India’s manufacturing base is playing a critical role in closing the gap between rich and poor countries: Dr Yasmin Ali Haque, UNICEF Representative

On Tuesday, the governments of Côte d’Ivoire and Ghana started COVID-19 vaccination campaigns which are focused at the protection of its healthcare workers.

Close on the heels of the first round of vaccinations in the African nations, over the next seven days another 11 million COVAX doses are expected to be delivered. These campaigns are among the first to use doses provided by the COVAX Facility’s Gavi COVAX Advanced Market Commitment (AMC).

The start of Africa’s biggest immunization drive in history through the COVAX Facility marks a step forward in the continent’s fight against COVID-19 and is a welcome shift towards bringing African countries off the sidelines and back into the vaccination race.

What is AMC?

It is the COVAX Facility’s mechanism which helps in providing donor-funded vaccines to lower-income countries.

Last week, both Ghana (600,000 doses) and Côte d’Ivoire (504,000 doses) took deliveries of the AstraZeneca/Oxford vaccine licensed and manufactured by the Serum Institute of India (SII).

According to reports, last month on February 15, the World Health Organisation, was granted Emergency Use Listing (EUL) of the vaccine, branded COVISHIELD.

On the campaign, Nana Akufo-Addo, President of the Republic of Ghana said: “COVID-19 has changed the world and has cost lives, battered health systems, and damaged livelihoods. Ghana welcomes the arrival of the first doses of COVID-19 vaccines through the COVAX AMC as a pathway to ending the acute phase of the pandemic.”

“The first doses will be prioritized for health and essential workers, and other at-risk groups. And, this will allow Ghana to get back to business, and build back our economy even stronger than before,” the Ghanian leader has said.

By the end of 2021, COVAX has plans to deliver at least 2 billion doses of COVID-19 vaccines and this will include at least 1.3 billion to the 92 economies which are eligible for support through the COVAX AMC.

Till date, COVAX doses have been delivered by SII to: India, Ghana, Cote d’Ivoire, while Pfizer-BioNTech has delivered doses to the Republic of Korea. In the coming days more deliveries by these two manufacturers are planned. Almost 11 million doses in total are planned to be delivered over the next seven days. And, in addition, AstraZeneca is set to commence shipments this week.

The effort to accelerate development and access to COVID vaccines is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the World Health Organization (WHO). These bodies are working in partnership with UNICEF as well as the World Bank, manufacturers and civil society organizations, and others.

Interaction with Dr Yasmin Ali Haque, the UNICEF Representative in India

She was at Serum Institute of India (SII), Pune, when the shipment containing 600,000 doses of COVID vaccines left for Ghana. A second shipment of 504,000 doses, sent from Mumbai, India, landed in Ivory Coast, West Africa on Tuesday (March 2, 2021).

She talks not only about the COVAX Facility, but also the initiative to provide equitable access to COVID vaccine and how it will help the world end the pandemic.

Following are excerpts from the conversation…

How did you feel as the first batch of vaccines left for its destination from the Serum Institute of India (SII) under COVAX Facility?

It was a historic moment as the first batch of 600,000 doses of COVID vaccine left for Ghana from the SII in India. It is for the first time that so many partners have come together to ensure that the vaccines that have the potential to save billions of lives reach people all over the world equitably. It is a major step in the global effort to beat this pandemic and a landmark achievement towards global equitable access to these life-saving vaccines.

How many vaccine doses will be provided under this facility and to whom?

The first batch of 600,000 doses has already reached Ghana. The COVAX Facility, co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and WHO, together with UNICEF, aims to dispatch 80 million doses by March and provide at least 2 billion doses of approved COVID-19 vaccines by the end of 2021.

As part of the COVAX Facility, UNICEF is leading efforts, in collaboration with the PAHO Revolving Fund to procure and supply doses of COVID-19 vaccines for the 92 low and lower middle-income countries on behalf of the COVAX Facility to enable them to protect their frontline healthcare and social workers, as well as other high-risk and vulnerable groups.

Of these, PAHO will be procuring and supplying doses to 10 countries in Latin America which are: Bolivia, Dominica, El Salvador, Grenada, Guyana, Haiti, Honduras, Nicaragua, St Lucia, St Vincent and the Grenadines. The COVAX Facility has put in a system of determining the destinations and recipient countries and number of doses.

How many of these doses will be provided by India?

Of the 2 billion, majority will come from SII, Pune, which has a license agreement with AstraZeneca and Novavax. India’s manufacturing base is playing a critical role in closing the gap between rich and poor countries. UNICEF from India will ship the vaccines to 82 low and middle-income countries participating in the COVAX Facility.

Why are these vaccines being procured only from SII in India?

COVAX Facility provides WHO-certified vaccines. AstraZeneca vaccine got WHO-certification on 15 February 2021.As more vaccines get the certification from WHO, based on their price and affordability other suppliers are being added to the pool.

What is the role of UNICEF in COVAX?

UNICEF is a proud and privileged partner of the COVAX Facility. Its role starts with the signing of the agreements for the procurement of the vaccine. We work with countries to see that they have put in place the protocols being advocated by the WHO Strategic Advisory group of experts and also to see that all the systems are in place for safe storage, transportation and administration of the vaccine.

UNICEF ensures safe, timely and efficient transportation of these vaccines from countries where they are produced to the countries where they are to be received. It works with governments and partners to make sure that vaccines reach those who need them the most.

Dr. Yasmin Ali Haque, UNICEF Representative in India, visits COVID-19 vaccine manufacturer plant in Pune, Maharashtra, India, on Wednesday. Credit: UNICEF

Besides, UNICEF is also supplying a billion syringes that will be needed to administer the vaccine safely. UNICEF started stockpiling these syringes in 2020 itself to meet this anticipated demand. These 4.5- inch- long syringes, if we put them end- to- end will cover the length of the whole world thrice. UNICEF is also buying 10 million safety boxes by 2021, so that used syringes and needles can be disposed of in a safe manner by personnel at health facilities, thus preventing the risk of injuries and blood borne diseases. Every safety box carries 100 syringes.

And how do you think COVAX Facility is going to help in ending the pandemic?

The equitable access to vaccines will contribute greatly towards containing the pandemic which has disrupted every aspect of life. Due to the pandemic, children and women have not received some of the essential services they needed. Now that the frontline workers will be vaccinated, these services will resume fast.

With these shipments, we are part of the historic journey to provide equitable vaccine access to lower income and lower middle income countries to ensure no one is left behind and that every vulnerable person around the world is protected from COVID-19 and its direct and indirect impact.