FILE PHOTO: The word "COVID-19" is reflected in a drop on a syringe needle in this illustration taken November 9, 2020. REUTERS…
FILE - "COVID-19" is reflected in a drop on a syringe needle in this illustration taken Nov. 9, 2020.

Nearly two billion doses of COVID-19 vaccines have been secured for equitable distribution in 2021 to the 190 countries that have signed on to a World Health Organization-led partnership, according to a Friday announcement from the group. 

Officials from the vaccine manufacturers said they expect delivery to begin in the first quarter of next year. 

The partnership, known as COVAX, said the supply includes at least 1.3 billion doses for low- and middle-income countries. 

With the first vaccine beginning to arrive in some high-income countries and a second nearing approval in the United States, the rest of the world has wondered when lifesaving treatment would reach them. 

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COVAX was established to avoid the usual delays in access to medical tools between high- and low-income countries.  

"Our goal of global equitable access to COVID-19 vaccines is alive and well," said Chief Executive Officer Seth Berkley of GAVI, the Vaccine Alliance that will lead distribution of the vaccines for COVAX.  

Berkley said he expects the first tranche of vaccines to cover health care workers and other highly vulnerable people to be delivered by the end of next June. Distribution then would ramp up, aiming to deliver enough to immunize 20% of COVAX members' populations by the end of the year.  

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However, none of the vaccines in the group's portfolio has received regulatory approval yet, and questions remain about funding to purchase and distribute them.  

"It’s very hard to see how the (2 billion) doses is anything but hypothetical at this point," said Kate Elder, senior vaccines policy advisor with the nonprofit Doctors Without Borders. 

According to the announcement, COVAX has signed a memorandum of understanding with U.S. pharmaceutical company Johnson & Johnson for 500 million doses of its vaccine, which is still undergoing clinical trials. The company says it expects results in January.  

COVAX also has signed an advance purchase agreement with British drugmaker AstraZeneca for 170 million doses of its candidate.  

That figure is much smaller than the 300 million doses listed in its June memorandum of understanding, Elder noted.

The Serum Institute of India has agreed to manufacture up to an additional 1.1 billion doses of either AstraZeneca's vaccine or a candidate from U.S. biotech company Novavax, still in development. French pharmaceutical company Sanofi and Germany-based GSK also have agreed to supply 200 million doses of their joint product, which recently suffered a setback in clinical trials.

COVAX currently does not have access to the two vaccine frontrunners from biotech company Moderna and drug firm partners Pfizer and BioNTech.  

Pfizer's vaccine has begun distribution in the United States, the United Kingdom and Canada. Moderna may receive approval in the United States as soon as Friday. 

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COVAX is in discussions with those companies but has not reached an agreement, said Richard Hatchett, chief executive officer of the Coalition for Epidemic Preparedness Innovations, which leads research and development for COVAX. 

"Watch that space," Hatchett said. 

The organization has raised $2.4 billion to begin to secure vaccines for low- and middle-income countries. It says it will need an additional $4.6 billion next year to complete the process, as well as $800 million for research and development and $1.4 billion to support vaccine delivery. 

"We still need more doses. And yes, we still need more money. But we have a clear pathway to securing the initial 2 billion doses," GAVI's Berkley said. 

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