Tag Archives: WHO

U.S. plans to give extra COVID-19 shots to at-risk Americans – Fauci

By Trevor Hunnicutt and Carl O’Donnell

WASHINGTON (Reuters) – The United States is working to give additional COVID-19 booster shots to Americans with compromised immune systems as quickly as possible, as cases of the novel coronavirus continue to rise, top U.S. infectious disease expert Dr. Anthony Fauci said Thursday.

The United States is joining Germany, France and Israel in giving booster shots, ignoring a plea by the World Health Organization to hold off until more people around the world can get their first shot.

U.S. regulators need to fully authorize the COVID-19 vaccines or amend their emergency use authorizations before officials can recommend additional shots, but the U.S. Centers for Disease Control and Prevention is working to make third doses available sooner under certain circumstances, officials said at a July meeting.

“It is extremely important for us to move to get those individuals their boosters and we are now working on that,” Fauci said on a press call, adding that immunocompromised people may not be sufficiently protected by their existing COVID-19 vaccinations.

Fauci said rising cases resulting from the spread of the contagious Delta variant in the United States can be turned around with additional vaccinations.

The Biden administration has been eager to thaw opposition by some Americans, including those who distrust the government, to taking the vaccine as the highly infectious Delta variant sweeps the country.

Seven U.S. states with the lowest COVID-19 vaccination rates account for half of the country’s new cases and hospitalizations in the last week, the White House said on Thursday.

The states are Florida, Texas, Missouri, Arkansas, Louisiana, Alabama and Mississippi, according to President Joe Biden’s COVID-19 coordinator, Jeff Zients, who spoke at the press briefing

Of those, Florida and Texas account for about a third of new coronavirus cases and an even higher share of hospitalizations in the country.

COVID cases are up about 43% over the previous week and daily deaths are up more than 39%, according to U.S. Centers for Disease Control and Prevention Director Dr. Rochelle Walensky, who also spoke on the call.

The United States hit a six-month high for new COVID cases with over 100,000 infections reported on Wednesday, according to a Reuters tally.

Some 864,000 vaccinations have been given in the past 24 hours, the highest since early July, the White House said.

Zients said the Biden administration supports U.S. businesses and other institutions requiring that their employees get vaccinated.

He added that the White House is considering requiring foreign visitors to be vaccinated as it plans to eventually reopen international travel but said it had made no final decision.

(Reporting by Jeff Mason, Susan Heavey, Carl O’Donnell and Trevor Hunnicutt; editing by Jonathan Oatis and Lisa Shumaker)

WHO’s pandemic project faces cash crunch amid vaccine, oxygen shortages

By Francesco Guarascio

BRUSSELS (Reuters) – The World Health Organization (WHO) is seeking $11.5 billion in urgent funding to fight the more infectious Delta variant of the coronavirus, a draft report seen by Reuters shows, amid worries wealthy nations are partly bypassing its COVID-19 programs.

A large portion of the cash being requested from the WHO’s partners is needed to buy tests, oxygen and face masks in poorer nations, says the document which is expected to be released this week. And a quarter of it would be to buy hundreds of millions of vaccines for them that would otherwise go elsewhere.

The paper, still subject to changes, outlines the results and financial needs of the Access to COVID-19 Tools Accelerator (ACT-A), the program co-led by the WHO to distribute fairly COVID-19 vaccines, drugs and tests across the world.

The program, set up at the start of the pandemic, remains vastly underfunded, and its coordinators are now acknowledging it will remain so as many governments look to address global COVID needs “differently,” an ACT-A official told Reuters, speaking on condition of anonymity.

As a result, it has cut by nearly $5 billion its total request for funds, the document shows. But it still needs $16.8 billion, almost as much as what has been raised so far, and $7.7 billion is required urgently.

The document also calls for a further $3.8 billion, on top of the $7.7 billion, to take up options for 760 million doses of COVID-19 vaccines that would be delivered next year.

“These options to buy need to be exercised in the coming months or vaccine doses will be lost,” the document warns.

WHO Director-General Tedros Adhanom Ghebreyesus last week said that $7.7 billion were urgently needed, but did not give a breakdown of planned spending, and did not say how much extra money was needed for vaccines.

The WHO was not immediately available to comment.

The latest cash crunch will underscore concerns about the long-term future of the program, which has struggled to secure supplies and equipment to tame a pandemic that has killed more than 4.2 million.

The vaccine portion of the project, called COVAX, is increasingly reliant on donations from wealthy nations, rather than its own supplies, after key manufacturer India restricted exports of shots to boost domestic vaccinations.

But the United States, European Union and Japan have also donated vaccines directly to countries as part of their vaccine diplomacy drives. Japan has also said it’s a quicker process than going through COVAX.

Some countries have provided equipment directly to others too. Last month, Australia said it would donate oxygen-related equipment, antigen test-kits as well as vaccines to Indonesia.

The plea for cash comes as a review of the ACT-A gets under way, with France, Germany and Canada among the countries steering the process. A report on the program’s results and shortcomings is expected in September by consultancy Dalberg Global Development Advisors, the ACT-A official said.

OXYGEN NEEDS

Among ACT-A’s immediate needs are $1.2 billion for oxygen to treat seriously ill COVID-19 patients in poorer countries where supplies are low, the report says.

Oxygen has moved up the priority list given vaccines are not available, the ACT-A official said, highlighting the repercussions from the shortage of shots as the Delta variant spreads to 132 countries.

COVAX has delivered about 180 million vaccines, far short of its 2 billion target by the end of this year.

Oxygen is needed to “control the exponential death surges caused by the Delta variant,” the document says.

Global demand for medical oxygen is currently more than a dozen times greater than before the pandemic, the document says, but many countries are struggling to access sufficient supplies.

The urgent need for the most basic treatment against COVID-19 one and a half years into the pandemic shows how little has been done to combat the virus in most of the world, the ACT-A official said, noting: “There hasn’t been much progress. What was urgent three months ago is still urgent now.”

“Inequity in access to life-saving COVID-19 tools has never been more apparent,” the document says.

In rich nations, most people have already been vaccinated, including the younger who are less at risk from COVID-19, whereas in poorer nations the most vulnerable are still waiting for a first dose and there is a lack of basic materials, such as face masks and other personal protective equipment (PPE).

“Avoidable death and unsustainable pressure on health systems is mounting in many countries due to insufficient access to oxygen and PPE,” the document says.

At least $1.7 billion are urgently needed to buy protective devices for healthcare workers in poorer nations, the document says, and another $2.4 billion are needed to boost testing in low-income countries.

(Reporting by Francesco Guarascio @fraguarascio; Editing by Josephine Mason and Mark Potter)

China rejects WHO plan for study of COVID-19 origin

By Gabriel Crossley

BEIJING (Reuters) -China rejected on Thursday a World Health Organization (WHO) plan for a second phase of an investigation into the origin of the coronavirus, which includes the hypothesis it could have escaped from a Chinese laboratory, a top health official said.

The WHO this month proposed a second phase of studies into the origins of the coronavirus in China, including audits of laboratories and markets in the city of Wuhan, calling for transparency from authorities.

“We will not accept such an origins-tracing plan as it, in some aspects, disregards common sense and defies science,” Zeng Yixin, vice minister of the National Health Commission (NHC), told reporters.

Zeng said he was taken aback when he first read the WHO plan because it lists the hypothesis that a Chinese violation of laboratory protocols had caused the virus to leak during research.

The head of the WHO said earlier in July that investigations into the origins of the COVID-19 pandemic in China were being hampered by the lack of raw data on the first days of spread there.

Zeng reiterated China’s position that some data could not be completely shared due to privacy concerns.

“We hope the WHO would seriously review the considerations and suggestions made by Chinese experts and truly treat the origin tracing of the COVID-19 virus as a scientific matter, and get rid of political interference,” Zeng said.

China opposed politicizing the study, he said.

The origin of the virus remains contested among experts.

The first known cases emerged in the central Chinese city of Wuhan in December 2019. The virus was believed to have jumped to humans from animals being sold for food at a city market.

In May, U.S. President Joe Biden ordered aides to find answers to questions over the origin, saying that U.S. intelligence agencies were pursuing rival theories potentially including the possibility of a laboratory accident in China.

White House press secretary Jen Psaki said on Thursday that the Biden administration is “deeply disappointed” in China’s decision and told reporters that “their position is irresponsible and, frankly, dangerous.”

Zeng, along with other officials and Chinese experts at the news conference, urged the WHO to expand origin-tracing efforts beyond China to other countries.

“We believe a lab leak is extremely unlikely and it is not necessary to invest more energy and efforts in this regard,” said Liang Wannian, the Chinese team leader on the WHO joint expert team. More animal studies should be conducted, in particular in countries with bat populations, he said.

However, Liang said the lab leak hypothesis could not be entirely discounted but suggested that if evidence warranted, other countries could look into the possibility it leaked from their labs.

One key part of the lab leak theory has centered on the Wuhan Institute of Virology’s (WIV) decision to take offline its gene sequence and sample databases in 2019.

When asked about this decision, Yuan Zhiming, professor at WIV and the director of its National Biosafety Laboratory, told reporters that at present the databases were only shared internally due to cyber attack concerns.

(Reporting by Gabriel Crossley and Stella Qiu; Additional reporting by Jeff Mason and Trevor Hunnicutt in Washington; Editing by Shri Navaratnam, Robert Birsel, Ana Nicolaci da Costa and Steve Orlofsky)

India’s excess deaths during pandemic up to 4.9 million, study shows

By Ankur Banerjee and Neha Arora

(Reuters) -India’s excess deaths during the COVID-19 pandemic could be as high as 4.9 million, a new study shows, providing further evidence that millions more may have died from coronavirus than the official tally.

The report by the Washington-based Center for Global Development, co-authored by India’s former chief economic adviser Arvind Subramanian, included deaths from all causes since the start of the pandemic through June this year.

India’s official tally of more than 414,000 deaths is the world’s third highest after the United States and Brazil, but the study adds to growing calls from experts for a rigorous nationwide audit of fatalities.

A devastating rise in infections in April and May, driven largely by the more infectious and dangerous Delta variant, overwhelmed the healthcare system and killed at least 170,000 people in May alone, official data show.

“What is tragically clear is that too many people, in the millions rather than hundreds of thousands, may have died,” the report said, estimating between 3.4 million and 4.9 million excess deaths during the pandemic.

But it did not ascribe all excess deaths to the pandemic.

“We focus on all-cause mortality, and estimate excess mortality relative to a pre-pandemic baseline, adjusting for seasonality,” the authors said.

The health ministry did not immediately respond to a Reuters email seeking comment.

Some experts have said excess deaths are the best way to measure the real toll from COVID-19.

“For every country, it’s important to capture excess mortality – the only way to prepare the health system for future shocks and to prevent further deaths,” Soumya Swaminathan, the chief scientist of the World Health Organization, said on Twitter.

The New York Times said the most conservative estimate of deaths in India was 600,000 and the worst-case scenario several times that. The government has dismissed those figures.

Health experts blame the undercounting largely on scarce resources in the vast hinterland home to two-thirds of India’s population of nearly 1.4 billion, and also many deaths at home without being tested.

India has reported a decline in daily infections from a May peak, with Tuesday’s 30,093 new cases making up its lowest daily count in four months.

Prime Minister Narendra Modi’s government has also been criticized for a messy vaccination campaign that many say helped worsen the second wave of infections.

Just over 8% of eligible adult Indians have received both vaccine doses.

In July, the government administered fewer than 4 million daily doses on average, down from a record 9.2 million on June 21, when Modi flagged off a free campaign to inoculate all 950 million adults.

(Reporting by Ankur Banerjee in Bengaluru and Neha Arora in New Delhi; Editing by Clarence Fernandez and Giles Elgood)

Vietnam to mix doses of Pfizer, AstraZeneca COVID-19 vaccines

HANOI(Reuters) – Vietnam will offer the coronavirus vaccine jointly developed by Pfizer and BioNTech as a second dose option for people first inoculated with the AstraZeneca vaccine, the government said on Tuesday.

Vietnam’s mass inoculation campaign is in its early stages, with fewer than 300,000 people fully vaccinated so far. It has so far used AstraZeneca’s viral vector vaccine and last week took delivery of 97,000 doses of the Pfizer-BioNTech mRNA shot.

“Pfizer vaccines will be prioritized for people who were given first shot of AstraZeneca 8-12 weeks before,” the government said in a statement.

Several countries, including Canada, Spain and South Korea, have already approved such dose-mixing mainly due to concerns about rare and potentially fatal blood clots linked to the AstraZeneca vaccine.

A Spanish study found the Pfizer-AstraZeneca combination was highly safe and effective, according to preliminary results.

But the World Health Organization’s chief scientist advised on Monday against mixing and matching COVID-19 vaccines, calling it a “dangerous trend” since there was little data available about the health impact.

The Vietnamese government in a separate statement said its health ministry was in talks with India to secure 15 million doses of COVID-19 vaccine Covaxin.

The country has so far received around 8 million doses of vaccines from multiple sources, including international COVAX scheme, donations and its own purchases.

Vietnam has been trying to expedite its vaccination campaign as the pace of infections grow, having hit daily records eight times this month. It reported 2,031 new infections on Tuesday, most of those in the epicenter Ho Chi Minh City.

Prior to May 2021, it had recorded less than 3,000 coronavirus cases in total. Its caseload is now 34,500, with 130 deaths.

Vietnam said on Tuesday it would soon receive 1.5 million doses of the AstraZeneca vaccine donated by Australia and an additional batch of one million doses of the vaccine from Japan this week.

(Editing by Ed Davies and Martin Petty)

WHO committee calls for gene editing tools to be shared with poorer nations

By Ludwig Burger

FRANKFURT (Reuters) -A World Health Organization (WHO) committee said on Monday that human genome editing technologies to treat serious disease should be shared more generously, to allow poorer nations to benefit from the highly dynamic scientific field.

“WHO should work with others to encourage relevant patent holders to help ensure equitable access to human genome editing interventions,” the 18-member committee said in a report, which covered a wide range of governance structures and processes.

The panel of gene editing experts was established in late 2018 after a Chinese scientist said he had edited the genes of twin babies to make then resistant to HIV infection.

Underlining the WHO’s existing stance, the report strongly opposed making modifications to the genetic code in humans that would be passed on to future generations, known as heritable germline genome editing.

“No-one in their right mind should contemplate doing it because the techniques are simply not safe enough or efficient enough and we’re not ready in terms of looking at all the ethical considerations,” said Robin Lovell Badge of Britain’s Francis Crick Institute, a committee member.

But the technology, with the CRISPR/Cas9 ‘genetic scissors’ as its most prominent tool, also holds the promise of curing diseases such as HIV or sickle-cell disease and boosting fundamental medical knowledge, and unequal access could cement global disparities, the panel warned.

“The danger in fully implementing intellectual property as we know it,” would be that rich countries benefit while poor countries bear the main burden of diseases such as sickle cell anemia, Anne Wangari Thairu-Muigai of Kenja’s Jomo Kenyatta University of Agriculture and Technology, told a press briefing.

Intellectual property in medicine became a contested issue when U.S. President Joe Biden in May proposed a temporary waiver of vaccine patents to make anti-COVID-19 shots more quickly available in low-income countries.

Pharmaceutical companies and other countries have argued such a step would be ineffective and risks discouraging work on future health technologies.

Seeking to head off irresponsible human gene modification, the panel also warned it should only be conducted where sufficient policies and oversight are in place, raising the specter of rogue clinics attracting medical tourism to loosely regulated countries with purported therapies or clinical trials.

Specific rules, however, could be a while in the making as WHO said its Science Division would be given up to 3 years to initiate an extensive review of the recommendations, while the review itself could take as long as 18 months.

(Reporting by Ludwig Burger; Editing by Toby Chopra)

Taliban say they control 85% of Afghanistan, humanitarian concerns mount

KABUL/ MOSCOW (Reuters) -Taliban officials said on Friday the Sunni Muslim insurgent group had taken control of 85% of territory in Afghanistan, and international concern mounted over problems getting medicines and supplies into the country.

Afghan government officials dismissed the assertion that the Taliban controlled most of the country as part of a propaganda campaign launched as foreign forces, including the United States, withdraw after almost 20 years of fighting.

But local Afghan officials said Taliban fighters, emboldened by the withdrawal, had captured an important district in Herat province, home to tens of thousands of minority Shi’ite Hazaras.

Torghundi, a northern town on the border with Turkmenistan, had also been captured by the Taliban overnight, Afghan and Taliban officials said.

Hundreds of Afghan security personnel and refugees continued to flee across the border into neighboring Iran and Tajikistan, causing concern in Moscow and other foreign capitals that radical Islamists could infiltrate Central Asia.

Three visiting Taliban officials sought to address those concerns during a visit to Moscow.

“We will take all measures so that Islamic State will not operate on Afghan territory… and our territory will never be used against our neighbors,” one of the Taliban officials, Shahabuddin Delawar, told a news conference.

He said “you and the entire world community have probably recently learned that 85% of the territory of Afghanistan has come under the control” of the Taliban.

The same delegation said a day earlier that the group would not attack the Tajik-Afghan border, the fate of which is in focus in Russia and Central Asia.

Asked about how much territory the Taliban held, Pentagon spokesman John Kirby declined direct comment.

“Claiming territory or claiming ground doesn’t mean you can sustain that or keep it over time” he said in an interview with CNN. “And so I think it’s really time for the Afghan forces to get into the field – and they are in the field – and to defend their country, their people.”

“They’ve got the capacity, they’ve got the capability. Now it’s time to have that will,” he said.

HUMANITARIAN CONCERNS

As fighting continued, a World Health Organization (WHO) official said health workers were struggling to get medicines and supplies into Afghanistan, and that some staff had fled after facilities came under attack.

The WHO’s regional emergencies director, Rick Brennan, said at least 18.4 million people require humanitarian assistance, including 3.1 million children at risk of acute malnutrition.

“We are concerned about our lack of access to be able to provide essential medicines and supplies and we are concerned about attacks on health care,” Brennan, speaking via video link from Cairo, told a U.N. briefing in Geneva.

Some aid will arrive by next week including 3.5 million COVID-19 vaccine doses and oxygen concentrators, he said. They included doses of Johnson & Johnson’s shot donated by the United States and AstraZeneca doses through the COVAX facility.

A U.S. donation of more than 1.4 million doses of the Johnson & Johnson vaccine arrived on Friday, the U.N. children’s agency UNICEF said.

In Afghanistan, a prominent anti-Taliban commander said he would support efforts by Afghan forces to claw back control of parts of western Afghanistan, including a border crossing with Iran.

Mohammad Ismail Khan, widely known as the Lion of Herat, urged civilians to join the fight. He said hundreds of armed civilians from Ghor, Badghis, Nimroz, Farah, Helmand and Kandahar provinces had come to his house and were ready to fill the security void created by foreign force withdrawal.

U.S. President Joe Biden said on Thursday the Afghan people must decide their own future and that he would not consign another generation of Americans to the two-decade-old war.

Biden set a target date of Aug. 31 for the final withdrawal of U.S. forces, minus about 650 troops to provide security for the U.S. embassy in Kabul.

Biden said Washington had long ago achieved its original rationale for invading the country in 2001: to root out al-Qaeda militants and prevent another attack on the United States like the one launched on Sept. 11, 2001.

The mastermind of that attack, Osama bin Laden, was killed by a U.S. military team in neighboring Pakistan in 2011.

(Reporting by Kabul, Moscow, Geneva and Washignton bureau, Editing by Timothy Heritage)

WHO urges countries ‘not to lose gains’ by prematurely lifting COVID-19 measures

ZURICH/BENGALARU (Reuters) -World Health Organization emergencies head Michael Ryan urged countries on Wednesday to use extreme caution when lifting COVID-19 restrictions so as “not to lose the gains you’ve made”.

Ryan’s comments come as England, hosting Europe’s soccer championships, prepares to end many COVID-19 restrictions on July 19, European countries ease travel curbs and Indian states relax their lockdowns, despite accelerating infections with the Delta variant worldwide.

Ryan said that while every nation must decide for itself, individuals including the unvaccinated must take responsibility to protect themselves and others, to keep hospitals from being overwhelmed by another pandemic wave.

“The idea that everyone is protected, and it’s ‘Kumbaya’ and everything goes back to normal, I think right now is a very dangerous assumption anywhere in the world, and it’s still a dangerous assumption in the European environment,” he told reporters during a meeting from Geneva.

“We would ask governments at this moment not to lose the gains you’ve made.”

Ahead of reopening, British Prime Minister Boris Johnson has said the epidemiological situation may be aided by the arrival of summer and school holidays.

Ryan said he believed British scientists were “very aware of the threat represented by variants, especially the Delta variant” and would open cautiously.

The WHO also urged countries including the United States and Switzerland that are vaccinating 12- to 15-year-old children to instead donate doses to the vaccine sharing program COVAX, to improve access for healthcare workers and the elderly in low-income countries.

“It’s not the pediatric population that is suffering the most,” said WHO vaccine expert Ann Lindstrand. “It is the adults, it is the medical risk groups.”

(Reporting by John Miller in Zurich and Manas Mishra in Bengaluru, Editing by Michael Shields and Nick Tattersall)

Exclusive: WHO estimates COVID-19 boosters needed yearly for most vulnerable

By Francesco Guarascio

BRUSSELS (Reuters) – The World Health Organization (WHO) forecasts that people most vulnerable to COVID-19, such as the elderly, will need to get an annual vaccine booster to be protected against variants, an internal document seen by Reuters shows.

The estimate is included in a report, which is to be discussed on Thursday at a board meeting of Gavi, a vaccine alliance that co-leads the WHO’s COVID-19 vaccine program COVAX. The forecast is subject to changes and is also paired with two other less likely scenarios.

Vaccine makers Moderna Inc and Pfizer Inc, with its German partner BioNTech, have been vocal in their view that the world will soon need booster shots to maintain high levels of immunity, but the evidence for this is still unclear.

The document shows that the WHO considers annual boosters for high-risk individuals as its “indicative” baseline scenario, and boosters every two years for the general population.

It does not say how these conclusions were reached, but shows that under the base scenario new variants would continue to emerge and vaccines would be regularly updated to meet these threats.

The U.N. agency declined to comment on the content of the internal document while Gavi did not immediately respond to a request for comment.

The document, which is dated June 8 and is still “work in progress,” also predicts under the base case that 12 billion COVID-19 vaccine doses will be produced globally next year.

That would be slightly higher than the forecast of 11 billion doses for this year cited by the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), signaling that the U.N. agency does not expect a significant ramp-up of vaccine production in 2022.

The document predicts manufacturing problems, regulatory approval issues and “transition away from some technology platforms” as potential drags on supplies next year.

It does not signal which technologies could be phased out, but the European Union, which has reserved the world’s largest volume of COVID-19 vaccines, has bet heavily on shots using messenger RNA (mRNA) technology, such as those by Pfizer and Moderna, and has forgone some purchases of viral vector vaccines from AstraZeneca and Johnson & Johnson.

WORST-CASE SCENARIO

The scenarios will be used to define the WHO’s global vaccination strategy and the forecasts may change as new data emerge on the role of boosters and the duration of vaccine protection, Gavi says in another document, also seen by Reuters.

So far about 2.5 billion doses have been administered worldwide, mostly in rich countries where over half of the population has received at least one dose, whereas in many poorer countries less than 1% has been vaccinated, according to Gavi’s estimates.

This gap could widen next year under the WHO’s most pessimistic forecast, as the need for annual boosters could push once again poorer nations to the back of the queue.

In its worst-case scenario, the U.N. agency says production would be 6 billion doses next year, due to stringent regulation for new shots and manufacturing issues with existing ones.

That could be compounded by the need for annual boosters for the entire world, and not just the most vulnerable, to combat variants and limited duration of protection.

In the more optimistic situation, all vaccines in the pipeline would get authorized and production capacity would ramp up to about 16 billion doses to meet demand. Vaccines would also be shared equitably across the world.

There would be no need for boosters as vaccines would show strong efficacy against variants and long protection.

(Reporting by Francesco Guarascio @fraguarascio; Editing by Josephine Mason and Emelia Sithole-Matarise)

Exclusive: Let down by rich and failing the poor, global vaccine scheme to be shaken up

By Francesco Guarascio

BRUSSELS (Reuters) – Shunned by rich countries and failing to meet the needs of the poorest, a program co-led by the World Health Organization (WHO) for fair distribution of COVID-19 vaccines is planning a shake-up, internal documents seen by Reuters show.

The COVAX program is far short of its target of delivering 2 billion doses by the end of the year, but does expect a big increase in supplies by early 2022, and wants to make sure that those, at least, reach the countries in direst need.

COVAX’s initial lofty ambitions to act as a clearing house for the world’s vaccines, collecting from the manufacturers in the most developed countries and quickly distributing to those in the most urgent need, have fallen flat.

So far, it has distributed a mere 90 million vaccines. While densely populated lower-income countries act as incubators for new and more dangerous strains of the coronavirus, some of the poorest countries have vaccinated less than 1% of their populations, according to estimates from Gavi, a global vaccine alliance that runs the scheme with the WHO.

The overhaul is meant to reduce COVAX’s financial risks, increase its focus on the countries most in need and reduce the participation of richer countries as both donors and recipients, according to a paper prepared by Gavi.

The document is expected to be adopted at a Gavi board meeting on Wednesday and Thursday.

“The suggestion is, subject to Board approval, to focus COVAX’s procurement efforts on all SFPs (self-financing participants) that will continue to need the facility, in such a way that enables simplified operations and reduced financial risks, based on the lessons learned over the past year,” a spokeswoman for Gavi said.

The WHO had no immediate comment, but usually lets Gavi speak about COVAX on its behalf.

CHARITY BEGINS AT HOME

Wealthy countries have generally preferred to use their financial clout to buy their own vaccines direct from the manufacturers.

And despite pleas from the WHO to share any surplus vaccines via its program, the United States, Japan and the European Union have all outlined plans to donate to countries directly, as well as to COVAX.

By prioritizing their own diplomatic and commercial interests, wealthy nations have in effect wrecked COVAX’s ambition to take overall charge of the global fight against the pandemic.

“The fact that Gavi’s board is now reviewing the way in which wealthier countries can continue to participate in the facility is in part a recognition that the set-up does not work,” said Kate Elder, senior policy adviser at the medical aid group Medecins Sans Frontieres.

About 190 countries are currently COVAX members, but one-third do not use its vaccines and only about 40 have launched their vaccination drives with jabs from COVAX, the Gavi document says.

In a separate internal document, Gavi estimates that membership may shrink to 120-130 next year.

Many rich nations are expected to step aside voluntarily, but the planned policy change will also make it costlier for middle-income countries to take part.

Whereas now Gavi takes significant financial risks in ordering vaccines on behalf of its members, next year middle-income nations that still need COVAX vaccines will have to pay for them fully in advance.

This means that countries in Latin America and the Middle East, as well as the likes of South Africa, may face higher costs and need to borrow money to secure doses.

PUTTING THE POOREST FIRST

However, the poorest countries, mostly in Africa and Southeast Asia, will keep the same conditions, with little or no costs to buy vaccines.

“The model would be redesigned with less flexible terms and conditions, aimed at simplification, and lowering financial risk to retain countries that need the facility whilst dis-incentivizing other countries from continued participation beyond the end of 2021,” one of the documents says.

And that should have tangible benefits for the poorest countries.

COVAX has raised nearly $10 billion, above its target for this year, and has begun receiving some surplus doses from rich nations. However, wealthy states’ earlier massive purchases of vaccines and curbs on exports from India, the facility’s main supplier, have left poorer countries short of supply.

Gavi believes that a projected increase in supply in the second half of the year could lift the share of those vaccinated in the poorest countries to nearly 30% by early 2022.

Gavi plans to spend $775 million to help countries distribute those vaccines and avoid repeating incidences of wastage caused by insufficient preparation and infrastructure.

With these countries facing a possible five-fold increase in the monthly throughput of vaccines, the risk of such wastage is high, one document says.

The money will be used to strengthen COVAX’s delivery system, provide better refrigeration equipment and improve healthcare systems, Gavi says.

(Reporting by Francesco Guarascio @fraguarascio; Editing by Josephine Mason)