新冠肺炎疫苗融资机制、新冠肺炎病毒预先市场承诺（AMC）和新冠肺炎肺炎疫苗支柱交付工作的评估：评估简报

EvaluationBrief May2025 Prepared forGavi, WHO, UNICEF, CEPIPrepared byRTI International3040 E.Cornwallis Road, PO Box 12194Research Triangle Park, NC 27709 USAwww.rti.orgWith Itad Ltd. (UK) and Genesis Analytics (S. Africa) INTRODUCTION COVID-19 was the most significant public healthemergency in over a century, with global economicand societal repercussions. At the start of thepandemic, international organizations and countriesrecognized that equitable vaccine access was keyto minimizing lives lost, ending the pandemic, andenabling economic recovery. On January 30, 2020,theDirector-General of the World HealthOrganization (WHO) declared the COVID-19outbreak a public health emergency of international Purpose of this brief This briefing paper distils key messagesfrom findings, lessons learned andrecommendations fromthe Evaluation ofCOVAX Facility and AMC and COVAXPillar Delivery Efforts.The evaluationrecommendations are intended to informongoing discussions for future pandemicpreparedness and response. concern(PHEIC),underscoring the urgent need for widespread vaccine distribution.Launched in April 2020, the Access to COVID-19 Tools Accelerator (ACT-A) was a multi-stakeholder partnership aimed at deploying COVID-19 tools to accelerate the end of thepandemic. One of its key pillars, the COVID-19 Vaccine Global Access Facility (COVAX),aimed to provide equitable vaccine access through pooled global funding for research,procurement, allocation, and distribution. COVAX was co-led by the Coalition for EpidemicPreparedness Innovations(CEPI), Gavi, the Vaccine Alliance (Gavi), United NationsChildren’s Fund (UNICEF), and the World Health Organization (WHO). The Gavi COVAXFacility and Advance Market Commitment (AMC) enabled 92 lower-and middle-incomecountries to access vaccines for vulnerable populations, supported byguidance, funding,technical assistance and delivery services throughthe COVAX Pillar. From 2020 to 2022, theCountry Readiness and Delivery(CRD) workstreamaimed to ensurecountry readiness to accept vaccines and support for the deployment of COVID-19 vaccinedoses.In response to lagging vaccination ratesin certain countries, the COVID-19 VaccineDelivery Partnership (CoVDP) was launched in 2022 to provide intensified supportto34countries with coverage below 10% to accelerate uptake.In line with publication oftheWHOand UNICEF interim guidance in July 2022, COVAX began towork with countries onintegrating COVID-19 vaccinations into routine immunization programs. LESSONS FROM COVAX 1.Amultilateral mechanism can add significant value within the global architecture tosupport equitable access to vaccines in pandemic contexts. The global response to COVID-19 highlights that vaccine nationalism, vaccine diplomacy, andcommercialinterests will influence pandemic responses. Any multilateral or market-basedsolution to vaccine equity must be designed to function effectively within this context, where theneeds of high-income countries (HICs) are met through alternative channels. Despite the challenges posed by the unprecedented and evolving circumstances in whichCOVAX was implemented, significant progress was made in achieving equitable vaccineaccess. This underscores the importance of a multilateral approach to developing, procuring,allocating, and supporting the rollout of vaccine technologiesinglobal health emergencies. 57% coverage 1.8 billion doses147 countries Distribution By the end of 2023, 2.2 billionpeople among the AMC92 countieswere vaccinated with the completeprimary series, which equates to57% coverage. The firstaccess tovaccines in LICwas not until February 2022, bywhich time 88% of HICs, 60% ofUMICs, and 30% of LMICs hadstarted vaccinations. By the end of2023, LICs had still only provided afirst vaccine dose to 36.1% of theirpopulation. Almost 1.8 billion doses weredelivered to AMC participants. Thisaccounts for 74% of doses in LICs,68% in African AMC countries, and39% in the 20 AMC LICs new toGavi. Impact of CoVDP In the CoVDP subset of the AMC92countries, primary series coverageincreased from 3% to 28% by May2023. Between December 2020 andNovember 2023, COVAX accountedfor almost 13% of the total number ofvaccines distributed globally 2.Ensuring equitable access to vaccines in a pandemic requires an end-to-endapproach, addressing a full, integrated range of functions and processes required tobring vaccines in atimely fashion to those at risk. An effective pandemic response requires an end-to-end approach covering the entire valuechain, from research and development (R&D) to procurement, policy, vaccine allocation, anddelivery at the country level. Coordination across functions like resource mobilization, humanresource management, political advocacy, risk management, and communication is crucial forsuccess. By 2021, COVAX had built a robust end-to-end solution for equitable vaccine access,enabling it to scale efforts in 2022 despite challenges. Findingsfrom theKey Aspects of COVAX Respo