Resilient Immunization Systems Key to Reducing Disparities in COVID-19 Vaccine Access

Share of people who received at least one dose of COVID-19 vaccine, Apr 28, 2021

Share of the total population that received at least one vaccine dose. This may not equal the share that are fully vaccinated if the vaccine requires two doses.

Source: Official data collated by Our World in Data

Even as life-saving COVID-19 vaccines promise a return to normalcy in many places, access to the vaccines has been unequal and the logistics of delivery, a massive challenge in even the best-resourced settings, have been largely overlooked and underfunded.

In a recent opinion piece, current and former global leaders point out that more than half of the global vaccine supply has been reserved by the world’s richest countries — home to just 16% of the world’s population — and only 0.2 percent of the over 700 million doses administered so far have been in low-income countries. Full funding and political support for the UN-led COVID-19 Vaccines Global Access (COVAX) facility is essential, but the best-case scenario for COVAX projects would immunize just 13% of the four billion individuals in low and middle-income countries in 2021. In order to increase vaccine supply, policy makers and funders need to address IP issues, ensure technology transfer and build manufacturing capacity to ensure the world has enough vaccines for everyone.

In parallel, there is a need to build more resilient and sustainable systems for the delivery of essential health services like vaccines. Even the most effective COVID-19 vaccines won’t stem the tide of the pandemic: delivery through equitable and efficient immunization systems will. Yemen, for example, has received 360,000 COVID-19 vaccine doses but is yet to report administering any. Libya and South Sudan have also received doses through COVAX but have only administered 0.4 percent and 0.1 percent of them, respectively. Doses secured by Ghana are languishing in storage because the country lacks the infrastructure and funding for large-scale distribution.

The humanitarian organization CARE estimates that for every $1 invested in procuring doses, $5 is needed to successfully inoculate people. This includes investment in training and supporting health workers, strengthening immunization systems and supply chains, and building vaccine acceptance.

The stories collected by the PGG partnership focus on 5 characteristics — centering on communities, adapting to change, prioritizing marginalized groups, using data and technology, and connecting clinical and community services — which are helping sustain health systems and communities during the pandemic. We at PGG believe these attributes should guide investment to ensure that health systems are empowered and equipped to deliver COVID-19 vaccines and safeguard access to other essential health services.

Here are some things that advocates can do to ensure not only the procurement of doses but also their deployment:

  • Call on governments, philanthropies, development banks and the private sector to fund vaccine delivery to ensure that precious doses are not wasted because of health system constraints. Policymakers can fund UNICEF’s appeal to raise $510 million to support their role within the ACT Accelerator for vaccine distribution in LMICs.
  • Urge high-income countries to increase funding for the World Bank’s COVID-19 response, which includes US$12 billion for procuring and strengthening immunization systems and vaccine logistics in LMICs.
  • Ahead of the June G-7 summit in June, demand that political leaders agree to a commitment of $30 billion a year for the next two years to ensure equitable vaccine access and to meet the financing gap of the ACT-A accelerator.
  • Write to country leaders urging them to invest in vaccine readiness at large. Rwanda’s COVID-19 vaccine delivery has been a success because the country had comprehensive vaccination plans in place even before doses were received.
  • Review asks from the Frontline Health Workers Coalition to see how you can support frontline health workers. The PGG partnership has found that community health workers are essential to shoring up essential health services. However, a COVID-19 vaccine readiness assessment found that only 30% of over 100 countries are investing in training vaccinators. Support organizations like Protecting Global Gains partner Amref that are helping Ministries of Health roll out COVID-19 vaccines.

To learn more about the various movements in the COVID-19 vaccine advocacy space, you can review petitions and sign-ons from CARE, Public Citizen, MSF and the ONE Campaign.

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