The World's Best Hope To End The Pandemic Still Needs More Doses

The shortfalls have created panic in many countries counting on Covax for their vaccination campaigns, along with resentment at wealthy nations that are swimming in vaccines.

On Jan. 23, 2020, the day the novel coronavirus forced the Chinese city of Wuhan into lockdown, two American doctors named Seth Berkley and Richard Hatchett met at the bar of the Hard Rock Hotel in Davos, Switzerland, to talk about vaccines. At that point it wasn't clear how soon, or even whether, effective vaccines for the disease caused by the virus could be developed. But Berkley, an epidemiologist who runs Gavi, a nonprofit that delivers immunizations to poor countries, was thinking about how the crisis would unfold if the virus swept across the globe. Hatchett, chief executive officer of the Coalition for Epidemic Preparedness Innovations, or CEPI, had just handed out research grants to three vaccine candidates. The two men were in Davos for the World Economic Forum, where public health organizations often go to drum up support and funding. Hatchett was concerned the world could see a repeat of the mistakes made during the H1N1 pandemic of 2009, when wealthy countries cornered the market for vaccines. (The fallout was limited; H1N1 turned out to be less deadly than feared.) He and Berkley agreed about the urgent need to raise money for vaccines even before they existed, so poor countries didn't get left behind in a stampede for doses. A month later, Berkley flew to Seattle to meet with Bill Gates, who'd helped establish Gavi two decades earlier with his soon-to-be ex-wife, Melinda. Gavi was designed to fix what was perceived as a failure of the market: Pharmaceutical companies lacked a financial incentive to provide vaccines to poorer countries at affordable prices. Gavi attempts to counter that by pooling both demand and money, which puts it in a position to give manufacturers large, long-term contracts. Gavi has now helped vaccinate more than 800 million children against pneumonia, meningitis, and a range of other diseases, preventing an estimated 14 million deaths with routine immunizations. Over breakfast, Berkley and Gates discussed how the Gavi model might be used if scientists succeeded in the search for vaccines against the disease, by then called Covid-19. Over the next few months, Berkley and Hatchett, backed by Gates, the European Union, and others, developed the Covax Facility, a public-private partnership Gavi manages with CEPI and the World Health Organization. It's now raised more than $10 billion as it aims to deliver 1.8 billion doses to more than 90 lower-income economies by early 2022.