2021 Revealed the Depths of Global Vaccine Inequity

But some think Covax was never going to meet its lofty goal. According to Venkatapuram, in early 2021, Covax officials were putting out PR statements to hide what was really going on behind the scenes. “They were using their communications to essentially speak to rich country leaders and rich countries, and to try to get them to join and cooperate, while not giving us a really good indication of the kind of precarious situation that we were in,” he says. 

A spokesperson for Gavi, the nonprofit that oversees Covax, challenged this characterization, telling WIRED by email that “despite constant shifts in regulatory timelines, available doses, and other factors, Covax has always maintained regular communication with participating economies including with respect to changes in supply volumes, schedules and timelines.” (The organization typically does not release the names of spokespeople.) 

As vaccine shipments failed to materialize, ambassadors of vaccine-poor countries were desperately contacting Covax to find out when they could expect their share. Rahman says she and her colleagues questioned Covax heads: When were vaccines coming for, say, Senegal? And, she recalls, they would respond with something like: “There are many moving parts.” “I’ve started to despise this phrase of ‘there are many moving parts,’ because to me it means they don’t know what’s going on,” she says. 

Rahman feels that those overseeing Covax weren’t coordinating with the authorities in the very countries they were trying to send vaccines to. Indeed, due to failure to consult adequately, many poor countries were forced to throw out thousands of expired doses for lack of the infrastructure required to store and transport them. If they had properly communicated with local authorities on the ground in these countries, this could have been avoided, says Rahman. “It’s just sort of a colossal clusterfuck, of not being organized in terms of indigenous knowledge.”

But Gavi’s spokesperson told WIRED that Covax “has been very vocal about the need for greater transparency from donors and manufacturers on when doses will be made available as without this information recipient countries cannot effectively plan for a successful, large-scale roll out. It is the case that often doses in the past have been offered to COVAX with less than 10 weeks’ shelf life and that these have, under the principle of no doses left idle, have been offered to countries that have been deemed capable of absorbing them at short notice. When accepted by countries, these have subsequently been shipped.”

Covax’s goal for 2022, the spokesperson said, will be “to help all countries it serves meet their national vaccination targets.”  

Right now, the World Trade Organization enforces patents on trade-related intellectual property rights, or TRIPS—an international legal agreement between all the organization’s member nations that ensures a minimum standard of IP protection that a country must provide. In the case of Covid vaccines, it currently means that only those companies that hold a patent can make them. 

But a handful of countries, including India and South Africa, have been calling for the WTO to temporarily waive Covid-19-related IP rights. Lifting them would mean that poorer countries could freely copy the vaccine technology and access the technical how-to guide for making them. In order to suspend these rights, all member countries of the WTO would need to agree to it. Over a hundred countries have backed the proposal, but there’s a divide within the organization: Representatives from rich countries argue that ensuring patent protection is critical to keeping pharmaceutical companies innovating, and those from poorer countries argue that these patents ultimately prevent cheap access and cause unnecessary death. (Owing to concerns about the Omicron variant, the WTO indefinitely postponed its meeting to discuss the TRIPS waiver, meaning it’s far from a settled matter.)