CORONA VIRUS

Oct. 27, 2021

Statement on the ninth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic

26 October 2021 

Statement

 

The ninth meeting of the Emergency Committee convened by the WHO Director-General under the International Health Regulations (2005) (IHR) regarding the coronavirus disease (COVID-19) pandemic took place on Friday 22 October 2021 from 13:00 to 17:05 Geneva time (CEST).

Proceedings of the meeting

Members and Advisors of the Emergency Committee were convened by videoconference.

The Director-General welcomed the Committee and thanked its members and advisers for their support and guidance throughout the COVID-19 pandemic. He highlighted the importance of the Committee’s work considering the ongoing challenges posed by the COVID-19 pandemic. The Director-General emphasized that a tailored risk-based approach of vaccination in conjunction with appropriate public health and social measures (PHSM) is needed and reiterated the global call for action to scale up vaccination to achieve 40% coverage for every country’s population by the end of 2021.

Representatives of the Office of Legal Counsel (LEG) and the Department of Compliance, Risk Management, and Ethics (CRE) briefed the members on their roles and responsibilities. The Ethics Officer from CRE provided the members and advisers with an overview of the WHO Declaration of Interests process. The members and advisers were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or direct conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each member who was present was surveyed. Two members reported changes in their professional responsibilities since the last meeting, but their new roles were assessed and not considered to generate a conflict of interest. One adviser has been appointed to WHO and will no longer participate in the Committee in his former capacity. As such, no conflicts of interest were identified.

The Secretariat turned the meeting over to the Chair, Professor Didier Houssin. Professor Houssin reviewed the objectives and agenda of the meeting.

The Secretariat presented updates on:

  • global epidemiological context and the factors driving transmission;
  • anticipated evolution of COVID-19 and forecasted potential future scenarios;
  • ongoing challenge of global COVID-19 vaccine inequity and projections for increasing COVAX Facility vaccine supply; and
  • States Parties’ increasing consistency in following recommendations regarding health measures for international traffic.  

The Committee discussed key issues including:

  • SARS-CoV-2 surveillance efforts and challenges;
  • immunity acquired through natural infection or vaccination and protection offered by both;
  • the value of intra-action reviews for States Parties to inform and enhance response efforts; and
  • the importance of maintaining risk-informed and multi-faceted PHSM.

The Committee expressed concerns over the challenges faced by the African Region in responding to the COVID-19 pandemic, including accessing sufficient vaccines, diagnostics, and therapeutics, as well as collecting, analysing, and reporting epidemiological and quality laboratory data, including genomic sequencing data, required to monitor the evolution of the COVID-19 pandemic. The Committee urged for adequate resourcing, capacity building, and technical support for the Region and its Member States to strengthen their surveillance and response efforts.

The Committee thanked WHO for its leadership in coordinating the global COVID-19 pandemic response and for its continued effort and support to States Parties in reporting on implementation of the Temporary Recommendations. The Committee highlighted the need for WHO Headquarters, Regional Offices, and Country Offices to continue supporting States Parties in implementing and reporting on Temporary Recommendations.

The Committee recognized the value of WHO’s continued coordination of short, medium, and long-term research agendas to address knowledge gaps and to respond to the evolving pandemic. Further research is needed on One Health aspects of SARS-CoV-2, tools and medical devices (such as reusable masks and respirators), and next generation vaccines, diagnostics, and therapeutics for long-term control of the pandemic. In addition, research is needed to understand the attributable impact of individual and combined PHSM in the evolving pandemic context, including aspects related to variants, host immunity from natural infection, and vaccine-derived immunity.

The Committee underlined that, while progress has been made through increased uptake of COVID-19 vaccines and therapeutics, analysis of the present situation and forecasting models indicate that the pandemic is far from finished. The Committee emphasized that there is a critical need for States Parties to continue using all available tools including PHSM, vaccination, diagnostics, therapeutics, and effective communications to control the pandemic and mitigate its negative impacts on health as well as social-economic and educational contexts. In addition, the Committee recognized that the protracted nature of the COVID-19 pandemic poses an additional burden in the context of complex humanitarian emergencies, mass migration, population displacement, and other crises. As such, the Committee suggested States Parties consider revising their preparedness and response plans and assistance policies to account for these interdependencies.

The Committee unanimously agreed that the COVID-19 pandemic still constitutes an extraordinary event that continues to adversely affect the health of populations around the world, poses a risk of international spread and interference with international traffic, and requires a coordinated international response. As such, the Committee concurred that the COVID-19 pandemic remains a public health emergency of international concern (PHEIC) and offered its advice to the Director-General.

The Director-General determined that the COVID-19 pandemic continues to constitute a PHEIC. He accepted the advice of the Committee and issued the Committee’s advice to States Parties as Temporary Recommendations under the IHR.

The Emergency Committee will be reconvened within three months or earlier, at the discretion of the Director-General. The Director-General thanked the Committee for its work.

Temporary Recommendations to States Parties

While the Committee noted that there are nuances associated with diverse regional contexts related to the implementation of the Temporary Recommendations, they identified the following as critical for all countries:

    1. MODIFIED: Continue to use evidence-informed Public Health and Social Measures (PHSM) and life-saving tools such as WHO recommended therapeutics, diagnostics, and vaccines for COVID-19.  States Parties are advised to regularly adjust their response strategies by monitoring their epidemiological situation, assessing their vulnerabilities including their health system capacity, as well as considering the adherence to and attributable impact of individual and combined PHSM. The use of masks, physical distancing, hand hygiene, and improving ventilation of indoor spaces remain key to reducing transmission of SARS CoV-2. The use of established PHSM in response to individual cases or clusters of cases, including contact tracing, quarantine and isolation, must continue to be adapted to the epidemiological and social context and enforced. Link to WHO guidance

 

    1. MODIFIED: Take a risk-based approach to mass gathering events by evaluating, mitigating, and communicating risks. Recognizing that there are different drivers and risk tolerance for mass gatherings and mass migrations, it is critical to consider the epidemiological context (including the prevalence of variants of concern, the strength of transmission, as well as contact tracing and testing capacity) when conducting this risk assessment in line with WHO guidance. In particular, fragile and vulnerable States Parties need additional support to address the challenges posed by conflicts, mass migration, or unplanned mass gatherings during the COVID-19 pandemic. Link to WHO guidance

 

    1. MODIFIED: Achieve the WHO call to action to have at least 40% of all countries’ populations vaccinated by the end of 2021. Increased global solidarity and production capacity is needed to protect vulnerable populations from the emergence and spread of SARS CoV-2 variants. States Parties are requested to share doses to increase global vaccine equity and to use a step-wise approach to vaccination, in accordance with advice from SAGE. Vaccination programmes should include vulnerable populations, including sea farers and air crews. To enhance vaccine uptake, States Parties are encouraged to assess enablers and barriers to vaccination. Link to WHO SAGE Prioritization Roadmap and SAGE Interim Statement on Booster Doses for COVID-19 Vaccination

 

    1. MODIFIED: Enhance surveillance of SARS-CoV-2 and continue to report to WHO to enable rapid identification, tracking, and evaluation of variants and continued monitoring of the pandemic’s evolution and its control. States Parties are encouraged to strengthen their surveillance systems by implementing a dual-pronged approach for acute event and molecular surveillance strategies, including timely and representative genomic surveillance data. States Parties should leverage existing national, regional, and global networks, such as the Global Influenza Surveillance and Response System, for SARS-CoV-2 surveillance. Link to WHO guidance

 

    1. EXTENDED: Maintain essential health services with sufficient funding, supplies, and human resources; strengthen health systems to cope with mental health impacts of the pandemic in adults and children, concurrent disease outbreaks, and other emergencies. Link to WHO position paper

 

    1. EXTENDED: Continue a risk-based approach to facilitate international travel and share information with WHO on use of travel measures and their public health rationale. In accordance with the IHR, measures (e.g. masking, testing, isolation/quarantine, and vaccination) should be based on risk assessments, consider local circumstances, and avoid placing the financial burden on international travellers in accordance with Article 40 of the IHR. Link to WHO guidance

 

    1. EXTENDED: Do NOT require proof of vaccination against COVID-19 for international travel as the only pathway or condition permitting international travel given limited global access and inequitable distribution of COVID-19 vaccines. State Parties should consider a risk-based approach to the facilitation of international travel by lifting or modifying measures, such as testing and/or quarantine requirements, when appropriate, in accordance with the WHO guidance. Link to WHO interim position paper and Link to WHO guidance

 

    1. MODIFIED: Recognize all vaccines that have received WHO Emergency Use Listing and all vaccine schedules as per SAGE recommendations, including in the context of international travel. Link to Explanation of WHO Emergency Use Listing and Link to WHO Emergency Use Listing

 

    1. EXTENDED: Address community engagement and communications gaps at national and local levels to reduce COVID-19 transmission, counter misinformation, and improve COVID-19 vaccine acceptance, where applicable. This will require reinforcing messages that a comprehensive public health response is needed. Link to WHO risk communications resources

 

  1. NEW: Support uptake of WHO recommended therapeutics by addressing increased accessibility and affordability. Local production and technology transfer can contribute to global equitable access to therapeutics. 

 1  https://www.who.int/teams/risk-communication

 2 https://www.who.int/activities/strengthening-partnerships-with-the-faith-community

 3  https://www.who.int/emergencies/partners

Oct. 12, 2021

WHO Director-General's opening remarks at the media briefing on COVID-19 - 7 October 2021
7 October 2021
More than 6.4 billion vaccine doses have now been administered globally, and almost one-third of the world’s population is fully vaccinated against COVID-19. But those numbers mask a horrifying inequity. Low-income countries have received less than half of one percent of the world’s vaccines. In Africa, less than 5% of people are fully vaccinated.
Today, WHO is launching the Strategy to Achieve Global COVID-19 Vaccination by mid-2022. The strategy outlines the road we must all take together to achieve our targets of vaccinating 40% of the population of every country by the end of this year, and 70% by the middle of next year.
With global vaccine production now at nearly 1.5 billion doses per month, there is enough supply to achieve our targets, provided they are distributed equitably.
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 – or AVAT – first for deliveries and donated doses. Vaccine equity will accelerate the end of the pandemic.
Yesterday, after a global consultation with patients and experts, WHO published a clinical case definition for post COVID-19 condition. This standardized definition will help clinicians to identify patients more easily and provide them the appropriate care, and is crucial for advancing recognition and research. WHO encourages all national authorities, policy makers and clinicians to adopt this definition.
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Good morning, good afternoon and good evening.

At this press conference almost exactly one year ago, I said that the world was eagerly anticipating the results of trials of vaccines against COVID-19.

And I said that once we had a vaccine, we must use it effectively, by making sure it’s available to all countries equitably.

The development and approval of vaccines in record time took us to the summit of scientific achievement; now we stand on the precipice of failure, if we don’t make the benefits of science available to all people in all countries, right now.

More than 6.4 billion vaccine doses have now been administered globally, and almost one-third of the world’s population is fully vaccinated against COVID-19.

But those numbers mask a horrifying inequity.

High- and upper-middle income countries have used 75% of all vaccines produced so far.

Low-income countries have received less than half of one percent of the world’s vaccines. In Africa, less than 5% of people are fully vaccinated.

As you know, earlier this year WHO set a target for all countries to vaccinate 10% of their populations by the end of September. 56 countries didn’t make it, through no fault of their own.

Today, WHO is launching the Strategy to Achieve Global COVID-19 Vaccination by mid-2022.

The strategy outlines the road we must all take together to achieve our targets of vaccinating 40% of the population of every country by the end of this year, and 70% by the middle of next year.

Achieving these targets will require at least 11 billion vaccine doses.

This is not a supply problem; it’s an allocation problem.

By the end of September, almost 6-and-a-half billion doses had already been administered worldwide. With global vaccine production now at nearly 1.5 billion doses per month, there is enough supply to achieve our targets, provided they are distributed equitably.

Contracts are in place for the remaining 5 billion doses. But it’s critical that those doses go where they are needed most – with priority given to older people, health workers and other at-risk groups.

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 – or AVAT – first for deliveries and donated doses.

We have the tools to bring the pandemic under control, if we use them properly and share them fairly. And we must remember that vaccines are a powerful tool, but not the only one – all countries must continue with a comprehensive, risk-based approach of public health and social measures, in combination with equitable vaccination.

Vaccine equity will accelerate the end of the pandemic. Achieving WHO’s vaccine equity targets will substantially increase population immunity globally, protect health systems, enable economies to fully restart, and reduce the risk of new variants emerging.

Today I’m delighted to be joined by the United Nations Secretary-General, António Guterres, who like us, has long called for global vaccine equity.

Secretary-General, thank you for your support and advocacy throughout the pandemic, and your special focus on vaccine equity. Welcome, and you have the floor.

[SECRETARY-GENERAL GUTERRES ADDRESSED THE MEDIA]

Thank you so much, Secretary-General Guterres, thank you for your leadership. As you said, this plan can only succeed with everyone’s cooperation.

We call on all countries to update their national COVID-19 vaccine targets and plans, to guide manufacturing investment and vaccine distribution;

We call on countries with high vaccine coverage to swap delivery schedules with COVAX and AVAT, and to fulfil their dose-sharing pledges immediately;

We call on vaccine-producing countries to allow free cross-border flow of finished vaccines and raw materials, and to enable sharing of know-how, technology and licenses;

We call on vaccine manufacturers to prioritize and fulfil contracts with COVAX and AVAT as a matter of urgency, to be more transparent on what is going where, and to share know-how and non-exclusive licenses to enable all regions to increase manufacturing capacity;

We call on civil society, community organizations and the private sector to continue to advocate local, nationally and globally for equitable access not just to vaccines, but also to tests and treatments;

We call on all countries to ensure they have the capacities in place to use all doses as rapidly and efficiently as possible;

And we call on global and regional multilateral development banks to support countries to more rapidly access the capital they need to fund vaccine delivery programmes.

===

Finally, although equitable distribution of vaccines will help to end the pandemic, its effects will continue to be felt for many years – especially for the people who have been infected and will continue to suffer from the effects of post COVID-19 condition, also known as “long COVID”.

Yesterday, after a global consultation with patients and experts, WHO published a clinical case definition for post COVID-19 condition.

The definition says that post COVID-19 condition usually occurs 3 months from the onset of COVID-19, with symptoms that last for at least 2 months, and which cannot be explained by an alternative diagnosis. Some patients have reported symptoms of post COVID-19 condition for much longer than 2 months.

Common symptoms include fatigue, shortness of breath, cognitive dysfunction, and others that have an impact on everyday functioning.

This standardized definition will help clinicians to identify patients more easily and provide them the appropriate care, and is crucial for advancing recognition and research.

WHO encourages all national authorities, policy makers and clinicians to adopt this definition.

Margaret, back to you.

Oct. 8, 2021

Publication of the ACT-Accelerator Strategic Review

The ‘Access to COVID-19 Tools (ACT) Accelerator Strategic Review: An independent report prepared by Dalberg’, was published today, Friday 8th October 2021.

This report was commissioned by the World Health Organization, on behalf of the ACT-Accelerator partners and as host of the ACT-Accelerator Hub.

The objective of the review was to inform decision-making on enhancing the ACT-Accelerator’s current functioning and its potential role beyond the first quarter of 2022, as well as to consider the mechanism’s achievements, best practices, challenges and gaps, as a basis for recommendations to enhance its future work.

More than 100 stakeholders, including industry, country, civil society, and community representatives contributed to the Strategic Review. The full results are available here [link].

The recommendations have been received by the Principals of the co-convening agencies and the Co-Chairs of the Facilitation Council and will be incorporated into the revised Strategy and Budget, which is being prepared for publication by the end of October.

Oct. 7, 2021

WHO, UN set out steps to meet world COVID vaccination targets 

  • Working with COVAX, African Vaccine Acquisition Trust and other partners – world can and must meet WHO targets to vaccinate 40% of the population of all countries by the end-2021 and 70% by mid-2022
  • Vaccine supply gaps to COVAX must be closed immediately for countries to reach the 40% year end target
  • United Nations Secretary-General and WHO Director-General call on countries and  manufacturers to make good on their commitments without further delays 

GENEVA, 7 October 2021 – The World Health Organization has today launched the Strategy to Achieve Global Covid-19 Vaccination by mid-2022  (the Strategy) to help bring an end to what has become a two-track pandemic:  people in poorer countries continue to be at risk while those in richer countries with high vaccination rates enjoy much greater protection.

WHO had set a target to vaccinate 10% of every country, economy and territory by the end of September but by that date 56 countries had not been able to do so, the vast majority of these are countries in Africa and the Middle East.

The new strategy outlines a plan for achieving WHO’s targets to vaccinate 40% of the population of every country by the end of this year and 70% by mid-2022.

“Science has played its part by delivering powerful, life-saving tools faster than for any outbreak in history,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But the concentration of those tools in the hands of a few countries and companies has led to a global catastrophe, with the rich protected while the poor remain exposed to a deadly virus. We can still achieve the targets for this year and next, but it will take a level of political commitment, action and cooperation, beyond what we have seen to date.”

“This is a costed, coordinated and credible path out of the COVID-19 pandemic for everyone, everywhere,” said United Nations Secretary-General Antonio Guterres. “Without a coordinated, equitable approach, a reduction of cases in any one country will not be sustained over time. For everyone’s sake, we must urgently bring all countries to a high level of vaccination coverage.”

To achieve the global vaccination targets, there should be 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 lastly extended vaccination of adolescents.

Vaccinating 70% of the global population requires at least 11 billion vaccine doses.   By the end of September, just over 6 billion doses had already been administered worldwide.  With global vaccine production now at nearly 1.5 billion doses per month, there is sufficient vaccine from a supply perspective to achieve the global vaccination targets provided that there is equitable distribution of those doses. 

Substantial financing has already been invested to procure most of the required vaccine doses for low- and lower-middle-income countries through COVAX, the African Vaccine Acquisition Trust (AVAT) and bilateral contracts.  There needs to be additional investment to secure the remaining vaccine doses for these countries as well as investment to support in-country delivery.  

The Strategy outlines the priority actions needed from the different actors to achieve the targets.

All Countries must:

  • Establish updated national COVID-19 vaccine targets and plans defining dose requirements to guide manufacturing investment and vaccine redistribution, and financial and programmatic resource needs to guide internal planning and external support;
  • Monitor vaccine demand and uptake carefully to rapidly adapt services and ensure continuity of vaccine supplies;
  • Commit to equitable distribution of vaccines in line with the WHO three-step approach;
  • Revise national vaccination strategies, policies and prioritization as needed to harness emerging evidence to maximize the impact of existing, modified and new vaccines.

Countries with high vaccine coverage must:

  • Swap vaccine delivery schedules, with COVAX and AVAT to enhance coverage in countries in need;
  • Fulfil and accelerate vaccine dose-sharing and donation commitments to COVAX in the near term, for those with existing pledges;
  • Establish new dose-sharing commitments to facilitate progress toward the 70% coverage target in every country.

Vaccine-producing countries must:

  • Allow the free cross-border flow of finished vaccines and raw materials;
  • Enable diversified vaccine production, both geographically and technologically, including through non-exclusive, and transparent licensing and sharing of know-how to allow transfer of technology and scale-up of manufacturing.  

COVID-19 vaccine manufacturers must:

  • Prioritize and fulfil COVAX and AVAT contracts as a matter of urgency;
  • Provide full transparency on the overall monthly production of COVID-19 vaccines and clear monthly schedules for supplies to COVAX, AVAT and low and low-middle income countries, to enable proper global and national-level planning and optimal use of scarce supplies;
  • Actively engage and work with countries that have high coverage and that have contracted high volumes of vaccines to allow the prioritization of COVAX and AVAT contracts, including through delivery schedule swaps, and facilitate rapid and early dose-sharing;
  • Commit to share know-how more rapidly, facilitate technology transfer and provide transparent non-exclusive voluntary licenses, to ensure that future vaccine supply is reliable, affordable, available, and deployed to every country in volumes and timing that achieves equitable access.

Civil Society, community organizations, and the private sector must:

  • Advocate locally, nationally and internationally for equitable access to COVID-19 vaccines, tests and treatments, calling for and monitoring in particular the specific actions required of manufacturers, governments and multilateral actors;
  • Mobilize and empower communities, including through social media and community networks, to generate strong vaccine demand and address misinformation and misperceptions that contribute to vaccine hesitancy;
  • Provide support to the in-country delivery of vaccination programmes and services.

Global and regional multilateral development banks and institutions must:

  • Enable countries to more rapidly access the capital and external support needed for in-country vaccine delivery, prioritizing low-income settings and especially targeting support to the technical, logistics and human resources required;
  • Engage fully with COVAX/ACT-Accelerator and AVAT, with integrated operations and real-time sharing of information to truly support equitable access;
  • Support international procurement and allocation mechanisms to enable all countries to equitably, efficiently and rapidly achieve the COVID-19 vaccine targets;
  • Support vaccine distribution plans and a campaign to convey the life-saving importance of approved COVID-19 vaccinations.

For their part, WHO, Gavi, UNICEF and CEPI must work in close collaboration with World Bank, World Trade Organization, International Monetary Fund, Africa CDC, AVAT, and other key partners to monitor progress, identify changes needed to resolve bottlenecks, coordinate information and prioritize actions; continue to co-lead and manage the COVAX Pillar of ACT-Accelerator; support the equitable allocation of available vaccines, particularly to low-, lower-middle-income and lagging countries; directly support countries to develop and sustain rapid, effective, high-quality COVID-19 vaccine delivery programmes that can achieve the global targets; address key research, policy, safety and regulatory issues that will optimize vaccine impact including effective supply, dosing and vaccine schedules, mixing and matching of products, protection against variants, and other issues; and monitor and report monthly on progress towards the global COVID-19 vaccination goals.

 

Oct. 7, 2021

WHO, UN set out steps to meet world COVID vaccination targets 

  • Working with COVAX, African Vaccine Acquisition Trust and other partners – world can and must meet WHO targets to vaccinate 40% of the population of all countries by the end-2021 and 70% by mid-2022
  • Vaccine supply gaps to COVAX must be closed immediately for countries to reach the 40% year end target
  • United Nations Secretary-General and WHO Director-General call on countries and  manufacturers to make good on their commitments without further delays 

GENEVA, 7 October 2021 – The World Health Organization has today launched the Strategy to Achieve Global Covid-19 Vaccination by mid-2022  (the Strategy) to help bring an end to what has become a two-track pandemic:  people in poorer countries continue to be at risk while those in richer countries with high vaccination rates enjoy much greater protection.

WHO had set a target to vaccinate 10% of every country, economy and territory by the end of September but by that date 56 countries had not been able to do so, the vast majority of these are countries in Africa and the Middle East.

The new strategy outlines a plan for achieving WHO’s targets to vaccinate 40% of the population of every country by the end of this year and 70% by mid-2022.

“Science has played its part by delivering powerful, life-saving tools faster than for any outbreak in history,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “But the concentration of those tools in the hands of a few countries and companies has led to a global catastrophe, with the rich protected while the poor remain exposed to a deadly virus. We can still achieve the targets for this year and next, but it will take a level of political commitment, action and cooperation, beyond what we have seen to date.”

“This is a costed, coordinated and credible path out of the COVID-19 pandemic for everyone, everywhere,” said United Nations Secretary-General Antonio Guterres. “Without a coordinated, equitable approach, a reduction of cases in any one country will not be sustained over time. For everyone’s sake, we must urgently bring all countries to a high level of vaccination coverage.”

To achieve the global vaccination targets, there should be 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 lastly extended vaccination of adolescents.

Vaccinating 70% of the global population requires at least 11 billion vaccine doses.   By the end of September, just over 6 billion doses had already been administered worldwide.  With global vaccine production now at nearly 1.5 billion doses per month, there is sufficient vaccine from a supply perspective to achieve the global vaccination targets provided that there is equitable distribution of those doses. 

Substantial financing has already been invested to procure most of the required vaccine doses for low- and lower-middle-income countries through COVAX, the African Vaccine Acquisition Trust (AVAT) and bilateral contracts.  There needs to be additional investment to secure the remaining vaccine doses for these countries as well as investment to support in-country delivery.  

The Strategy outlines the priority actions needed from the different actors to achieve the targets.

All Countries must:

  • Establish updated national COVID-19 vaccine targets and plans defining dose requirements to guide manufacturing investment and vaccine redistribution, and financial and programmatic resource needs to guide internal planning and external support;
  • Monitor vaccine demand and uptake carefully to rapidly adapt services and ensure continuity of vaccine supplies;
  • Commit to equitable distribution of vaccines in line with the WHO three-step approach;
  • Revise national vaccination strategies, policies and prioritization as needed to harness emerging evidence to maximize the impact of existing, modified and new vaccines.

Countries with high vaccine coverage must:

  • Swap vaccine delivery schedules, with COVAX and AVAT to enhance coverage in countries in need;
  • Fulfil and accelerate vaccine dose-sharing and donation commitments to COVAX in the near term, for those with existing pledges;
  • Establish new dose-sharing commitments to facilitate progress toward the 70% coverage target in every country.

Vaccine-producing countries must:

  • Allow the free cross-border flow of finished vaccines and raw materials;
  • Enable diversified vaccine production, both geographically and technologically, including through non-exclusive, and transparent licensing and sharing of know-how to allow transfer of technology and scale-up of manufacturing.  

COVID-19 vaccine manufacturers must:

  • Prioritize and fulfil COVAX and AVAT contracts as a matter of urgency;
  • Provide full transparency on the overall monthly production of COVID-19 vaccines and clear monthly schedules for supplies to COVAX, AVAT and low and low-middle income countries, to enable proper global and national-level planning and optimal use of scarce supplies;
  • Actively engage and work with countries that have high coverage and that have contracted high volumes of vaccines to allow the prioritization of COVAX and AVAT contracts, including through delivery schedule swaps, and facilitate rapid and early dose-sharing;
  • Commit to share know-how more rapidly, facilitate technology transfer and provide transparent non-exclusive voluntary licenses, to ensure that future vaccine supply is reliable, affordable, available, and deployed to every country in volumes and timing that achieves equitable access.

Civil Society, community organizations, and the private sector must:

  • Advocate locally, nationally and internationally for equitable access to COVID-19 vaccines, tests and treatments, calling for and monitoring in particular the specific actions required of manufacturers, governments and multilateral actors;
  • Mobilize and empower communities, including through social media and community networks, to generate strong vaccine demand and address misinformation and misperceptions that contribute to vaccine hesitancy;
  • Provide support to the in-country delivery of vaccination programmes and services.

Global and regional multilateral development banks and institutions must:

  • Enable countries to more rapidly access the capital and external support needed for in-country vaccine delivery, prioritizing low-income settings and especially targeting support to the technical, logistics and human resources required;
  • Engage fully with COVAX/ACT-Accelerator and AVAT, with integrated operations and real-time sharing of information to truly support equitable access;
  • Support international procurement and allocation mechanisms to enable all countries to equitably, efficiently and rapidly achieve the COVID-19 vaccine targets;
  • Support vaccine distribution plans and a campaign to convey the life-saving importance of approved COVID-19 vaccinations.

For their part, WHO, Gavi, UNICEF and CEPI must work in close collaboration with World Bank, World Trade Organization, International Monetary Fund, Africa CDC, AVAT, and other key partners to monitor progress, identify changes needed to resolve bottlenecks, coordinate information and prioritize actions; continue to co-lead and manage the COVAX Pillar of ACT-Accelerator; support the equitable allocation of available vaccines, particularly to low-, lower-middle-income and lagging countries; directly support countries to develop and sustain rapid, effective, high-quality COVID-19 vaccine delivery programmes that can achieve the global targets; address key research, policy, safety and regulatory issues that will optimize vaccine impact including effective supply, dosing and vaccine schedules, mixing and matching of products, protection against variants, and other issues; and monitor and report monthly on progress towards the global COVID-19 vaccination goals.