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handle is hein.crs/govecuq0001 and id is 1 raw text is: Congressional Research Service Global COVID-19 Vaccine Distribution 0 March 26, 2021 Background The COVID-19 pandemic has led to severe health and economic consequences across the globe, as governments work to contain spread of the virus and its variants. Officials have instituted a range of physical lockdowns and quarantine measures. In late 2020, researchers identified several new COVID-19 variants, which present challenges to pandemic control. For example, parts of Brazil, South Africa and the United Kingdom are experiencing surges in COVID-19 cases, believed to be caused in part by variants that have emerged in those countries. Vaccines and other countermeasures are playing a growing role in COVID-19 control. Researchers continue to study the safety and effectiveness of various COVID-19 vaccine candidates. Congress has appropriated approximately $15 billion through supplemental appropriations (P.L. 116-123, P.L. 116-136, P.L. 116-260, and P.L. 117-2) for a range of global COVID-19 responses. Congress authorized the U.S. Agency for International Development (USAID) to use $4 billion of those funds in support of multilateral COVID-19 vaccine efforts. Actions by the Biden Administration to deepen U.S. multilateral engagement, such as joining the COVID-19 Vaccines Global Access Facility (COVAX), may lead to additional U.S. government support for global COVID-19 control. Global COVID-9 Vaccine Distribution In April 2020, the World Health Organization (WHO) and partners launched the Access to COVID-19 Tools Accelerator (ACT-A) to accelerate the development, production, and distribution of COVID-19 diagnostics, therapeutics, and vaccines. To date, several countries and WHO have approved four COVID-19 vaccines for emergency use, while vaccines produced in China and Russia that have not been authorized for emergency use are also in use in many countries. More than 80 other COVID- 19 vaccine candidates are in human clinical trials and numerous COVID-19 therapeutics are in development. Some observers estimate that COVID-19 vaccines will not be widely available in low- and middle-income countries (LMICs) until at least 2022. COVAX, the vaccine arm of the ACT-A-co-led by WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance-aims to donate two billion doses of COVID-19 vaccines for use in LMICs by the end of 2021. High- income countries may also purchase COVID-19 vaccines through COVAX to access economies of scale and likely receive more affordable prices. Advances. Nearly 200 countries have joined COVAX. The United States is the largest donor to COVAX, having pledged $2.5 billion in 2021. Other key donors include: Germany ($110 million), the European Commission ($490 million), Japan and Canada ($200 million each), Saudi Arabia, ($150 million), the Gates Foundation ($160 million), France ($120 million), and Italy ($100 million). On February 24, 2021, WHO announced the inaugural shipment of COVID-19 vaccines through COVAX, with the delivery of 600,000 doses to Ghana. COVAX plans to send 600 million doses to Africa by December 2021. As of March 17, 2021, COVAX had shipped 30 million COVID- 19 vaccines to 50 countries worldwide. Challenges. In 2021, COVAX aims to procure enough COVID-19 doses to cover 20% of the populations in 92 LMICs. Health experts estimate that to reach herd immunity, 60-80% of a given population should be vaccinated, raising questions about how LMICs might procure additional doses outside of COVAX. Moreover, as of March 4, 2021, COVAX had a $2.4 billion funding gap. Availability of COVID-19 vaccines in LMICs might also be affected by safety questions and resulting vaccine hesitancy. Several countries temporarily suspended use of the AstraZeneca-produced vaccine after individuals who received the vaccine reportedly developed blood clots. On March 18, the European Medicines Agency (EMA) concluded that the vaccines are not associated with an overall increase in blood clots and the benefits of the AstraZeneca vaccine outweigh its risks. After receiving incomplete trial data from the company, U.S. regulators also have raised questions over the vaccine's efficacy. Though use of the AstraZeneca vaccine has resumed, many countries are reporting higher rates of vaccine hesitancy in the wake of these developments. COVAX has purchased 170 million doses of the AstraZeneca vaccine. Global Vaccine Access Insufficient vaccine supply coupled with uneven capacity to pay for the vaccines have led to global vaccine access gaps. Whereas manufacturers have produced only a fraction of the eight billion doses they have been paid to produce, some countries have purchased enough doses to vaccinate their populations several times over. For example, Canada pre-ordered an average of 11 doses per citizen, reportedly because the country does not have capacity to manufacture vaccines and must rely on imported doses. Unequal vaccine distribution has stirred controversy in the international community. Since December 2020, over 400 million COVID-19 vaccine doses have been administered worldwide; of those doses, less than 10% have gone to LMICs. Some Non-Governmental Organizations, WHO, and several world leaders, have lamented these inequities. In February 2021, French president Emmanuel Macron urged G7 countries to send 5% of their vaccine doses to Africa. Vaccine Diplomacy China and Russia appear to be using vaccine sales and donations to bolster their international standing. Many https://crsreport