世界发展银行-Assessing-Country-Readiness-for-COVID-19-Vaccines---First-Insights-from-the-Assessment-Rollout_28页_6mb

Summary of the World Bank's Assessment of Country Readiness for COVID-19 Vaccines

Core Content

The World Bank, in collaboration with WHO, UNICEF, Gavi, and the Global Fund, conducted readiness assessments for 128 low and middle-income countries to prepare for the global rollout of the COVID-19 vaccine. These assessments aimed to identify gaps in preparedness, provide insights into country-level capacity, and support the development of effective vaccination strategies. The assessments were part of the COVAX initiative, which seeks to ensure equitable access to vaccines.

Main Points

• Global Initiative: The assessments were launched in November 2020 and are based on the VIRAT-VRAF 2.0 tool, which evaluates readiness across ten core programmatic areas and 50 indicators.
• World Bank Support: The World Bank has committed $12 billion in fast-track financing to support vaccine procurement, distribution, and health system strengthening for eligible countries.
• Country Readiness: While many countries have developed National Deployment and Vaccination Plans (NDVP) and established National Coordinating Committees (NCC) and National Technical Working Groups (NTWG), significant gaps remain in training vaccinators, social mobilization, and demand generation.
• Vaccine Safety Systems: Over 68% of countries have developed vaccine safety systems, but only 27% have created social mobilization and public engagement strategies to promote vaccine uptake.
• Digital Systems: The assessments highlight opportunities for countries to develop specialized digital systems to track vaccine distribution and monitor safety.
• Cold Chain Infrastructure: Strengthening the cold chain and logistics is critical, and the assessments show that many countries are working to improve these systems.
• Public Health Functions: The Joint External Evaluation (JEE) tool, which assesses health security preparedness, shows that child immunization systems are not strong predictors of readiness for adult vaccination campaigns.
• Regional Disparities: Readiness scores vary significantly by region, with ECA having the highest median readiness score, followed by LAC and MNA. LAC shows the greatest dispersion in scores, suggesting uneven progress.

Key Insights

1. JEE Scores and Readiness for Adult Vaccination

• JEE Immunization Scores are not strongly correlated with country readiness for adult vaccination.
• Countries with developed immunization capacity (JEE score 3) show a median readiness score of 0.5, while those with limited capacity (JEE score 2) have a median score of 0.36.
• This suggests that adult vaccination campaigns require new and different readiness levels compared to traditional child immunization programs.

2. Regional Variations in Readiness

• ECA countries have the highest median readiness score.
• LAC countries show the greatest variation in readiness scores, from 0.06 (Haiti) to 0.76 (Colombia).
• MNA and SAR countries have lower readiness scores, indicating a need for more support.

3. Progress on Vaccine Delivery Chain

• Most countries have made significant progress in strengthening the vaccine delivery chain, particularly in planning, coordination, and logistics.
• Many countries are prioritizing speed over systemic improvements, which may limit long-term benefits.

4. Gaps in Readiness

• Training of vaccinators and social mobilization remain major gaps.
• Only 30% of countries have developed processes to train the large number of vaccinators needed.
• 27% of countries have created social mobilization and communication strategies.

5. Use of Digital Tools

• The VIRAT-VRAF 2.0 tool helps countries quantify financing needs and track readiness progress.
• Digital systems like eVIN and CoWin are being used to improve vaccine tracking and safety monitoring.

6. Momentum for Vaccination

• The assessments have elevated the importance of readiness to the highest levels of decision-making.
• They have unified government, health professionals, the private sector, and communities in the largest vaccination campaign in history.
• This has generated unprecedented momentum for vaccine deployment, especially in low and middle-income countries.

Conclusion

The readiness assessments for COVAX countries provide valuable insights into the preparedness of 128 countries to deploy COVID-19 vaccines. While significant progress has been made in several areas, key gaps remain, particularly in training, social mobilization, and demand generation. The assessments have helped identify and prioritize areas for support, and have been instrumental in accelerating vaccine rollouts. The VIRAT-VRAF 2.0 tool is a comprehensive framework that supports country-level planning, capacity building, and resource allocation for the vaccination campaign.

Key Information

• Total Countries Assessed: 128
• Total Countries with Completed Assessments: 127 (including West Bank & Gaza)
• VIRAT-VRAF 2.0 Tool: Assesses readiness across 10 core areas and 50 indicators
• World Bank Financing: $12 billion allocated for vaccine procurement and health system strengthening
• COVAX Vaccine Supply Forecast (2021):
  • First Quarter: 95 million doses (85 million for AMC countries)
  • Second Quarter: 365 million doses (285 million for AMC countries)
• Vaccination Campaigns: Already underway in Kenya, Nigeria, and Rwanda
• NDVP: National Deployment and Vaccination Plan is a critical tool for vaccine rollout planning
• JEE: Joint External Evaluation tool used to assess health security preparedness
• GDP Losses: Delaying vaccine rollout can result in $14 billion in GDP losses for Africa per month

Supporting Frameworks and Partnerships

• COVAX: Aims to provide equitable access to vaccines
• ACT-A: Accelerates access to COVID-19 tools
• Gavi: Plays a key role in vaccine financing and regulatory support
• WHO and UNICEF: Provide guidelines, tools, and technical assistance
• Global Fund: Supports health systems and vaccine logistics

The assessments have been crucial in identifying gaps and guiding investments, and are expected to feed into World Bank projects and global vaccine strategies.