COVAX and the United States
Of the committed countries, 29 European countries have joined through the European Commission.
Team Europe, comprised of 29 countries, is excluded from the counts of self-financing participants’ agreement structures.
AMC countries may receive additional doses to vaccinate more than 20% of their populations but must provide funds through a tiered cost-sharing obligation for these additional amounts. India, because of its large population, has a unique agreement with COVAX to receive enough doses to cover only 7-9% of its population.
Not all vaccine candidates receiving CEPI funding have an agreement with COVAX to supply COVID-19 vaccine doses. Only 6 of the 11 candidates contain supply of COVID-19 vaccine doses as part of their funding agreements: AstraZeneca, Clover Biopharmaceuticals, CureVac, Novavax, SK Bioscience, and University of Queensland/CSL. However, CEPI recently announced that the University of Queensland/CSL vaccine candidate would not be continued beyond the Phase I trial.
For a vaccine candidate to be distributed through COVAX, the candidate must be on the WHO Emergency Use or Prequalification list or receive approval from a limited set of country-specific regulatory authorities. These regulatory authorities include the Therapeutic Goods Administration (Australia), European Medicines Agency (EU), Health Canada (Canada), Swissmedic (Switzerland), Medicines and Healthcare products Regulatory Agency (UK), or U.S. Food and Drug Administration (U.S.).
COVAX has an agreement with Serum Institute of India to provide an additional 900 million doses of either the AstraZeneca or Novavax vaccine.
COVAX has right of first refusal access to candidates funded by CEPI. These candidates are estimated to provide 1 billion doses.
The 3% mark was determined by the WHO as the approximate proportion of health care workers within countries’ populations.
The additional 17%, summing to the 20% mark, is an approximation by the WHO for countries to be able to vaccinate their high-risk populations, such as older adults and individuals with underlying health conditions.
In the framework, a country’s threat level will be assessed based on the spread of COVID-19 in the country and presence of other influenza viruses. A country’s vulnerability level will be assessed based on its health systems capacity according to the universal health coverage index and occupancy of hospital beds.
According to the SAGE Prioritization Roadmap, this group may include individuals with comorbidities and economically disadvantaged groups. The Roadmap also acknowledges the need for variation in priority groups among countries.
This total excludes payments from the 29 countries included in Team Europe.
Additionally, at the end of 2020, COVAX faced a $755 million funding gap, according to available data.