Nunes, C., McKee, M., Rushton, S. orcid.org/0000-0003-1055-9871 et al. (1 more author) (2025) “I think from the beginning, the ambitions were compromised”: a case study of COVAX as vaccine equity policy operationalisation. International Journal of Health Planning and Management. ISSN: 0749-6753
Abstract
Background
COVAX was designed to support the discovery, development, and distribution of COVID-19 vaccines globally, at scale and pace. This article examines how COVAX promoted vaccine equity and what lessons can be learnt.
Methods
Informed by a scoping review of lessons learnt from GHPs, we reviewed 109 documents related to COVAX and other GHPs and conducted 23 key informant interviews with representatives from GHPs, civil society, academia, and the private sector. Data were synthesised thematically using Rushton and Williams's framework.
Results
Data showed how the global health policy context shaped COVAX, with experience with Gavi and CEPI influencing its governance structure. We highlighted weaknesses in transparency and accountability, limited engagement with civil society organisations [CSO] and LMIC stakeholders, contested policy debates (e.g., different framing) and paradigms (e.g., prioritising technical and financial over political solutions).
Conclusions
COVAX largely replicated existing GHP approaches, subsidising research and development and then paying for resulting discoveries. While recognising how this reflects global power structures, in the inevitable next global health crisis, the international health community must advocate for greater LMIC and CSO involvement in decision-making, sharing of intellectual property and technology transfer, and rebalancing of flows of innovation costs and benefits to a broader range of actors across public and private sectors.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2025 The Author(s). The International Journal of Health Planning and Management published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
Keywords: | COVAX; global health partnerships; global health policy; innovation; pandemic; vaccine equity; vaccines |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Social Sciences (Sheffield) > School of Sociological Studies, Politics and International Relations |
Date Deposited: | 03 Oct 2025 11:31 |
Last Modified: | 03 Oct 2025 11:31 |
Status: | Published online |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1002/hpm.70028 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:232195 |