图片: Erick Kaglan/世界银行多哥办公室
Part of the world's countries are making good progress vaccinating their citizens against COVID-19, which will save lives and get their economies back on track. But most low- and middle-income countries are still struggling to get enough doses just to protect their health and frontline workers, as well as their most vulnerable. Indeed, 66% of people in high-income countries have so far received at least one shot of a COVID-19 vaccine, compared to 2% of people in low-income countries.
Grappling with vaccine supply bottlenecks
That stark disparity is driven largely by a fierce and lopsided global competition for a finite COVID-19 vaccine supply.
In response, the World Bank Group has embarked on the fastest and largest crisis response in our history. Since March 2020, we have deployed more than $150 billion to help countries fight the health, economic, and social impacts of the pandemic. Within the first 60 days of our response, we were delivering projects in 100 countries to meet emergency health needs, strengthen pandemic preparedness, protect poor people and jobs, and jumpstart a climate-friendly recovery.
Supporting countries with $20 billion for vaccine purchase and distribution
In October 2020, before COVID vaccines became available for broad use, we approved $12 billion for purchase and deployment of the vaccines in lower-income countries. Of that, $4.6 billion is so far supporting vaccine rollouts in 55 countries. Half are the world’s poorest countries, and more than half of the funded projects are in Africa. The financing is not just to procure vaccines, but also to support countries to get vaccines in people’s arms.
In June, we increased that vaccine financing envelope to $20 billion over 18 months to continue helping countries purchase vaccines, get them into people’s arms and strengthen national health systems for the longer term.
Working with partners to accelerate access to vaccines
To take on vaccine supply limitations for developing countries, we are partnering with COVAX , the global mechanism which aims to provide equitable access for every country, and the African Vaccine Acquisition Trust (or AVAT) which is led by the African Union and the Africa CDC and supported by other partners such as Afreximbank, UNECA, and UNICEF. Our goal: to make our financing available to countries to purchase vaccines through each of these mechanisms.
A recent surge of dose-sharing pledges has begun to increase the flow of more vaccines to countries that need them. But much more is necessary, and pledges need to turn into action. We are leading the Multilateral Leaders Task Force on COVID-19 Vaccines, Therapeutics and Diagnostics, which was established by the heads of the International Monetary Fund, World Bank Group, World Health Organization and the World Trade Organization to track, coordinate and advance the delivery of COVID-19 vaccines, therapeutics and diagnostics. The task force has launched a new global database and country-by-country data dashboards, to track and monitor global and country-level gaps and support faster and more targeted solutions to accelerate access to COVID-19 vaccines, treatments and tests in developing countries. The task force members also met with the CEOs of leading vaccine manufacturing companies to discuss strategies to improve the access to COVID-19 vaccines, especially in low- and lower middle-income countries and in Africa
The World Bank is also a partner of the ACT-Accelerator, a collaboration of global health agencies to ensure equitable access to vaccines, tests and treatments for developing countries, and co-leads its health systems connector together with the Global Fund and WHO.
Helping countries to get ready for massive vaccine campaigns
Countries not only need more doses, they must also be ready to distribute them domestically. To that end, almost half of the vaccine financing countries have requested from the World Bank so far goes to strengthening national vaccine distribution systems. This includes developing better data and tracking systems, improving cold chains, training health workers and community engagement that builds essential public trust in health systems.
A number of countries – often with World Bank support – have made significant progress in recent years strengthening their health care infrastructure. Even so, some lack the capacity to carry out what will probably be among the biggest health interventions in their histories.
The latest data from our readiness assessments (prepared together with Gavi, the Global Fund, UNICEF and WHO) show that, while almost 95% of countries have developed national vaccination plans and 81% have safety measures in place, only 64% have developed plans to train the large number of vaccinators who will be needed for the campaign. Only about half of the countries have public engagement plans to generate public confidence, trust and demand for COVID-19 vaccines.
Increasing vaccine production, especially in Africa
For much of this year, there has been a growing awareness of the need to ramp up vaccine production, especially in or near countries currently starved of doses.
With that in mind, the International Finance Corporation (IFC), the World Bank’s private sector arm, has partnered with French, German and U.S. development finance institutions on a €600 million investment in South Africa’s Aspen Pharmacare, which is playing a major role producing COVID-19 treatments, therapies and vaccines on the African continent.
In addition, IFC is investing in several local, commercially viable vaccine manufacturers in low- or middle-income countries to expand their production of COVID-19 vaccines under license or working on their own COVID-19 vaccine, or both.
We need global COVID vaccine equity, not just because it’s the right thing to do, but it is the only way we can bring the pandemic under control. That’s why the World Bank Group with key partners, is making an unprecedented effort not just to help get us to that better place but to get there as soon as possible.
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