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. 2023 Dec:4:100096.
doi: 10.1016/j.hpopen.2023.100096. Epub 2023 Apr 13.

COVAX - Time to reconsider the strategy and its target

David Bell  1 , Garrett W Brown  2 , Wellington A Oyibo  3 , Samiratou Ouédraogo  4 , Blagovesta Tacheva  5 , Elena Barbaud  5 , Andreas Kalk  6 , Valéry Ridde  7 , Elisabeth Paul  8
Affiliations

COVAX - Time to reconsider the strategy and its target

David Bell et al. Health Policy Open. 2023 Dec.

Abstract

COVAX, the international initiative supporting COVID-19 vaccination campaigns globally, is budgeted to be the costliest public health initiative in low- and middle-income countries, with over 16 billion US dollars already committed. While some claim that the target of vaccinating 70% of people worldwide is justified on equity grounds, we argue that this rationale is wrong for two reasons. First, mass COVID-19 vaccination campaigns do not meet standard public health requirements for clear expected benefit, based on costs, disease burden and intervention effectiveness. Second, it constitutes a diversion of resources from more cost-effective and impactful public health programmes, thus reducing health equity. We conclude that the COVAX initiative warrants urgent review.

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Conflict of interest statement

Elisabeth Paul (last/corresponding author) is an active member of the Technical Review Panel of the Global Fund and of the Independent Review Committee of Gavi. However, this paper was written in total independence from these institutions. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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References

    1. World Health Organization. COVAX - Working for global equitable access to COVID-19 vaccines [Internet]. 2022 [cited 2022 Jan 19]. Available from: https://www.who.int/initiatives/act-accelerator/covax.
    1. World Health Organization. WHO releases global COVID-19 vaccination strategy update to reach unprotected [Internet]. 2022 [cited 2023 Jan 5]. Available from: https://www.who.int/news/item/22-07-2022-who-releases-global-covid-19-va.... - PMC - PubMed
    1. World Health Organization. Access to COVID-19 tools funding commitment tracker [Internet]. 2022 [cited 2023 Jan 6]. Available from: https://www.who.int/publications/m/item/access-to-covid-19-tools-tracker.
    1. The Global Fund. Seventh Replenishment - Fight for What Counts [Internet]. 2022 [cited 2023 Jan 6]. Available from: https://www.theglobalfund.org/en/seventh-replenishment/.
    1. Savinkina A, Bilinski A, Fitzpatrick M, Paltiel AD, Rizvi Z, Salomon J, et al. Estimating deaths averted and cost per life saved by scaling up mRNA COVID-19 vaccination in low-income and lower-middle-income countries in the COVID-19 Omicron variant era: a modelling study. BMJ Open [Internet]. 2022;12(9). Available from: https://bmjopen.bmj.com/content/12/9/e061752. - PMC - PubMed