In order to beat the COVID-19 pandemic, many measures have been put in place to contain the spread. Worldwide, scientists and doctors have been working to develop a COVID-19 vaccine as a long-term solution. Vaccines are used to prevent disease and not cure them. A vaccine is a type of medicine that trains the body to recognise and fight a disease it has not seen before. That way, if you ever get infected it will deal with it before you even know it.2
The ACT Accelerator and the COVAX pillar
The ACT Accelerator is a ground-breaking global collaboration to accelerate the development, production, and affordable access to COVID-19 tests, treatments, and vaccines. It brings together governments, scientists, businesses, civil society, philanthropists and global health organisations.3 The ACT Accelerator consists of four pillars of work: diagnostics, treatment, vaccines and health system strengthening. Each pillar is essential to the overall effort.
COVAX is the vaccine pillar of the accelerator. It is co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO). It was launched in April by the (WHO), the European Commission and France in response to the pandemic. Covax aims to accelerate the development and manufacture of COVID-19 vaccines and to guarantee fair and equitable access for every country in the world.
It is the only truly global solution to this pandemic because it is the only effort to ensure that people in all corners of the world will get access to COVID-19 vaccines, regardless of their wealth.4
Why we need it
There are already more than 200 COVID-19 vaccines in development. So why do we need the COVAX pillar? While the response from the scientific community has been phenomenal, no-one knows which of these efforts will be successful in producing a safe and effective vaccine. The numbers are not on our side. Usually the probability of success for a vaccine in the preclinical phase is around 7%, rising to 15–20% for vaccines that reach clinical tests. This means that most candidate vaccines are likely to fail.
COVAX will address a number of issues. Most important is to ensure that the most suitable candidate vaccines get the backing they need to give the greatest chances of succeeding. The more diverse the portfolio of backed vaccines, the more likely they are to be successful. Another issue is that the vaccine will be in high demand with a limited supply. COVAX will need to ensure that access to any successful vaccines is not dependent upon the ability to pay.
How exactly will it work?
COVAX works on the principle of safety in numbers. This means pooling resources from participating countries in order to back a larger number of candidate vaccines than any single country could do alone. COVAX has the broadest portfolio of vaccine candidates in the world. This same principle is to be implemented for manufacturing. Normally it can take over a decade to develop a vaccine—yet they are aiming to be ready to manufacture by the end of 2021.
This will be done by using adaptive trials—carrying out different phases simultaneously instead of in sequence as is usually the case.
Manufacturing will make use of push and pull financing. Push will be financing activities as they happen in production facilities. Pull will provide manufacturers additional incentives to scale-up, through commitments to buy substantial volumes of vaccine, if their vaccine is successful.
Since most of the vaccine candidates in development will not succeed, there are obvious risks. By taking this approach, pooling resources and sharing the risks, the chances of succeeding are increased. The rewards stand to be shared as well.
Because unless everyone is protected, we are all at risk.