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An international fund to ensure future COVID-19 vaccines will be distributed fairly around the world has been launched, to counter fears that the richest nations could secure supplies at the expense of poorer regions.

Global vaccines alliance organization GAVI has launched the Advance Market Commitment for COVID-19 Vaccines (GAVI Covax AMC) with the UK, Italy and the Bill and Melinda Gates Foundation among its lead backers.

The event saw it raise $567m towards an initial target of $2bn. This will help it immunize healthcare workers in GAVI-supported countries as well as high-risk individuals, and create a buffer of doses to be deployed wherever it is needed most.

If clinical trials and manufacturing goes well, the first vaccine stocks could be ready for distribution by the end of 2020.

Three current frontrunners – US-based Moderna Inc., the UK’s University of Oxford and AstraZeneca PLC and China’s CanSino Biologics - are seen as most likely to achieve this ambitious goal of ultra-rapid availability, if and when they can prove safety and efficacy in late-stage trials.

All three are being supported by governments in their respective countries, who have all indicated that they want to secure immunization for their populations as a priority.

However, AstraZeneca has become the first company to confirm that it will participate in GAVI’s initiative with its adenovirus-based vaccine candidate AZD1222.

GAVI and its partner the Coalition for Epidemic Preparedness Innovation (CEPI) will pay the company $750m from the new fund to support the manufacturing, procurement and distribution of 300 million doses of the vaccine, which will be reserved for low to middle income countries.

AstraZeneca has also announced in parallel a licensing agreement with vaccines manufacturer Serum Institute of India (SII) to supply one billion doses for low and middle-income countries, with a commitment to provide 400 million doses before the end of this year. The company also recently agreed to supply 400 million doses to the US and the UK, as both countries have underwritten the vaccine’s development.

This means AstraZeneca has now doubled its targeted output of the vaccine to a huge 2bn doses a year. CEPI will work with AstraZeneca to scale up production in Europe, with its quota of 300m doses expected to be ready by July 2021.

GAVI launched its new fund on 4 June, just a day after news emerged that the US had selected five candidate vaccines for fast-tracked support via its Operation Warp Speed. Meanwhile the European Union could use an existing €2.4bn ($2.7bn) fund to secure advance orders of vaccines for its 27 member states, and China is also expected to prioritize its adult population of 1.43 billion people first.

The GAVI Covax AMC was launched at the Global Vaccine Summit hosted by the UK government. The livestreamed virtual event saw 30 heads of state and government pledge a total of $8.8bn to fund GAVI's existing program of work for another five years.

Seth Berkley, CEO of GAVI, praised the donations from governments, and AstraZeneca’s commitment. He added: “We encourage other vaccine manufacturers to work with us towards the shared global goal of finding solutions for this unprecedented pandemic.”

Details of the fund are yet to be finalized, but Berkeley said it would be open to all countries, even those richer nations who have already struck deals with manufacturers.

“Even countries who have already done bilateral deals with [a] company will be able to mitigate the risk of not backing a winning vaccine by joining the facility.” He said this would give nations access to a portfolio of vaccines, “increasing the likelihood of success when they get their fair share alongside all other countries.”

While international leaders hope to begin administering a vaccine by the end of 2020, the roll-out of the vaccine is likely to take much longer. Berkeley forecast that if available vaccines were targeted to the most at-risk populations, the acute phase of the pandemic could be brought to an end by the end of 2021.

AstraZeneca First To Commit

AstraZeneca and Oxford University have committed to operating on a not-for-profit basis for the duration of the coronavirus pandemic period to enable broad and equitable access, including for low and lower-middle income countries.

 

AstraZeneca's CEO Pascal Soriot said: "This vaccine will reach hundreds of millions of people in low and middle income countries. This announcement we make today will increase our manufacturing capacity to a total of 2 billion doses. Our goal is to leave nobody behind and hope many other parties will join the effort to eliminate this devastating disease."

Other leading companies involved in COVID-19 vaccine programs include big vaccine players Pfizer, Sanofi and GSK and Merck & Co  Representatives from these companies also joined in the event and pledged to support GAVI’s broader vaccines work and COVID-19 goals, and look likely to follow AstraZeneca's example in the coming weeks.

Experts forecast that as many as 15 billion vaccine doses will be needed in order to beat the pandemic, a figure so huge that most see the manufacturing and distribution to be the most demanding of all the challenges of a global COVID-19 vaccination program.

The European Union has played a key role in helping Gavi and the World Health Organization bring together the international coalition, which has already raised $8bn in an earlier virtual pledging event held on 4 May. 

The European Commission president Ursula von der Leyen announced the EU would provide €300m to Gavi’s work for the next five years, and said: "Our common aim, with Gavi and many other partners, is to speed up the delivery of an affordable COVID-19 vaccine for all who need it. To that end, we are ready to discuss the merits of a global COVID-19 vaccine procurement."

However the new fund hasn’t yet won unanimous support from world leaders, who will want to thrash out the details before committing.

President Trump was among those offering a message of support for GAVI, but stopped short of naming a donation, and made no mention of the COVID-19 vaccine fund. His escalating rhetoric against China and pledge to cut all ties with WHO amid allegations of negligence in relation to the pandemic means the US may decide to not join the fund.

The next key date for international action will be 27 June, when the EU and Global Citizen will host another pledging event called 'Global Goal: Unite for Our Future'.

This will call on world leaders to make further commitments toward fair global access, not only to COVID-19 vaccines, but also diagnostics and therapies.

 

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