Mass global COVID-19 vaccination is coming. It will be one of the largest ever rollouts of global public goods. Proper vaccine procurement and distribution and a well run, fleet-footed immunization campaign will be crucial to rebuilding our economies. “No one will be safe until everyone is” as the WHO reminds us. Done poorly, there will be holes in the fence.
1) Risks associated with vaccine procurement The centerpiece of international coordination is the COVID-19 Global Vaccine Access Facility (Covax Facility). It will support:
An initial proportional allocation of doses to countries until all countries reach enough quantities to cover 20% of their population;
A follow-up phase to expand coverage to other populations. If severe supply constraints persist, a weighted allocation approach would be adopted, taking account of a country’s COVID threat and vulnerability.
In addition to this, countries are also working unilaterally to sign pre-purchase agreements to secure supplies to the rest of their population. These can be huge, covering up to 600% of their national vaccine demand. As Professor Kenneth Shadlan of LSE has commented: “national purchases beget national purchases: fearing being left out in the cold as scarce supplies are being gobbled up, any country that can procure vaccines directly [is now trying] to do so.” COVAX is to some extent being left behind as some media reports and Figure 1 shows.
The rush to secure supplies and a decline in international coordination are fertile grounds for conflicts of interest. And, of course, even if supplies are purchased through COVAX this does not guarantee that they will be equally distributed or that they won’t end up in private pharmacies or black markets.
It is also worth recognizing the huge asymmetry of information that exists in the market between pharmaceutical companies and countries. Often, countries will sign up to swingeing confidentiality provisions on their pharmaceutical deals with little consideration of later impacts. It was unthinkable that oil and mining deals would be disclosed a decade ago, there is now a global principle of disclosure and action by over 40 countries to open those deals up. This would be especially appropriate for the vaccine rollout given that some of the major companies involved have offered it as a global good and have promised to price deals fairly.
2) Corruption risks associated with delivering a mass vaccination program: Beyond the vaccine purchases themselves, there will be a huge supply chain to deliver a vaccination program on the ground. And as we have seen from securing PPE and other supplies to fight the pandemic, there will likely be major corruption and fraud risks associated with these, especially when rolled out at speed. The smaller, less visible contracts that lie behind the rollout of mass vaccination appear especially vulnerable to abuses and looting (see U4's analysis here), challenges which the Global Vaccination Alliance GAVI itself acknowledges.
Objectives and guiding questions for the research: Currently, there is almost no data on how different governments plan to secure, procure, and deliver their vaccination programs. Our thesis is that public integrity and trust for these programs will be bolstered by explaining the basics on how these deals are being planned, what the terms are, why a particular vaccine was a good choice, and leveraging existing civic monitoring mechanisms following COVID-19 emergency procurement to ensure an effective rollout of vaccination programs, especially in low-income countries & countries with poorer governance.
Governments and public buyers to apply open contracting standards across their vaccination programs, helping them properly collect and publish information, manage risks throughout the whole contracting cycle, starting from planning to buying to vaccination;
Civil society organizations advocate for better data collection and disclosure, identify and report on risks along this cycle and conduct monitoring of specific parts of the chain as their expertise allows.
The guide should answer the following questions:
How to find out what vaccines are already available on the market (COVID-19 vaccines registry with producers, prices, terms, cold-chain requirements, approved in countries with strict regulatory regimes or WHO-prequalified etc);
What are the key mechanisms for procuring the vaccines themselves (COVAX, national procurement systems, IFIs, International organizations (UNICEF etc.);
How should governments approach COVID-19 vaccine demand quantification (including prioritizing population groups) and procurement planning inc. what the key steps are and how to provide clear, accessible information on the whole program and its spending;
What are the challenges and most likely corruption risks in COVID-19 vaccine contracting cycle and how might they be mitigated (with appropriate examples);
What do citizens need/want to know about COVID-19 vaccine procurement and about ancillary goods and services (inc training, supply chain equipment, e.g. cold chain, etc)?
What should civil society understand about sub-contracts awarded for the delivery of vaccines, what type of awards may be made (e.g. logistics, storage) and what are the red-flags to look out for?
How to better collect, publish and visualize data including through the use of tools like the Open Contracting Data Standard and how might such data be used.
The expected deliverables of these research projects include:
An actionable guide for governments and civil society organizations on how collect, publish, visualize, use and properly communicate data throughout the COVID-19 vaccine contracting cycle;
Draft guide for governments and civil society: end of February 2021
Final guide for governments and civil society: end of March 2021
Organizations or individuals from any country are eligible to apply.
We will prioritize proposals under 25,000 USD
Application: Please submit a short document (5 pages max) outlining:
the methodology you want to pursue;
how you will approach information collection;
how you intend to make your guide actionable;
your professional experience in public procurements, healthcare & vaccine procurement, skills and capacity to undertake the guide development. Please summarize similar guides that resulted in improvements of certain processes.
Please also upload CV(s) and an example of past guides development.
All documents should be submitted via a Screendoor application form.