ANALYSIS: How richer countries got their vaccine supplies first

See How Rich Countries Got to the Front of the Vaccine Line Many low-income nations lacked the means to preorder doses, and their residents have received just 0.1 percent of vaccine shots given worldwide. The New York Times

In the early days of the pandemic, when drug makers were just starting to develop vaccines, placing orders for any of them was a risk. Wealthier countries could mitigate that risk by placing orders for multiple vaccines and, by doing so, tied up doses that smaller countries may have otherwise purchased, according to experts.

As a result, most higher-income countries were able to pre-order enough vaccines to cover their populations several times over, while others had trouble securing any doses at all. Throughout 2020, even middle-income countries had difficulties winning contracts.

“We saw it with countries like Peru and Mexico,” said Andrea Taylor, a researcher at Duke University who is studying the vaccine purchase agreements. “Money wasn’t the problem for them. They have the financing to make the purchases, but they couldn’t get to the front of the line.”

Low-income countries made their first significant vaccine purchase agreements in January 2021 — eight months after the United States and the United Kingdom made their first deals, according to data compiled by Unicef.

The result has been that, as of March 30, 86 percent of shots that have gone into arms worldwide have been administered in high- and upper-middle-income countries. Only 0.1 percent of doses have been administered in low-income countries.

“Inequities are growing, unfortunately,” Ms. Taylor said, “and we expect that to be the case for at least the next six months while wealthy countries continue to keep the majority of doses rolling off production lines.”

Covax, a global effort to distribute vaccines equally that is run by the World Health Organization and others, has tried to alleviate some of the imbalances. Its primary goal is to provide vaccines to 92 lower-income countries, through its program called Advanced Market Commitment, or A.M.C. Those vaccines are paid for with cash donations by governments and organizations; the United States has donated $2.5 billion, for example, and Germany has donated $1.1 billion. ...As of March 30, Covax has shipped 32.9 million vaccine doses to 70 countries and regions. Most of those shipments were donations to lower-income countries. To put that number in context, it is just 6 percent of the 564 million doses that have been administered worldwide.

The World Health Organization expects that supply to increase, however. According to a budget released this month, the organization said Covax was “on track to hit its target of supplying at least two billion vaccine doses in 2021.” And 1.3 billion of those doses, the budget said, would be donations to lower-income countries.

But even with that influx, poor countries may end up waiting years before their populations can be fully vaccinated. Kenya, for example, expects that by 2023 it will have just 30 percent of its population vaccinated, and that’s with Covax covering the first 20 percent. That long wait would give the virus more time to spread, and potentially give rise to new mutations....

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