Covax, the vast global vaccination program, struggles to get shots into arms.


Deaths from Covid-19 were surging across Africa in June when 100,000 doses of the Pfizer-BioNTech vaccine arrived in Chad. The delivery seemed proof that Covax, the United Nations-backed program to immunize the world, could get the most desirable vaccines to the least developed countries.

Yet five weeks later, Chad’s health minister said, 94,000 doses remained unused.

Nearby in Benin, only 267 shots were being given each day, a pace so slow that 110,000 of the program’s AstraZeneca doses expired. Across Africa, confidential documents from July indicated, the program was monitoring at least nine countries where it said doses intended for the poor were at risk of spoiling this summer.

The vaccine pileup illustrates one of the most serious unrecognized problems facing the immunization program: difficulty getting doses from airport tarmacs into people’s arms.

Covax was supposed to be a global powerhouse, a multibillion-dollar alliance of international health bodies and nonprofits that would ensure that poor countries received vaccines as quickly as the rich. Instead, it has struggled to acquire doses: It stands half a billion short of its goal.

Driven by a nonprofit funded by the Gates Foundation, Covax has gotten vaccines to poorer countries faster than was previously typical. It also developed a system to compensate people for serious post-vaccine reactions and protect vaccine makers from legal liability.

Still, the 163 million doses it has delivered — most free to poorer nations, with the rest to countries like Canada that paid their way — are a far cry from plans to have at least 640 million doses available by now.

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Now, poor countries are dangerously unprotected as the Delta variant of the virus runs rampant, the very scenario that Covax was created to prevent. And the longer the virus circulates, the more dangerous it can become, even for wealthy countries.