Distributing the Vaccine in South Africa and Issues with COVAX

This NYTimes piece does a good job discussing some of the challenges South Africa is facing in its efforts to secure a COVID-19 vaccine as it battles a resurgence of the virus. The article highlights several issues with COVAX, an international vaccine purchasing and allocation facility which South Africa has contributed to. COVAX uses advanced market commitments to speed up the development of vaccines and secure guaranteed (but limited) access for poorer countries.

A key issue COVAX faces is price transparency: countries do not know exactly what they are paying for. The NYT article notes:

South African medical advisers say the Covax system is vital but also deeply frustrating. Governments must pay up front without knowing what vaccine they will receive or getting any guarantees on when the doses will arrive. Covax estimates the price per dose but offers little recourse if the cost is ultimately much higher. Countries must assume all of the risk if the vaccine fails or if anything goes wrong.

Given the devastating consequences of waiting to vaccinate in South Africa and existing resource constraints, individual philanthropists/organizations with deep pockets and tolerance for uncertainty around price could step in with an expansive commitment. The Oxford-Astra Zeneca vaccine, which was approved by the UK’s regulator today and is relatively easier to distribute, would be a prime candidate for an agreement.

Most Important Problem in Development Right Now?

Is figuring out a way to finance and rapidly distribute the COVID-19 vaccination in developing countries the most important problem in development today?

COVID-19 has caused a significant slowdown in growth/economic activity in developing countries. That slowdown requires a robust macroeconomic response (typically stimulus). Countries that have not done so need to focus on putting stronger COVID-19 mitigation measures (masks, etc) in place so that economic activity can resume (and children can go back to school where they have not already).

Certainly, macroeconomic responses and mitigation measures are the most pressing “near-term” development priorities but people with expertise and money (both in developing world and developed world) should be working on figuring out logistics and financing of vaccine distribution now.

It is heartening to see Bill Gates and international agencies (GAVI) applying their expertise to the problem.