Covid-19: We must put in place a financial plan of action for achieving vaccine equity

Dear G7 leaders,

We are writing ahead of your crucial summit meeting in the United Kingdom to urge you to provide the leadership the world needs in responding to covid-19. 

It is now imperative that we put in place a financial plan of action for achieving the vaccine equity needed to save lives, restore hope, and overcome the pandemic—and your summit provides an opportunity to underpin that plan with financial commitments.

You will be meeting against a distressing backdrop. Covid-19 infections are running at a record high and deaths are rising. The Director General of the World Health Organization has warned that deaths in 2021 could surpass the levels reached last year. The human suffering continues to unfold on an international scale. Many countries are today struggling with high transmission rates, over-stretched intensive care units, and desperate shortages of oxygen.

As scientists from various disciplines, we have been working to understand, contain, and control the virus. But we are also members of a human family—and we are deeply aware of our responsibilities to our fellow citizens around the world. 

The development of vaccines was a triumph of science and endeavour. The delivery of vaccines to the world’s poorest countries and people will require a triumph of international cooperation, leadership, and hard financial planning.

Our concern is that vaccines are trickling down too slowly to poor countries. As wealthy countries move towards coverage rates of 70 per cent and above, coverage across sub-Saharan Africa remains less than 1 per cent. The vaccine gap between rich and poor countries is growing by the day. Changing this picture is an ethical imperative. It is also an epidemiological necessity. 

The phrase “none of us are safe until all of us are safe” is not a political slogan, but a scientific fact. Faced with a global pandemic, we are all as strong as the weakest link in the chain. That should be clear from the rapid spread of more transmissible variants. Vaccination has the power to protect us all—and the sooner we are all protected, the sooner societies, economies, and the lives of people around the world can recover. We have been concerned by the spread of vaccine nationalism, above all because it is self-defeating. In fighting a global pandemic, the safety of all people—including citizens of the G7 countries—depends on the protection of everyone. 

We applaud your efforts to address the challenges posed by covid-19 through international cooperation. Several G7 countries have contributed generously to COVAX, which has now delivered over 50 million doses to more than 120 countries, and the wider ACT-Accelerator (ACT-A) architecture.

However, it is increasingly evident to us that the pace and scale of international cooperation must be stepped up. That applies first and foremost to vaccination. But we must not lose sight of the wider pressures on fragile health systems. The scenes from India have provided a reminder of the suffering associated with shortages of medical oxygen. Meanwhile, we are deeply aware that primary healthcare services are suffering from the disruption caused by covid-19.

It is against this background that we call on you to galvanise international action. We support the call of Gordon Brown, Graça Machel, and others for the G7 to fully finance its share of the resources needed to support ACT-A over the next two years. The current financing gap amounts to around $66bn (including $19bn for this year). Closing that gap would provide the resources needed to accelerate progress towards universal adult vaccination.

Countries attending the G7 summit should agree a simple financing formula for allocating contributions. Based on a burden-sharing formula developed by South Africa and Norway, these countries would cover around-two-thirds of overall ACT-A financing, or around $43bn over two years. The G7 is also well placed to mobilise through agencies like the IMF and World Bank the additional finance needed to support vaccine delivery and essential services through investment in health systems, especially primary healthcare.

We are, of course, aware that every G7 country is facing its own financial pressures. Yet there is an overwhelming case for you to act. The costs of vaccinating the world will be dwarfed by the economic costs of failing to act. More importantly, the human costs of continuing a business-as-usual pathway are simply unacceptable, including for citizens living in the G7 countries.

This is your opportunity to draw a line in the sand, save lives, and set the world on a course for recovery. We urge you to seize that opportunity on behalf of humanity.


Joy Lawn, Director MARCH Centre (Maternal Adolescent Reproductive & Child Health)  

Marc Lipsitch, Director, Center for Communicable Disease Dynamics

John Edmunds, London School of Hygiene and Tropical Medicine 

Andrew Pollard, University of Oxford 

Sarah Gilbert, University of Oxford and Vaccitech co-founder

Peter Hotez, Co-Director of the Center for Vaccine Development at Texas Children’s Hospital and Dean of the National School of Tropical Medicine at Baylor College of Medicine

Francesco Checchi, London School of Hygiene and Tropical Medicine

Neil Ferguson, Director, Jameel Institute and MRC Centre for Global Infectious Disease Analysis

Adrian V. S. Hill, Director, The Jenner Institute

Azra Ghani, Imperial College London  

Steven Riley, Imperial College London

Polly Roy, London School of Hygiene & Tropical Medicine 

Jesem Douglas Yamall Orellana, Instituto Leônidas e Maria Deane – ILMD/FIOCRUZ/MS

Competing interests: JL declares no personal COIs, but has received UK ODA funding to her institution in the past. ML declares honoraria/consulting from Merck, Affinivax, Sanofi-Pasteur, and Bristol Myers-Squibb, research funding (institutional) from Pfizer, and an unpaid scientific advice to Janssen, Astra-Zeneca, One Day Sooner, Pfizer, and Covaxx (United Biomedical). JE is a member of SAGE and declares his partner previously worked for GSK. AJP is Chair of UK Dept. Health and Social Care’s (DHSC) Joint Committee on Vaccination & Immunisation (JCVI) but does not chair or participate in the COVID19 vaccine committee. He is a member of the WHO’s SAGE. AJP is chief investigator on clinical trials of Oxford University’s COVID19 vaccine funded by NIHR. Oxford University has entered a joint COVID19 vaccine development partnership with Astra Zeneca. SG is an employee of the University of Oxford and am named as an inventor on a patent covering the use of ChAdOx1 in vaccines and a patent application on the SARS-CoV-2 vaccine ChAdOx1 nCoV-19. I hold shares in Vaccitech, which uses ChAdOx1 in other applications. PH is an inventor on a COVID-19 vaccine technology owned by Baylor College of Medicine that was recently licensed non-exclusively to a company. FC none declared. NF declares research grants from the UK Medical Research Council, UKRI and NIHR, research grants from Gavi and the Bill and Melinda Gates Foundation, research grant from Janssen Pharmaceuticals on antiviral treatments for dengue fever, advisory positions with the UK government and the World Health Organization. AH is a co-inventor of the Oxford-AstraZeneca-Serum Institute of India COVID-19 vaccine and may benefit from a share of any royalty stream to Oxford University. AG declares funding from WHO, Bill and Melinda Gates Foundation, The Wellcome Trust, the Medical Research Council, PATH, The Global Fund, Gavi and is a Trustee, Malaria No More UK; Epidemiology Advisory Board, Moderna; Global COVID Steering Group, GSK. SR none declared. PR none declared. JDYR none declared.