Progress and Priorities in Promoting Transparency along the COVID-19 Vaccine Value Chain

An efficient and effective global deployment of COVID-19 vaccine depends on the availability of transparent and accurate data across the value chain—from research and development to manufacturing, contracting, and distribution. Robust data enables decision makers to make informed decisions on what vaccine to buy, when, and at what price as well as how to better allocate resources for rapid deployment. Transparent information about the amount of funds invested and the conditions of contracts with manufacturers also creates accountability for the billions of tax-payer dollars funneled into the production and distribution of COVID-19 vaccine.

In contrast, opacity leaves policymakers to make uninformed decisions at best; at worst, the lack of available information leads to wasted doses and inequitable distribution, which in turn contributes to the emergence of new variants and further breakdown of health systems and economies as the pandemic fails to meet a swift end.

CGD co-hosted an online event in November with the U4 Anti-Corruption Resource Centre, bringing together key stakeholders from multilateral entities, country governments, policy research, and civil society to discuss the progress and challenges in pursuit of a transparent and equitable roll out of COVID-19 vaccine. Following on earlier calls for transparency, this event built on new research from U4 and pointed to two main areas of progress as well as two priorities going forward.

Point of Progress 1: Central data repositories have increased transparency and facilitated global cooperation.

Public databases such as UNICEF’s COVID-19 Vaccine Market Dashboard, launched in December 2020, and more recently, the Multilateral Leaders Taskforce on COVID-19 Vaccines Therapeutics, and Diagnostics, launched in June 2021 by the World Bank, International Monetary Fund (IMF), World Trade Organization (WTO), and World Health Organization (WHO) shed light on some aspects of global supply and demand, including vaccines approved for use; doses secured and donated globally; the COVAX Facility’s vaccine deliveries; the number of doses allocated, ordered, released for shipment, in transit, and shipped; and reported vaccine price ranges from public sources.

The Taskforce database also features country-by-country dashboards, illustrating the gaps between daily vaccination rates and doses needed to achieve 40 and 70 percent vaccination coverage targets. Priya Basu, the head of the Secretariat for the Multilateral Leaders Taskforce, underlined the role of data in driving action for a transparent and equitable roll out of vaccines. For example, as Basu referenced, data from the Taskforce’s dashboard induced the recent deal between the United States government, Moderna, and the African Union to make 110 million doses of vaccines available to African countries in the coming months. This arrangement involves deferring delivery dates in the United States where vaccine rates are higher while pushing them up for African countries where vaccine rates are lower—a move known as “queue swapping.” By making clear the available supply of vaccine, the Taskforce’s database helps inform such policies to move global vaccine supply and address inequities.

Although these dashboards improve the transparency of data, the lack of coordination between repositories limits their impact. In November 2021, the IMF and WTO launched the COVID-19 Vaccine Trade Tracker, which reports on global vaccine supply—an element of the Taskforce’s dashboard as well. Similarly, the IMF recently introduced the COVID-19 Global Targets and Progress Tracker, which duplicates the focus of the Taskforce’s dashboard on indicators like vaccine supply and deliveries. Storing data on separate platforms makes it more difficult for decisionmakers to access and analyze the available evidence, ultimately undermining the use of this data to strengthen the global response.

Point of Progress 2: High-income countries have primarily acted out of self-interest, but they have also made meaningful—albeit limited—contributions to the global pandemic response through aid.

Many high-income countries have hoarded vaccines and the technology to produce them, responding to the pandemic with nationalism. As a result, almost 70 percent of the population in high-income countries has been fully vaccinated compared to only 3.7 percent of the population in low-income countries. By signing the World Health Assembly resolution in May 2020, high-income countries pledged to guarantee universal access to COVID-19 vaccines to end the pandemic. However, high-income countries’ support for the pandemic response beyond their national borders has been too little too late.

Governments in high-income countries have largely left their role in the global response to their foreign aid arm. Aid agencies have helped address vaccine inequities. For example, Paul Richard Fife, the Director of the Department for Human Development at the Norwegian Agency for Development Cooperation, discussed Norway’s track record of co-chairing the Facilitation Council within the WHO’s Access to COVID-19 Tools Accelerator (ACT-A) group, contributing funds and doses to COVAX, supporting data sharing mechanisms, and leading negotiations at the WTO on fair pricing for low- and middle-income countries. Comparable actions from other high-income countries have helped deliver vaccines to low- and middle-income countries, although glaring inequities remain. An aid-focused response is not enough to vaccinate the world and end the pandemic; high-income countries must adopt a global agenda.

Remaining Challenge 1: Companies and governments must share delivery schedules immediately.

Central repositories like the Taskforce’s database represent an encouraging step towards a transparent and equitable pandemic response, but these databases are still incomplete. In particular, a crucial data piece of data is missing at present: delivery schedules. In the COVID-19 crisis, governments, procurement mechanisms, and companies have often accepted contracts without clear delivery schedules, redacted delivery schedules over confidentiality concerns, and forgone penalties associated with late delivery in the interest of protecting their place in the queue and guaranteeing supply. However, without accurate data on when vaccines will show up at ports and airports, policymakers must scramble to set up a deployment scheme, potentially leaving many shots unused and many vulnerable individuals at risk. As Basu and Fife underscored, information about delivery schedules is crucial to equip policymakers with the robust data needed to develop a strategic—rather than hasty—vaccine deployment. Delivery schedules are particularly important at this stage of the pandemic, as recent estimates suggest a surplus of vaccine will be available by the end of the year, making distribution the most pressing issue to end the pandemic.

In addition to improving national-level responses, transparent delivery schedules for COVID-19 vaccines creates an important mechanism of accountability for decision makers. As Eduardo Bohórquez, the Executive Director of Transparency International Mexico, highlighted, transparency is not synonymous with integrity. Thus, as countries share information like delivery schedules, it will create opportunities for social accountability both at the national and global levels.

Remaining Challenge 2: High-income countries must go beyond aid and have an all-government response to their COVID global engagement.

As previously highlighted, high-income countries have limited their role in the vaccine roll out outside their borders to aid, donating few doses compared to the stockpiles procured for their own populations and earmarking a small amount of funding for global efforts like COVAX relative to the amount allocated to their national response. Prioritizing their own population while attempting to support other countries’ responses creates a policy incoherence, as Karen Hussmann, an independent expert and researcher with U4, pointed out.

Fife called on high-income countries to consider the global situation when forming national policies for COVID-19 vaccine procurement and distribution to truly curb the pandemic. Countries must consider global equity in the vaccine roll out as central to their national response rather than a political opportunity to demonstrate goodwill. Beyond human rights arguments to support equity, countries are vulnerable to further economic collapse and health system burdens if the pandemic continues. This global perspective would also stimulate an all-of-government approach rather than assigning development or aid agencies to manage countries’ contributions to the global pandemic response alone.

High-income countries can also learn from early mistakes and change course to be more transparent going forward. This perspective is especially important as they begin to procure and distribute boosters while large populations in low- and middle-income countries remain unvaccinated. Charles Kenny, a Senior Fellow at the Center for Global Development, urged high-income countries to release the expiration dates of doses to make clear the timeline for using doses domestically and identify how much of their supply will be wasted if not reallocated elsewhere. By sharing dose expiration dates, among other measures, high-income countries can be held accountable to avoid unnecessary stockpiling and effectively and efficiently get shots in arms.

Conclusion

Over the past few months, data transparency has improved, and new initiatives and repositories have been launched, improving global data availability and shedding light on key gaps to address through global and national responses. Yet, key challenges remain in the quest for a transparent and equitable vaccine roll out. Decision makers must promote transparency throughout the vaccine value chain to establish a precedent and ultimately elevate the efficiency, effectiveness, equity, and integrity of the global vaccine roll out. Beyond the current pandemic, the global community must also set standards, analyze experiences, and weigh the costs and benefits of transparency to prepare for better responses to future crises.