While COVID-19 surges continue to ride out across the world, the Access to COVID-19 Tools Accelerator (ACT-A) published today an independent strategic review looking at how it has made progress across its three pillars of diagnostics, therapeutics, and vaccines.
The World Health Organization (WHO) created ACT-A less than 3 months into the pandemic, and the report recommends that the program continue as long as global coordination around COVID-19 tools is valuable—in other words, the authors write, most likely through 2022.
Recommendations included an increased emphasis around downstream work to optimize the currently available tools, more equitable representation and participation with ACT-A (eg, more representatives from lower- and middle-income countries [LMICs]), and the creation of a data-sharing framework for programmatic and financial reporting.
The report also alludes to external challenges such as COVID-19 variants of concern and domestic-focused responses, as well as internal challenges around ACT-A's scope, coordination, operations, and representation. "Looking ahead, ACT-A and its Pillars now have an opportunity to re-shape how they work and engage with countries to ensure they are as impactful as possible in the next phase of response," the authors write.
COVAX criticized
One of the most public-facing parts of ACT-A is the COVAX program, which was created to help LMICs access COVID-19 vaccines. However, as a Stat exposé reported today, the program was stymied early on and now accounts for less than 5% of all COVID-19 vaccines administered globally. Issues included delayed, unexpected, or absent deliveries; vaccines nearing expiration; an utter lack of communication for many waiting countries; and procurement difficulties.
The latter manifested in a variety of ways, including the Serum Institute of India's inability to export vaccines for about 6 months, the suspicion that COVAX contracts were at the back of the manufacturing queue, and the lagging fulfillment of higher-income countries' vaccine pledges (18% of the promised 785 million doses had been delivered to COVAX by Sep 24).
According to Stat, COVAX blames most of its shortcomings on vaccine manufacturers, but as Kate Elder, MSc, senior vaccines policy advisor at Medecins Sans Frontieres' Access Campaign, said in the article, "I don’t think that manufacturers’ behavior, which has been tested time and time again and always delivered the same thing, is uniquely why COVAX is not delivering. … I think there was plenty that was under the control of the architects of COVAX which was a misstep."
Indeed, it was only with this last allocation wave that COVAX prioritized countries with lower vaccination rates. In June, the United Kingdom received 530,000 doses, while all of Africa only received four times that amount.
For its part, ACT-A's review highlights some of COVAX's positives—it had the world's most diverse and largest research and development portfolio of COVID-19 vaccines in September 2020—and calls out bilateral deals between high-income countries and vaccine producers as a main hurdle to its success.
"As a result, the COVAX Facility has adapted its focus to better serve countries in this new environment," the authors write, noting the new allocation prioritization and an emphasis on dose sharing. And, while the program was only 16% of the way to its 2021 goal by the end of September, the authors say that by year's end, 70% of the 2 billion-dose target will be met. The program will also work more closely with countries to improve readiness and vaccine administration post-delivery.
COVID fluctuates across the globe
Countries with vaccination rates both high and low continue to grapple with COVID-19, but some are seeing lower case numbers.
In the United Kingdom, where 72% of the population is at least partially vaccinated, officials said that COVID-19 cases in school children have been up 67% in the past 2 weeks and that 2.5% of students were not attending school due to COVID-19, according to Metro. Reuters says that the overall country prevalence has reached 1 in 70, its highest level since August.
Romania, which has a significantly lower vaccination rate, at 31%, is also struggling with COVID-19. The country saw a record 15,037 new cases 2 days ago, according to Universul.net, and a little under 14,000 new cases were confirmed today. Because of the surge, the country had already begun implementing new restrictions (to subsequent protests, Reuters notes). Indoor and outdoor mask mandates are beginning this weekend, as well as additional limitations for unvaccinated people, including restricted business access and a curfew, Universul.net says.
A month ago, Romania had about 2,000 cases a day.
Russia and Vietnam, where 34% and 37% of people, respectively, are at least partially vaccinated, are seeing two different trends. Russia, which is on an upsurge, reported 27,246 new cases and 936 new deaths today, the highest deaths since the start of the pandemic and the third consecutive day surpassing 900, according to Outlook India.
On the other hand, Vietnam identified 4,806 new cases and 114 deaths today, according to Vietnam Plus. While the news site also says that Ho Chi Minh city reported 485 more cases than the day before, the country's overall prevalence has fallen from about 135 cases per 1 million people on Aug 31 to 63 per million on Oct 6, according to Our World in Data.
Other countries seeing lower cases include India and Malaysia. In India, 21,257 people tested positive for COVID-19 today, and the number of active cases is at its lowest in 205 days, according to the Deccan Herald. And, for the first time since the country's March 2020 lockdown, foreign tourists can apply for visas starting Oct 15, Al Jazeera reports. As for Malaysia, the country's daily cases remain below 10,000 for the sixth day in a row, coming in at 9,751 new cases today, according to Malay Mail.
More global headlines
- Jamaica is forced to dump 55,000 vaccine doses due to vaccine hesitancy, according to Global Voices. About 10% of the country is fully vaccinated, with 18% more partially vaccinated.
- The WHO published the methodology it uses to estimate excess COVID-19 deaths.
- Australian doctors warn of easing up restrictions in Sydney too rapidly as the city prepares to end its lockdown of more than 100 days next week, according to Reuters.
- The global total today is 237,074,906 cases, including 4,839,814 deaths, according to the Johns Hopkins COVID-19 tracker.
All vaccination rates were taken from Our World in Data.
