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1. Beyond the “Gavi-Eligible”: High-Leverage Opportunities for Gavi to Enhance Vaccine Access and Uptake in Ineligible Middle-Income Countries

Author:
Rachel Bonnifield, Morgan Pincombe, and Janeen Madan Keller
Publication Date:
04-2024
Content Type:
Policy Brief
Institution:
Center for Global Development (CGD)
Abstract:
The global locus of undervaccination is increasingly shifting from the poorest countries in the world—which are eligible for support from Gavi, the Vaccine Alliance (Gavi)—to middle-income countries (MICs) that do not qualify for traditional Gavi support. Given these growing challenges, Gavi must rethink its engagement with those MICs that are ineligible for traditional support. Although this engagement is intended to be “catalytic” and has been intentionally targeted to country needs, it also has been relatively small-scale and ad hoc. Gavi’s next five-year strategic period from 2026 to 2030, known as “Gavi 6.0,” offers a window of opportunity for its board and leadership to consider new and different ways for Gavi to engage with MICs to advance global vaccine access and improve vaccination outcomes. To have the greatest impact in this context, Gavi must lean into its comparative advantage in market shaping and demand consolidation to drive its contributions to global vaccination efforts with finite resources. We offer recommendations for Gavi to operationalize broader engagement with MICs, specifically by enabling an expanded cohort of MICs to access more affordable prices for both newer, costlier vaccines and future vaccines via opt-in framework agreements and by supporting a global coordinating hub to shape a forward-looking immunization innovation agenda.
Topic:
Public Health, Vaccine, Global Health, and Middle-Income Countries
Political Geography:
Global Focus

2. Digital Health Credentials and COVID-19: Can Vaccine and Testing Requirements Restart Global Mobility?

Author:
Lawrence Huang
Publication Date:
04-2022
Content Type:
Special Report
Institution:
Migration Policy Institute (MPI)
Abstract:
More than two years into the COVID-19 pandemic, rising vaccination levels and widespread testing in many countries are giving governments and the public increasing confidence in international travel. A central part of efforts to restart mobility are digital health credentials, which verify a person’s vaccination, testing, and/or recovery status. These credentials help to minimize the risk of travelers carrying the virus, and unlike paper credentials that must be manually inspected in airports and at borders, digital credentials can be automatically verified. But even as digital health credentials are becoming increasingly common, gaps in international coordination and technical integration issues between different credential systems remain. As a result, migrants and travelers moving between—and at times within—countries must navigate a complex maze of digital systems. This report examines the implications of digital health credentials for international travel and for immigrants’ and travelers’ access to domestic services and venues that also use such credentials. It also explores the implications for specific groups: tourists and business travelers, students, labor migrants, asylum seekers and refugees, and unauthorized migrants. Finally, it offers policy recommendations to facilitate mobility and minimize risks for people on the move.
Topic:
Health, Immigration, Border Control, Employment, Mobility, Vaccine, and COVID-19
Political Geography:
Global Focus

3. The WTO and vaccine supply chain resilience during a pandemic

Author:
Chad P. Bown
Publication Date:
09-2022
Content Type:
Working Paper
Institution:
Peterson Institute for International Economics (PIIE)
Abstract:
Cross-border supply chains and international trade enabled the manufacturing and delivery of billions of vaccine doses to inoculate the world against COVID-19. At the same time, the pandemic revealed how the World Trade Organization (WTO) must change to become more useful in the face of a public health emergency. This paper describes the market failures—especially on the supply side—justifying the domestic subsidies and contracting arrangements used to accelerate vaccine research and development and to increase the scale of vaccine production to save lives, livelihoods, and economic activity during a pandemic. It highlights tradeoffs associated with the US subsidies and the priority-rated contracts written through the Defense Production Act under Operation Warp Speed. This case study reveals a rich environment in which cross-border supply chains exacerbate input shortages in ways that constrain vaccine production, highlighting the need for the WTO to embrace new forms of international policy coordination for pandemic preparedness and response. As part of a pandemic treaty, the paper proposes a plurilateral agreement on vaccine supply chain resilience that would include novel and enforceable disciplines for export restrictions, provisions to trigger coordinated subsidies across countries to jointly scale up vaccine output- and input-production capacity, and market surveillance initiatives on supply chain transparency.
Topic:
International Trade and Finance, Vaccine, COVID-19, WTO, and Supply Chains
Political Geography:
Global Focus

4. Patents, Pandemics, and the Private Sector: The Battle Over Public Health Norms During COVID-19

Author:
Vartika Neeraj
Publication Date:
05-2022
Content Type:
Journal Article
Journal:
Journal of Public and International Affairs (JPIA)
Institution:
School of Public and International Affairs (SPIA), Princeton University
Abstract:
The COVID-19 pandemic has revealed the influence that private pharmaceutical companies and philanthropic foundations have on global health governance. Private actors have been able to maintain the norm of intellectual property rights, despite opposition from developing countries and growing opposition from powerful actors in developed countries. This article examines how private actors have wielded their material resources, expert authority, and discursive powers to overrule the wishes of governments. It concludes by exploring the public health consequences of their growing hold on international governance and offers some policy recommendations to mitigate distorted public health outcomes.
Topic:
International Relations, Intellectual Property/Copyright, International Development, Public Health, Vaccine, and COVID-19
Political Geography:
Global Focus

5. Difficult Debate on an Intellectual Property Protection Waiver to Fight COVID-19

Author:
Szymon Zaręba
Publication Date:
01-2022
Content Type:
Special Report
Institution:
The Polish Institute of International Affairs
Abstract:
The negotiations currently taking place at the WTO on the suspension of, among others, patent protection for vaccines and medicines against COVID-19, are at a standstill. This creates a risk of widening the rift between developing countries, which mostly support the idea, and some developed countries, which oppose it. It also makes it more difficult to increase the supply of patented items, particularly of vaccines, to an extent undermining other efforts by countries and international organisations to contain the pandemic. It is in the interest of Poland and the EU to overcome this impasse.
Topic:
Intellectual Property/Copyright, European Union, Vaccine, COVID-19, and WTO
Political Geography:
Europe, Poland, and Global Focus

6. Vaccine Equity in ConflictAffected Areas: The Challenges of Development, Production, Procurement, and Distribution

Author:
Katherine DeLand
Publication Date:
05-2022
Content Type:
Policy Brief
Institution:
International Peace Institute (IPI)
Abstract:
While the wide-ranging impacts of COVID-19 are being felt in all countries and communities, the pandemic is having a disproportionately large impact on vulnerable populations, such as people living in areas affected by fragility, conflict, and violence. Vaccines hold enormous promise to mitigate these impacts, but the complications inherent to armed conflict make accessing vaccines especially challenging. Even when countries do receive vaccines, they often face challenges in rolling out vaccination programs, whether because they lack adequate capacity or because the doses are set to expire or are not acceptable to the communities set to receive them. This issue brief focuses on the challenges of equitably distributing COVID-19 vaccines to populations in conflict-affected areas. It begins by looking at general issues related to the development, approval, production, procurement, and distribution of vaccines. It then examines the particular challenges to distributing vaccines in conflict-affected areas both before and during the vaccine rollout. The report concludes with several recommendations for stakeholders and policymakers to improve the delivery of vaccines in conflict-affected areas: Redistribute global resources to increase the supply of vaccines to conflict-affected countries; Increase the transparency and predictability of global vaccine supplies; Enhance cooperation and coordination at the national and local levels to deliver vaccines to conflict-affected areas through existing humanitarian response mechanisms; and Ensure that vaccination campaigns in conflict-affected areas adhere to humanitarian principles.
Topic:
Health, Conflict, Vaccine, COVID-19, and Humanitarian Response
Political Geography:
Global Focus

7. Reducing mobility of SARS-CoV-2 variants to safeguard containment

Author:
Martin Hellwig, Viola Priesemann, and Guntram Wolff
Publication Date:
05-2021
Content Type:
Working Paper
Institution:
Bruegel
Abstract:
Escape variants can cause new waves of COVID-19 and put vaccination strategies at risk. To prevent or delay the global spread of these waves, virus mobility needs to be minimised through screening and testing strategies, which should also cover vaccinated people. The costs of these strategies are minimal compared to the costs to health, society and economy from another wave.
Topic:
Health, Governance, Global Political Economy, Vaccine, and COVID-19
Political Geography:
Global Focus

8. Using Advance Market Commitments for Public Purpose Technology Development

Author:
Alan Ho and Jake Taylor
Publication Date:
06-2021
Content Type:
Policy Brief
Institution:
Belfer Center for Science and International Affairs, Harvard University
Abstract:
Over the last year, there has been a renewed focus on improving American competitiveness in key fields of science and technology. Numerous bills and executive initiatives have been implemented or proposed to dramatically increase investment into science and technology. Recent examples, including the Endless Frontiers and the Clean Futures Act, use a wide variety of policy tools to advance research and development (R&D) along multiple axis. Here we consider the free market portion of these tools, in which the private sector plays a key role in determining topic and direction, while the public sector supports these activities through high-level directives, conditional contracts, and other mechanisms. While other approaches such as public purpose consortia and R&D tax credits have been considered elsewhere, here we focus on Advance Market Commitments. Advance Market Commitments (AMCs)are a powerful policy tool that can be used to ensure that America can retain leadership in technology fields such as climate change, computing, and medicine. In an AMC, a U.S. agency commits to buying some specified new technology before that technology exists. This provides a price, specification, and framework for evaluation that can streamline decision making and funding approaches in the private sector and accelerate progress towards well defined technical outcomes without being directed about the underlying solution and steps along the path. As such, AMCs represent a powerful option for ground-up technological building where private investment replaces the role of more traditional, blue sky government funding, and the larger market for the resulting product is jump-started by an initial government market.
Topic:
Markets, Science and Technology, and Vaccine
Political Geography:
Global Focus

9. COVID-19 and the Global Vaccine Race

Author:
Lorenza Errighi
Publication Date:
03-2021
Content Type:
Commentary and Analysis
Institution:
Istituto Affari Internazionali
Abstract:
If 2020 was the year of “mask diplomacy”, as countries raced to tackle the spread of the SARS-CoV-2 virus and acquire the necessary protective gear and equipment, 2021 is likely to be remembered as the year of “vaccine diplomacy”. Growing competition between states to secure the necessary quantities of vaccines to inoculate their population has already become an established feature of the post-COVID international system and such trends are only likely to increase in the near future. It normally takes up to a decade to transition from the development and testing of a vaccine in a laboratory to its large-scale global distribution. Despite current challenges, the speed of COVID-19 vaccination campaigns is unprecedented. To put an end to the current pandemic – which in one year has led to the loss of 2.6 million lives and triggered the worst economic recession since the Second World War – the goal is to ensure the widest immunisation of the world population in a timeframe of 12 to 18 months. In this context, COVID vaccines emerge as instruments of soft power, as they symbolise, on the one hand, scientific and technological supremacy and, on the other, means to support existing and emerging foreign policy partnerships and alliances with relevant geopolitical implications. From their experimentation in laboratories, to their purchase and distribution, the vaccine has emerged as a significant tool for competition between powers, often associated with the promotion of competing developmental and governance models across third countries.
Topic:
Diplomacy, Health, Vaccine, and COVID-19
Political Geography:
Global Focus

10. Covid-19’s Not Through With Us Yet

Author:
Dahr Jamail
Publication Date:
09-2021
Content Type:
Journal Article
Journal:
Cairo Review of Global Affairs
Institution:
School of Global Affairs and Public Policy, American University in Cairo
Abstract:
As vaccines offer hope for a world after Covid, experts warn that in many ways, the fight is only beginning.
Topic:
Science and Technology, Vaccine, Pandemic, COVID-19, and Medicine
Political Geography:
Global Focus