Explainer: Global Covid vaccine alliance: did SA miss its shot?

The jury is still out on whether everyone will have access.

If you’re a little confused about Covax, the global coordinating effort to get vaccines to everyone in the world who needs them, you’re not alone. In the last two weeks, conflicting reports have emerged about whether South Africa has paid the money it owes to Covax, and how this will affect our chances of having a Covid-19 vaccine any time soon. 

According to The Conversation, there are 260 Covid-19 vaccine candidates at various stages of development around the world. Of these, 60 are currently going through clinical, or human trials. A handful even claim to just about prevent Covid-19, or serious forms of it, entirely.

It’s good news for everyone. But has SA missed the boat? 

As it turns out, there is no clear cut answer to these questions – yet.

What’s Covax?

Let’s start at the beginning. In April 2020, the World Health Organisation (WHO), the European Commission and France came together to try to find a way to ensure that everyone in the world would have equal access to Covid-19 vaccines. Covax, which stands for Covid-19 Vaccine Global Access, is an idea that emerged from this broader strategy. Covax involves bringing vaccine manufacturers, countries, scientists, philanthropists and the private sector together to make sure that Covid-19 vaccines are accessible to everyone, and to negotiate fair prices.

It’s supposed to take the competitive element out of vaccine distribution between countries. The goal is to have 2 billion doses of a vaccine available by the end of 2021, and to make these available to high risk, vulnerable people, as well as healthcare workers, first. 

Countries participating in Covax are supposed to be guaranteed vaccine access to at least 20% of their populations first; these vaccines should also be made available as soon as they’re ready, at fair prices.

You can read the WHO’s entire Covax explainer here and check out its summary here:

COVAX: Ensuring global equitable access to COVID-19 vaccines – YouTube

Is SA involved?

Yes. SA is one of the countries participating in Covax right now. However, there’s been some confusion over whether SA paid its Covax contribution on time.

On December 3, President Cyril Ramaphosa announced that SA had pledged over R300 million to Covax, through the Solidarity Fund – which was set up by the government at the start of the pandemic to coordinate funds from donors and government to fight Covid-19 in SA.

Last week, News24 reported that SA had missed the deadline to make the required payment of R500 million to Covax, which was why the Solidarity Fund stepped in. But senior health and treasury officials also told the publication that the payment could not be processed until certain processes had unfolded, including properly assessing whether the payment was appropriate (they concluded that it was) and making sure the money for the payment could be found.

Finance minister Tito Mboweni told Parliament that the deadline for the R500 million was actually December 15 and said it would indeed be paid.

But SA will reportedly need over R4 billion more to make sure it is at the front of the queue when a vaccine becomes available, he said.

Writing in the Daily Maverick this week, Fatima Hassan, head of the Health Justice Initiative, said it was not quite true that SA had missed the initial payment deadline. She said that Covax is a voluntary scheme, and much of what it entails is still being worked out by everyone concerned. For example, not all countries and drug companies have signed on, yet.

So will everyone have access?

The jury is still out on this one.

According to this report in the Daily Maverick, SA has spent about R10 million on vaccine clinical research and committed to join Covax. The report suggests that rich countries in the North, including the US and the UK, representing just 13% of the world’s population, have bought about half of the world’s potential vaccine supplies already. High income countries have reportedly already bought 80% of the two forerunner vaccine candidates, the Pfizer/BioNTech and the Moderna vaccine.

SA is currently conducting four Covid-19 vaccine trials, but there is also no guarantee that those vaccines will go to SA first.

What’s the problem?

One of the problems with SA joining up to Covax is that, because it’s considered a middle-income country, it doesn’t get any subsidisation for joining. It has to fork out that R500 million just like other countries with much bigger pockets. Nevertheless, SA has committed to make the payment, as Mboweni explained.

There are other challenges for us down South, and for the rest of the continent. For one thing, at least one of the vaccine front-runners needs to be transported and stored at extremely low temperatures – something that will not be easy for warm countries on the continent, according to The Conversation.

But importantly, governments – including ours – are actively trying to make sure these challenges are overcome. At an ANC NEC meeting this week, Ramaphosa said SA was in the final stages of finalising its Covax membership and that the country would likely have access to a vaccine for 10% of its population by mid-2021. 

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