GAVI pleads for urgency as COVID-19 firms up in Africa

By Henry Opondo

With the COVID-19 pandemic already affecting 47 Gavi-supported countries mostly in Africa, Gavi, the Vaccine Alliance has taken new steps to help strengthen the preparedness of health systems in lower-income countries with the full support of its Board.

According to the WHO, at least 33 African countries had reported more than 600 cases and 17 deaths due to COVID-19, the disease caused by the new coronavirus. More than 40 people have recovered.

Gavi will also be working closely with WHO, CEPI, World Bank, UNICEF and other partners to create the optimal conditions for the acceleration of priority candidate vaccines with a focus on access. This includes assuring adequate scale-up of production and delivery to be sure the vaccine gets to where it is needed to stem the pandemic.

“We have already seen the impact COVID-19 can have on health systems in wealthier countries; in countries with already fragile health systems it could be catastrophic,” said Dr Ngozi Okonjo-Iweala, Chair of the Gavi Board. “As has become brutally clear in recent months, this disease doesn’t respect borders, which is why it will take a truly global response to defeat it. Gavi is making funding immediately available for lower-income countries to respond to the crisis. Routine immunisation against other deadly diseases like measles, yellow fever and diphtheria also must continue – we cannot have two global outbreaks on our hands.”

“The rapid evolution of COVID-19 in Africa is deeply worrisome and a clear signal for action,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “But we can still change the course of this pandemic. Governments must draw on all of their resources and capabilities and strengthen their response.” 

Twelve countries in the African region are now experiencing local transmission. It is crucial that governments prevent local transmission from evolving into a worst-case scenario of widespread sustained community transmission. Such a scenario will present a major challenge to countries with weak health systems.

“Africa can learn from the experiences of other countries which have seen a sharp decline in COVID-19 cases through rapidly scaling up testing, isolating cases and meticulously tracking contacts,” said Dr Moeti. 

Under the new measures, countries that qualify for Gavi support will be able to quickly reallocate up to 10% of grants extended to them under Gavi’s Health Systems Strengthening programme to respond to the threat posed by COVID-19. This would allow countries to fill critical gaps in areas such as hygiene and infection control training for health workers, infection control supplies, surveillance and laboratory testing whilst they wait for specific funds being allocated by the global community for the COVID-19 response. Gavi is exploring providing additional flexibility on reallocation of funds.

Currently, 21 countries have expressed an interest in reallocating resources under this initiative. As a priority, Gavi will work with countries to try and mitigate any risk COVID-19 poses to routine immunisation programmes in the countries that it supports. By allowing funding to be reallocated towards meeting the threat of COVID-19, Gavi is helping countries to reduce the overall burden of the pandemic on their health systems. This aims to reduce the risk that routine immunizations will be disrupted, leading to even more unnecessary loss of life and strain on the health system.

In addition to strengthening health systems, the Gavi Board reinforced that the organisation collaborate with Alliance members to create the optimal conditions for the identification of priority candidate vaccines with a focus on access. Board members also expressed support for the use of Gavi’s innovative financing instruments, such as IFFIm and Gavi’s Advance Market Commitment to accelerate vaccine development and access where needed. These mechanisms are live and ready to go having already proved their worth by providing billions of dollars in financing for vaccine scale-up and delivery to 60% of the world’s children.

As well as working with international stakeholders and Alliance partners to accelerate and scale up vaccine development and delivery, Board members proposed adopting a country-led approach to start preparing now for deployment of a vaccine once one becomes available. These include working with Alliance partners to ensure availability and ultimately procurement of an adequate supply of vaccines for the world’s poorest countries thanks to Gavi’s market-shaping experience. 

In reiterating support for Gavi’s third donor pledging conference, to be hosted by the UK Government on 3-4 June 2020 to mobilise at least US$ 7.4 billion in additional resources to protect the next generation with vaccines, Board members also challenged Gavi to find new ways of using its platform to assist in finding a solution to the most serious public health crisis in a lifetime.

“Though a COVID-19 vaccine is at least 18 months away, we need to start thinking now about how it will be scaled up and deployed,” said Dr Seth Berkley, Gavi CEO. “Demand for any vaccine is likely to be so high so unless we plan ahead there is a real risk it ends up in the hands of just a few countries. If this happens, it is a recipe for disaster, ensuring the disease continues to circulate globally well after a means of stopping it is developed. That is why we will be urgently exploring mechanisms and incentives to ensure vaccines are available to the most vulnerable, no matter where they live.”

Gavi’s engagement in the global response to COVID-19 is consistent with a commitment made by the G7 group of nations on March 16 to, “support the launch of joint research projects funded by both public and private resources, and the sharing of facilities, towards rapid development, manufacture and distribution of treatments and a vaccine, adhering to the principles of efficacy, safety, and accessibility.”

The G7 leaders’ statement, in affirming its support for WHO’s leadership in tackling disease outbreaks and emergencies, also called for “no geographical vacuum” to be allowed in the global effort for preparedness and response.

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