Health Policy Open (Dec 2023)

COVAX – Time to reconsider the strategy and its target

  • David Bell,
  • Garrett W. Brown,
  • Wellington A. Oyibo,
  • Samiratou Ouédraogo,
  • Blagovesta Tacheva,
  • Elena Barbaud,
  • Andreas Kalk,
  • Valéry Ridde,
  • Elisabeth Paul

Journal volume & issue
Vol. 4
p. 100096

Abstract

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COVAX, the international initiative supporting COVID-19 vaccination campaigns globally, is budgeted to be the costliest public health initiative in low- and middle-income countries, with over 16 billion US dollars already committed. While some claim that the target of vaccinating 70% of people worldwide is justified on equity grounds, we argue that this rationale is wrong for two reasons. First, mass COVID-19 vaccination campaigns do not meet standard public health requirements for clear expected benefit, based on costs, disease burden and intervention effectiveness. Second, it constitutes a diversion of resources from more cost-effective and impactful public health programmes, thus reducing health equity. We conclude that the COVAX initiative warrants urgent review.