donated doses, earmarked 26.8M of those doses to 29 nations. 23.2M doses have been delivered

Japan has directed 89% of its donated doses to a single region: Asia-Pacific.

Japan has only donated doses to just one country outside of Asia-Pacific: Iran
10/
A full list of donations, sources, links are included in the interactive.

The whole interactive is worth your time. Read it here!

Via @samckiernan @serena_tohme @ThinkGlobalHlth @CFR_org 11/11

thinkglobalhealth.org/article/billio…

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More from @TomBollyky

Tom Bollyky Profile picture
Oct 29, 2021
Developing safe & effective vaccine faster in a pandemic?

Helps but benefits only nations that can manufacture

Ensuring every region can make + administer vaccines as fast as rich nations?

Priceless.

Here's how via @JHSPH_CHS @JenniferNuzzo & me et al
bit.ly/3EwEA5n
The COVID-19 pandemic has highlighted some strengths and some significant gaps and weaknesses in this global pandemic R&D and response ecosystem 2/

centerforhealthsecurity.org/our-work/publi…
On one hand, pre-pandemic research into mRNA vaccines & public investment in COVID-19 vx R&D paid off hugely

Not one but several highly effective COVID-19 vaccines were developed, trialed & brought to market in 1 year

Previous record was 4 years (mumps) 2/
h/t @OurWorldInData
Read 23 tweets
Tom Bollyky Profile picture
Jun 9, 2021
Maximizing potential benefit of vaccine donations depends on doses going where they can do the"most good" but there's no consensus on where that would be

Murray @IHME_UW @RCReinerJr & I propose an approach that prioritizes epidemiology over geopolitics 1/
thelancet.com/journals/lance…
This week's summit in Cornwall, UK should be the time when G7 leaders finally act on their promises to send surplus COVID-19 vaccine supplies to the many other countries where they remain scarce #G7UK

But how will those vaccine donations be allocated? 2/
bloomberg.com/news/articles/…
COVAX has been criticized by @ZekeEmanuel @GovindPersad & others for its population-based allocation scheme that does not direct most of its early vaccine supplies to the settings at the greatest risk of otherwise having high COVID-19 death rates 3/
nytimes.com/2021/05/24/opi…
Read 9 tweets
Tom Bollyky Profile picture
Mar 27, 2021
Recent US pledge of 2.5 M vaccine doses to Mexico is notable:

-It's the largest single bilateral pledge of doses so far in this crisis

- It's going to a nation in great need

- It came from a democracy

Here's me in @TheAtlantic on why that matters 1/
theatlantic.com/ideas/archive/…
So far, 14 countries have donated a total of 22.5 million doses to 97 nations

Most donations outside of Asia-Pacific have been too small (150k doses or less) to meet local or global demands

2/
 thinkglobalhealth.org/article/politi…
Vaccine donations are distributing fewer doses than COVAX (22.5 million v. 32 million) but they are going to more countries (97 v. 60).

Yet, many of those donations are not going to the poorer nations most in need of doses 3/

thinkglobalhealth.org/article/politi…
Read 8 tweets
Tom Bollyky Profile picture
Jan 20, 2021
President-elect Biden has set a goal of vaccinating 100 million Americans (30% of the population) in 100 days.

It is an ambitious, achievable goal.

Here is what that will require, via @JenniferNuzzo, Sid Baccam @IEMNews, and me in the @nytimes 1/
nytimes.com/2021/01/20/opi…
Primary constraint on vaccinating more Americans so far has not been supply

Despite production shortfalls, US still distributed close to enough doses to vaccinate average of 1M people daily

Bigger hurdles have been administration & demand 2/
covid.cdc.gov/covid-data-tra…
Reaching 1 million people per day requires expanding beyond vaccinating small number of individuals on scheduled-basis to doing more mass vaccination

After 9/11, federal gov't thought through how to vaccinate many Americans in a short time 3/
liebertpub.com/doi/pdf/10.108…
Read 10 tweets
Tom Bollyky Profile picture
Dec 30, 2020
Good news! Vaccine is relatively cheap, easy to produce & store, well tolerated. 3B doses projected in 2021

Haven't seen submission or decision, but MHRA reportedly approved 2 dose regimen (62% effective) & is encouraging a 1-dose regimen to speed access
Results published in Lancet indicate say this a/b 1 dose regimen

It will be interesting to see public response and distribution strategy for regimen w/lower efficacy than Pfizer/Moderna options & uncertainty about duration of protection
thelancet.com/journals/lance…
Apparently, Oxford/AstraZeneca has not even filed a submission package with EMA yet. FDA decision isn't coming soon either.

This is such an important vaccine for global access and so much is strange about how its sponsors have pursued it
reuters.com/article/us-hea…
Read 4 tweets
Tom Bollyky Profile picture
Dec 29, 2020
Revolutions often go full circle, recreating circumstances that led to initial upheaval

For 2d time in 20 yrs world faces a treatment access crisis

1st crisis transformed #globalhealth but laid seeds for latest crisis over vaccines

My latest w/@ChadBown
foreignaffairs.com/articles/world…
20 yrs ago, crisis over AIDS drugs brought deep & lasting changes, pumping $$ into R&D of new meds & creating new institutions to deliver them

But it also shifted focus of #globalhealth 2/

foreignaffairs.com/articles/world…
Global health became less a/b cooperation among nations on common threats and more a/b aid-driven initiatives and public-private partnerships to solve the problems of *other* people—mostly in low-income countries 3/
Read 7 tweets

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