Covax aims to break the Covid-19 pandemic in 2022 by ensuring a steady supply of vaccines at last for the world's poorest countries -- and swiftly getting them into arms.
The global scheme, aimed at procuring donor-funded jabs for the 91 weakest economies, delivered its one billionth dose last weekend -- a major milestone that came far later than anticipated after a year of setbacks.
The battle for Covax in 2021 was getting hold of doses -- besides rich countries cornering most of the vaccine supply, it faced export bans from producer countries, regulatory red tape and manufacturing delays.
Rather than bulk-bought jabs, the scheme ended up relying on doses donated by wealthy nations, which too often were about to expire and couldn't be used in time.
Covax sees the new front in 2022 as smoothing the supply chain -- from a reliable stream off the production lines to efficient distribution set-ups in recipient countries.
The facility is co-led by the World Health Organization (WHO); the Gavi vaccine alliance, which handles procurement; and CEPI, the Coalition for Epidemic Preparedness Innovations, which invests in prospective vaccines.
- 'Inequity 2.0' fear -
Covax this week called for $5.2 billion over the next three months to steady the ship this year.
"We can break the cycle of transmission and the pain and suffering," Gavi chief Seth Berkley told the funding drive launch.
However, "what we do not have today are the resources to help countries adapt to the new challenges that we know Covid-19 will create in 2022".
Covax therefore wants to build a pool of 600 million doses to ensure a reliable supply, and to cover eventual variables such as boosters or new variant-specific vaccines.
It also needs to support readiness and delivery in poorer nations, and cover the costs of syringes and transportation.
"I think we'll still have rocky supply for the next six months or so and I'm a little worried, frankly, if there are new variant vaccines, that we might have an inequity 2.0," said Berkley.
Covax reckons it has enough confirmed vaccine supplies to jab 45 percent of the population in the poorest 91 economies.
But the WHO wants 70 percent fully jabbed in every country by July to end the acute phase of the pandemic -- a much bigger stretch, given how far behind many countries are, especially in Africa, where more than 85 percent of people are yet to receive a single dose.
At the current pace of vaccine roll-out, 109 countries will miss the mid-2022 target, the WHO has said.
- 'Back on track' -
Covax was launched in June 2020, when few would have imagined that several highly effective vaccines would emerge within nine months. Historically, the vast majority of potential vaccines fail.
The first Covax doses were administered in March 2021, "but then we hit barrier after barrier", said Berkley.
"We were able to get this back on track -- and now you're seeing an accelerated drive towards getting vaccines out."
The next billion doses is expected to take four to five months to deliver.
Of the billion doses delivered so far, around 285 million were AstraZeneca, 260 million Pfizer, 150 million Moderna, 125 million Janssen, 95 million Sinopharm and 85 million Sinovac.
Only WHO-approved vaccines can be used, of which there are eight so far. The latest is a major CEPI-funded vaccine, Novavax, which could do much of the heavy lifting in 2022.
- Jabs for all 'achievable' -
CEPI chief executive Richard Hatchett said the target was now building capacity in poorer countries to roll out mass vaccination at speed.
"The last mile is going to be the major challenge for 2022," he told a World Economic Forum session.
Up to 25 countries need particular help getting their vaccination programme in shape.
Overall, some 9.8 billion Covid-19 vaccine doses have been administered around the world. Covax jabs account for 82 percent of injections in the 91 poorest economies.
The top Covax donor-funded dose recipients so far are Bangladesh with 130 million, Indonesia 87 million, Pakistan 77 million and the Philippines 66 million.
Hatchett said that with the manufacturing capacity now available, helping poorer countries turn those doses into vaccinations could transform the course of the pandemic.
Whether primary vaccination or a booster, getting a jab to everyone who wants one "is an achievable goal in 2022", he insisted.