2022-04-13-世界卫生组织-Explainer_for_COVAX_Allocation_Phase_2_6页_297kb

COVAX Phase 2 Allocation Mechanism Summary

Core Content

The COVAX Allocation Mechanism has entered Phase 2, which aims to improve vaccine access and equity for AMC-91 participants by shifting from a supply-driven approach to a demand-driven one. This new phase reflects the evolving pandemic situation and the increasing global vaccine supply, with a focus on supporting countries with lower vaccination coverage to meet their self-defined targets.

Main Goals of Phase 2

1. Support individual country targets and ambitions to control the disease and reopen society.
2. Contribute to global vaccination coverage goals, aligning with WHO targets and considering all vaccine sources.

Key Shifts in Phase 2 Approach

• Demand-driven allocation: Countries submit demand based on their needs, and supply is allocated in response.
• Account for all supply sources: Includes COVAX and non-COVAX vaccines, enhancing equity.
• Long-term rolling allocations: Provide a 6-month outlook with potential ranges to reflect uncertainty.
• Predictable demand process: Regular and structured collection of demand information from participants.

Rationale for the New Approach

Phase 1 was launched in February 2021 and adapted through an Interim Phase in July 2021. Three key shifts were made:

1. Reserving dedicated supply for low-coverage countries from all sources.
2. Incorporating absorption capacity into allocation decisions starting in Q4 2021.
3. Adapting shipment sequencing based on threat and vulnerability, using epidemiological data.

Phase 1 Principles in Context

While Phase 2 introduces new mechanisms, it builds on the principles of Phase 1, which included:

• No doses should remain idle.
• Allocation serves all participants willing to receive vaccines.
• Only approved vaccines (EUL, PQ, or SRA) are allocated.
• Minimize the time gap between first and last participant receiving doses.
• Allocate based on participant preferences where possible.

Allocation Design for Phase 2

Phase 2 is structured in three steps, aiming to create a predictable monthly process for rolling allocation of long-term supply:

1A. AMC Participants Provide Demand Information

• AMC participants set their own vaccination targets and overall needs.
• They submit monthly demand forecasts with product breakdowns, which are updated regularly.
• COVAX provides guidance through SAGE recommendations, regional and national immunization advisory groups, and technical tools for demand forecasting and deployment planning.

1B. COVAX Gathers Supply Information

• COVAX compiles a 6-month supply forecast, integrating data from manufacturers and donors.
• Non-COVAX supply is also considered, including bilateral deals, regional agreements, and domestic production.
• Public dashboards are used to provide supply visibility to countries and stakeholders.

2. COVAX Aggregates Demand and Matches It with Supply

• COVAX regularly aggregates demand and compares it with supply projections.
• Prioritization rules are applied when supply is insufficient, focusing on:
  • Certainty of supply.
  • Ensuring continuity for all participants.
  • Prioritizing low-coverage countries based on coverage, shelf-life, and product preferences.
  • Fulfilling remaining demand for other participants.
  • Offering excess supply to all participants.

3. COVAX Provides Long-Term Allocation and Updated Outlook

• A 6-month rolling allocation is provided each month, with ranges to reflect uncertainty.
• Participants are invited to accept the allocated supply, and delivery volumes are confirmed through dialogue with countries and manufacturers.

Governance Changes

• IAVG (Independent Allocation Validation Group): Transitioned from approving allocations to providing strategic advice and monitoring equity.
• JAT (Joint Allocation Taskforce): Continues to manage the allocation tool, match supply and demand, and prepare vaccine allocation decisions. It also serves as the secretariat for the IAVG.

Key Information

• Total doses allocated in Phase 1: ~2Bn doses for 149 participants.
• Doses shipped by February 2022: 1.2Bn doses, including 1.1Bn to 86 AMC participants.
• Humanitarian Buffer: 5% of donor-funded supply is reserved for humanitarian needs.
• Focus of Phase 2: Only donor-funded, facilitated, and donated doses for AMC participants are considered.
• Separate processes: Cost-sharing participants (SFPs) and ancillaries (e.g., syringes) are managed through other mechanisms.

Conclusion

Phase 2 of the COVAX Allocation Mechanism represents a significant shift towards more flexible, demand-responsive, and equitable vaccine distribution. It aims to ensure that all countries, especially those with lower vaccination coverage, can access vaccines in line with their needs and strategies, while maintaining supply security and program continuity.