Delivering Together: Partnerships to Deliver Vaccines During a Pandemic – Learning from COVID-19 Vaccine Delivery – World

Proposal for a system to support the provision of medical measures based on the lessons learned from the COVID-19 vaccine delivery support mode

prologue

The development and deployment of a novel coronavirus disease (COVID-19) vaccine has been the fastest in immunization history. But the pandemic has also exposed large-scale structural inequalities, such as the inability of all countries to have equal access to a COVID-19 vaccine. One year after the introduction of the vaccine, 47% of the world’s population had been vaccinated for the first time, but only 36% of the population in low- and lower-middle-income countries had coverage. Coverage was even lower in low-income countries, where only 6% of the population was vaccinated. By January 2022, 34 countries remained below 10% coverage in the preliminary series. Fluctuating supply and lack of forecasts for vaccines and other products have made planning and preparedness at the national level difficult in many low- and middle-income countries (LMICs). Moreover, many LMICs had limited experience with vaccination programs and novel vaccine products for adults on this scale, especially the elderly and other priority groups.

Two years after the COVID-19 vaccine was first available, and after a large and predictable supply is finally available by the fourth quarter of 2021, countries and their partners The combined efforts of these efforts have resulted in narrowing the vaccine capital gap between low-income groups. Lower middle income countries and global averages. This is also true for primary series coverage aimed at the general population and priority groups, but inequalities between and within countries still exist.

Countries received support from a wide range of partners at the regional and global level, including the United Nations Children’s Fund (UNICEF), the World Health Organization (WHO) and Gavi of the Vaccine Alliance. In the early days of the pandemic, the three agencies worked together to help countries self-prepared, implement vaccination, We have started to support the development and expansion of the scale. CRD’s delivery support helped provide the evolving guidance and technical assistance needed for preparation and early deployment. This support includes providing tools and technical guidance in an environment of uncertainty, e.g., vaccine introduction readiness assessments, global guidance for strategic national deployment and development of vaccination plans, data reporting indicators and frameworks. work establishment. In addition, the CRD coordinates the flow of information among key partners, oversees programmatic oversight of access to early funding, training of national and sub-national staff, development of data systems, deployment, and informs vaccine allocations. established a mechanism to leverage country insights to

In 2020-2021, the three institutions worked in closer and more frequent collaboration within their respective mandates through their respective national, regional and global offices. As the pandemic unfolded, they sought ways to streamline their decision-making. In January 2022, the three government agencies will establish the Covid-19 Vaccine Delivery Partnership (CoVDP), building on existing relationships, including emergency response and existing relationships through the Gavi Alliance, to deliver the vaccine on a global scale. adopted a more structured model for delivery support. The CoVDP partnership aims to support vaccine supply in COVAX 92 “Advance Market Commitment” countries (AMC92), which are primarily representative of low- and middle-income countries, in particular a subset of the 34 eligible countries. focused on providing operational support to To accelerate scale and coverage, coverage for major series in January 2022 was 10% or less. In CoVDP, government agencies are brought together under one organizational “umbrella” for strategic alignment, with strong ties to senior leadership within government agencies, and the highest levels of political decision-making in each country. Led by a Global Lead Coordinator with the ability to engage politically in

In addition, CoVDP assisted countries with specialized technical assistance, quick-impact funds that can be deployed flexibly and quickly, demand planning, and dedicated country engagement channels that disrupt various layers of support at the global, regional and national levels. . Objective criteria agreed between partners will ensure that this coordinated operational support (e.g., high-level political advocacy at the highest levels of government, rapid impact funding, professional technical assistance) was used to prioritize countries receiving first. Assisting a wider range of countries (e.g. technical guidance on product selection and vaccination strategies, knowledge sharing between countries). The partners also agreed on the core principles of national ownership and national centrality, and on coordinating their assistance to each country as one supporting team supporting one national team led by the national government.

This report documents this global delivery assistance model for the delivery of COVID-19 vaccines, highlights the key functions required for delivery assistance, and provides guidance for future vaccines (and other health care measures). ) synthesizes important findings for the design, development, and implementation of delivery mechanisms. in an emergency setting. Recognizing clearly that many partners have provided support and have been important in driving national success, this report complements and supports national and regional efforts to provide support. focus on CRD and CoVDP as multilateral partnership agreements at the global level.

The recommendations in this report focus on mechanisms to support the provision of health care. Such mechanisms should be part of the global ‘end-to-end’ medical preparedness and response (MCM) platform developed, and thus the broader pandemic preparedness and response architecture, by WHO and pandemics. should be integrated into a coordinated health emergency management system. Accord. We will also improve access and health care through capacity building of health workers at the community level, strengthening health systems and primary health care (PHC), including routine health care delivery systems, and investing in sustainable local health product manufacturing. Expanding delivery capacity is also important. Vaccines and other medical supplies – all needed to improve equitable access and uptake in the pandemic response.

This report is based on interviews with 50 people from each agency who were closely involved in helping to deliver COVID-19 vaccines, and the results of COVID-19 vaccine deliveries over a three-year period. It is based on an extensive review of the material documenting the operational model of assistance. The recommendations in this report are forward-looking and based on best his practices and lessons learned during the COVID-19 response. A summary of bottlenecks or issues that her CRD and CoVDP encountered during the response and that were not adequately addressed are provided in the Appendix.