For months now, the World Health Organization has been appealing to rich states to donate supplies to the COVID-19 Vaccines Global Access initiative. But the response to the international program known as COVAX has been somewhat underwhelming.

In countries like Germany, some 45% of the population have now received at least one vaccine jab, according to figures from the Robert Koch Institute, the national public health body. Yet elsewhere, the vaccination rollout is only just getting underway. And in some African countries, such as Tanzania and Chad, the vaccination drive has not even begun.

"The inequality of access to vaccination is the biggest challenge: 75% of vaccine supplies have been sent to just ten countries. Less than one percent of all doses have gone to countries with low GDPs," said the WHO in a written statement to DW. "Unfortunately, this represents a two track recovery from the pandemic."

However, COVAX seems to have started picking up speed in the last few days. At an online donors' conference, additional funding of some $2.4 billion (€1.9 billion) was pledged — some $400 million more than anticipated. This, COVAX says, would allow it to supply 1.8 billion more vaccine doses to people in poorer countries.

"A drop in the ocean"

These funding pledges could help COVAX to get a little closer to its goal of distributing vaccine supplies more fairly worldwide. But international relief organizations say that they do not go far enough. Mareike Haase, who is responsible for world health policies at Bread for the World, told DW: "Countries are pursuing their own strategic interests and are tending to donate directly to allies. But in our view it is COVAX that has to be in charge of distribution if it is to be equitable."

Recently, for example, the United States vowed to deliver some 80 million vaccine doses to poorer countries in Latin America and the Caribbean, in south and southeast Asia and in Africa. But US president Joe Biden said only three-quarters of the supplies would be distributed via the international COVAX initiative, the rest would be sent directly.

In addition, the supplies are just a "drop in ocean," says Haase."These are just short-term solutions." She says that far greater efforts are needed in the face of new virus variants and the need for refresher jabs. "We will keep returning to the situation where poorer countries cannot afford vaccines and that is why COVAX simply does not go far enough." In addition, Haase is calling for patent protection to be waived for the duration of the pandemic. But the European Union continues to oppose this move. 

India suspends vaccine exports for now

India's decision to ban vaccine exports is also likely to come as a blow to COVAX. The Serum Institute of India (SII) was one of the biggest vaccine suppliers worldwide. But now exports have been suspended, in all likelihood until October. Originally, exports were supposed to restart in June. This could mean a shortfall of millions of doses. The world's biggest vaccine manufacturer, the Serum Institute, produces COVID vaccines for the British-Swedish pharmaceutical company AstraZeneca — and had been Africa's biggest source of vaccines prior to the ban.

But India, itself, is currently hard hit by the pandemic. The exports were originally promised when the country was experiencing relatively low levels of infection. Then in spring the seven-day incidence rates rocketed to highs of about 200 per 100,000 inhabitants in just a few weeks. "We see the traumatic effects of the dreadful COVID-19 wave in South Asia  — a wave, which also severely hampered global vaccine deliveries, including COVAX," the WHO said in a written statement to DW.

The vaccine gap remains

Big donations, on the one hand, and a breakdown in exports, on the other: Relief organizations like Bread for the World are critical of COVAX per se. "In our view it has already been shown that the COVAX system fundamentally does not work," Mareike Haase told DW. In her opinion, the fact that COVAX works on a voluntary basis is a major drawback. "The problem is that countries who prefer to secure their vaccines  bilaterally rather than via COVAX have bought up everything available and are hoarding supplies. At the same time, COVAX never got sufficient funding and companies preferred to sell their vaccines to the highest biggers rather than working with COVAX."

The Bread for the World expert is also critical of the aims of COVAX. Originally, the plan was to vaccinate enough people in the world to achieve herd immunity, but, in the meantime, there is talk of 20% to 30% of the population. That is a fraction of the number really required to stop the pandemic in its tracks. "From the outset we would have liked to see a different system, a binding one that aimed to achieve equality and to give all countries access to vaccines." Mareike Haase says it is necessary to treat with caution the pledges made by Germany and the United States to COVAX "when you simultaneously see the big gap."