Financing vaccine equity: funding for day-zero of the next pandemic

Abstract

A lack of timely financing for purchases of vaccines and other health products impeded the global response to the Covid-19 pandemic. Based on analysis of contract signature and delivery dates in Covid-19 vaccine advance purchase agreements, this paper finds that 60–75 per cent of the delay in vaccine deliveries to low- and middle-income countries is attributable to their signing purchase agreements later than high-income countries, which placed them further behind in the delivery line. A pandemic Advance Commitment Facility with access to a credit line on day-zero of the next pandemic could allow low- and middle-income countries to secure orders earlier, ensuring a much faster and equitable global response than during Covid-19. The paper outlines four options for a financier to absorb some or all of the risk associated with the credit line and discusses how the credit would complement other proposals to strengthen the financing architecture for pandemic preparedness, prevention, and response.

Equitable Access to Vaccines: Myth or Reality?

“…Relatively few studies have empirically analyzed the drivers of COVID-19 vaccination rates globally. Our work relates closest to that of Goel and Nelson (2021), Deb et al (2021), and Agarwal and Reed (2022). Looking at subnational data in the United States, Goel and Nelson (2021) analyzed socio-economic factors influencing vaccination rates across states.…”

“…While the results from our study underscore the actual delivery of vaccines as the most critical component driving vaccination rates, we share in the finding that infrastructure matters as well. Agarwal and Reed (2022) dig further into what drives deliveries of vaccines. They find 60-75 percent of the delay in vaccine deliveries to low-and middle-income countries is attributable to their signing purchase agreements later than highincome countries, which placed them further behind in the delivery line.…”

“…The challenges focused on the factors impacting the development, dissemination, and deployment of vaccines, as categorized by Forman (2021) and Wouters et al (2021). While data were initially limited on deal making between governments and vaccine manufacturers, studies drew on the experience during the H1N1 outbreak to warn of vaccine market dominance by rich countries-a phenomenon later observed during the COVID-19 pandemic (Fidler 2010, So and Woo 2020, Bollyky et al 2020, Deb et al 2021, Agarwal and Reed 2022.…”

“…In practice, whether a factor is within a country's control is less clear-cut for many reasons. For example, securing vaccine deals and signing purchase agreements may directly affect vaccine delivery (Agarwal and Reed 2022). Therefore, the delivery of vaccine doses may not be entirely beyond country's control.…”

“…Agarwal and Reed (2022) find that 60-75 percent of the delay in vaccine deliveries to low-and middle-income countries is attributable to their signing purchase agreements later than high-income countries.5 The ban was rescinded in October 2021.©International Monetary Fund. Not for Redistribution…”