The World Health Organization (WHO) believes that is possible to get 70% of the world vaccinated against COVID-19 by June – but only if wealthy countries redirect their doses and orders to poorer countries that are lagging behind.

Eleven billion vaccines are needed to reach the 70% target, said WHO Director-General Dr Tedros Adhanom Ghebreyesus at the launch of the global body’s Strategy to Achieve Global Covid-19 Vaccination by mid-2022.

More than 6.4 billion doses had already been administered globally, and one-third of the world’s population is fully vaccinated against COVID-19,” said Tedros.

“Contracts are in place for the remaining five billion doses, but it’s critical that those go where they are needed most, with priority given to older people, health workers and other at-risk groups,” said Tedros.

“We can only achieve our targets if the countries and companies that control vaccine supply put contracts for COVAX, and the African Vaccine Acquisition Trust (AVAT) first for deliveries, and donated doses.”

Tedros added that there was “horrifying inequity” as high and upper-middle-income countries had used 75% of all vaccines produced so far while low-income countries have received “less than half of 1% of the world’s vaccines”.

Earlier this year, WHO set three global vaccination targets to end the pandemic: 10% of the world’s population vaccinated by the end of September, 40% by December and 70% by next June.

Failed to meet 10% target

But 56 countries, mostly in Africa and the Middle East, failed to meet the 10% target last month. The average vaccination rate in Africa is 4.4%.

However, WHO’s Dr Kate O’Brien, head of vaccines and immunisation, said that around 200 million vaccines were needed for all countries to reach 10% coverage – less than a week’s production, as around 1.5 billion vaccine doses are being produced every month.

Bruce Aylward, Tedros’ special adviser, added that 40% of people were already fully vaccinated in North America, South America and Asia, while the Western Pacific was close to that. 

“Of course, the problem in sub-Saharan Africa,” said Aylward. “There’s enough vaccine in the world, but we have a distribution and delivery problem. If we can’t solve that problem in 12 weeks, that speaks poorly for the urgency we need to end the pandemic.” 

He challenged every country with over 40% coverage, saying that if they were not prioritising helping lower-income unvaccinated parts of the world and COVAX then “they’re simply not doing enough to help achieve global equity”. 

‘Costed, coordinated and credible’

Describing the WHO strategy as a “costed, coordinated and credible path out of the COVID-19 pandemic for everyone, everywhere”, United Nations Secretary-General António Guterres said that $8-billion was needed to meet the 70% target, both to buy doses and support in-country delivery.  

Guterres expressed frustration that neither the UN nor the WHO had the power to compel wealthy countries or vaccine manufacturers to distribute vaccines fairly.

“I’ve long been pushing for a global vaccination plan to reach everyone everywhere sooner rather than later; a plan that should be implemented by an emergency task force made up of present and potential vaccine production countries, the WHO, COVAX partners, international financial institutions, working with the pharmaceutical companies to guarantee the production of enough doses and their equitable distribution,” said Guterres.

“Unfortunately, I have not been heard. Yet instead of global, coordinated action to get vaccines where they are needed most, we have seen vaccine hoarding, vaccine nationalism and vaccine diplomacy.”

He warned that vaccine inequality is the best ally of the COVID-19 pandemic. 

“It’s allowing variants to develop and run wild condemning the world to millions more deaths and prolonging an economic slowdown that could cost trillions of dollars,” said Guterres.

Three steps

The WHO strategy proposes a three-step approach to vaccination, with all older adults, health workers, and high-risk groups of all ages, in every country vaccinated first, followed by the full adult age group in every country and finally adolescents.

It directs all member states to establish updated national COVID-19 vaccine targets and plans that “define dose requirements to guide manufacturing investment and vaccine redistribution”.

It appeals to countries with high vaccine coverage to swap their vaccine deliveries with COVAX and AVAT, accelerate donation commitments, and establish new dose-sharing commitments aimed at reaching the 70% target in every country.

It also calls for COVID-19 vaccine manufacturers to prioritize and fulfil COVAX and AVAT contracts, and be transparent about their monthly production.

 “We’ve heard the commitments. We’ve heard the talk. The DG has called for actions, and those are very clear in the strategy,” said O’Brien.

“Countries that have a substantial number of doses already and have achieved high vaccine coverage can swap their place in line for additional doses for the coming weeks and the coming months. The critical feature here is to get the doses to those places that are still lagging behind the target. The second part of this is that funding is needed for those countries to actually deliver the doses.”

Image Credits: WHO.