{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:33:56Z","timestamp":1787607236517,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Challenges"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>As the world has a history of vaccine nationalism, especially during the 2009 Swine flu pandemic, the COVAX alliance, a globally collaborated mechanism, was created by World Health Organization (WHO), GAVI, and UNICEF to address the inequity of COVID\u201019 vaccines. One of the primary aims of this alliance was to deliver vaccines to low\u2010 and middle\u2010income countries (LMICs), which otherwise have less or no capacity to access vaccines from the open market. It is crucial to explore the contribution of COVAX in bridging the gap in equity, accessibility, and affordability of COVID\u201019 vaccines between high\u2010 and low\u2010income countries (LICs). We selected Group 20 (G20) COVAX participants and the African Union (AU) as case studies to estimate these gaps. The bilateral purchase data shows that by December 2021, the G20 countries had vaccines more than double their population, whereas the AU could procure only about one fifth (19%) of their population. Out of 52 AU countries whose data was available, only 21 of them could strike a bilateral deal with vaccine manufacturers. Even after COVAX delivery, the share of the population that could be vaccinated in AU was just 36.8%, less than the target of WHO (40%) for December 2021. It was found that the COVAX alliance worked better than the open market competition for LMICs and LICs. The cost of vaccinating 20% of the population was 0.7% of the current health expenditure for G20 countries, whereas AU countries had to spend 5.5%. COVAX bears more cost (1%\u20133%) for AU countries than G20 countries (less than 1%). COVAX made COVID\u201019 vaccines more affordable and accessible to these countries. However, LICs were disproportionately affected even with the COVAX Facility mechanism owing to their lack of vaccine deployment infrastructure.<\/jats:p>","DOI":"10.1002\/puh2.185","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T08:24:30Z","timestamp":1715243070000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["COVAX and COVID\u201019 Vaccine Inequity: A case study of G\u201020 and African Union"],"prefix":"10.1002","volume":"3","author":[{"given":"Anjali","family":"Pushkaran","sequence":"first","affiliation":[{"name":"Prasanna School of Public Health, Manipal Academy of Higher Education  Manipal Karnataka India"},{"name":"Department of Health Policy London School of Economics and Political Science  London UK"},{"name":"Center for Evidence\u2010based Diplomacy Global Health Research and Innovations (GHRIC)  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay Kumar","family":"Chattu","sequence":"additional","affiliation":[{"name":"Department of OS &amp; OT, Temerty Faculty of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"United Nations University\u2010Institute on Comparative Regional Integration Studies (UNU\u2010CRIS)  Bruges Belgium"},{"name":"School of Public Health, University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Health Policy Prasanna School of Public Health, Manipal Academy of Higher Education  Manipal Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Gavi launches innovative financing mechanism for access to COVID\u201019 vaccines.2020.Gavi the Vaccine Alliance. 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