Nigeria might have to develop a stronger strategy to acquire COVID-19 vaccines outside the COVAX as export restrictions in India, scale-up hurdles at manufacturing sites and regulatory bureaucracies have forced the global scheme to cut its 2021 supply forecast by 25 percent.
The World Health Organisation (WHO), Gavi, The Vaccine Alliance and other co-coordinators had projected that roughly 1.8 billion vaccines would be pooled by the end of 2021 to give up to 30 percent coverage in all lower- and middle-income countries participating in the programme.
But thanks to supply hiccups, the latest update of COVAX supply forecast indicates that a total of approximately 1.4 billion doses are the most realistic target achievable for 2021.
“COVAX is making strenuous efforts to address and mitigate these risks. In addition to ongoing dialogue with the Government of India, we are calling on donors and manufacturers to make supply schedules transparent, so that it is not possible for manufacturers to prioritise bilateral customers over COVAX; to give up their place in the queue to COVAX where countries are ahead of COVAX and have enough doses to meet domestic needs, expand, accelerate, and systematise dose donations,” the coordinators urged in the review.
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As of August end, the scheme had delivered 330 million doses, with an additional 1.1 billion expected to be available for delivery between September and the end of 2021.
A threat to the scheme poses a significant challenge to a source that has provided about 70 percent of the vaccines available in Nigeria.
Of the 1.4 billion doses expected under the most likely scenario, 1.2 billion will be available for all participating countries to cover 20 percent of their populations.
However, Nigeria has only been able to cover 2.5 percent of its estimated 206 million population fully with 10.4 million doses received from both COVAX and other sources.
Full coverage of 20 percent of the population means an additional 71.9 million doses would be required to augment what is available, which is unlikely to come from COVAX given the uncertainty it faces.
The major risk to the scheme’s supply is led by the uncertainty around the resumption of exports from the Serum Institute of India (SII) and manufacturing scale-up challenges affecting Johnson & Johnson and AstraZeneca vaccines.
Manufacturers’ prioritising bilateral supply arrangements over COVAX agreements is also a driver of uncertainty to the scheme, which also faces delays in regulatory approval of candidates that it has signed deals with, such as Novavax, SII Novavax and Clover.
If India, for instance, lifts the export ban and J&J returns to its earlier commitments for 2021 supply, major additional doses could become available to COVAX in 2021, the coordinators said.
This adds to the slew of doubts that Nigeria may never achieve its herd immunity goal of fully vaccinating up to 70 percent of its population against the coronavirus as access to vaccines remains stifled.
Analysts think Nigerians might have to live with the virus as an endemic disease such as malaria or have it fade away, just as how the Spanish flu of 1918 disappeared after killing an estimated 500,000 Nigerians.
