Chapter II
Economic Commission for Latin America and the Caribbean (ECLAC)
B. Lines of action Line 1. Strengthen mechanisms for pooled international procurement of vaccines and essential medicines Description and objective The main objective of this line of action is to improve the negotiating position of CELAC countries vis-à-vis international laboratories and other mechanisms that supply vaccines and essential medicines to combat COVID-19. The aim is to gain access to a larger number of such products as soon as possible, by strengthening pooled international procurement mechanisms. While this line of action seeks to solve an urgent problem in the very short term, it could also generate benefits when dealing with other health emergencies in the future.
Diagnostic assessment or rationalea Access to vaccines is highly unequal between the countries of Latin America and the Caribbean; and, more than a year and a half into the pandemic, the region remains in a complex situation. Although, in August 2021, all countries had started their vaccination rollouts, all but a few had made slow progress, and only about 24,8% of the region’s population had been fully vaccinated. This slow start reflects the difficulties faced by suppliers in meeting the agreed-upon requirements, the problems faced by many countries when negotiating with the firms, and the weak functioning of the COVAX mechanism for global access to vaccines against COVID-19, which did not deliver the vaccines to the region’s countries as rapidly as required. As mentioned in the first part of chapter I, a country can procure vaccines through various channels: through direct agreements between its government and the manufacturers; through aggregate purchases between countries; and through participation in the COVAX Mechanism, as well as through donations between countries. The ability of countries to access vaccines has been affected by economic factors (availability of funds to procure vaccines), government efficiency (some countries have performed much better than others, even when per capita income is controlled for), and political power (to influence delivery decisions by the firms). Negotiation processes have been heterogeneous. As of mid-April 2021, at least 17 countries in Latin America had reached agreements with various laboratories through advance vaccine purchase commitments; and 14 of them would also obtain vaccines through the COVAX Mechanism. In addition, four countries are potential recipients of vaccines funded by the COVAX AMC Mechanism. Only Cuba has excluded itself from these mechanisms and opted to develop its own vaccine. In the Caribbean, however, no country has direct agreements with laboratories, although eight of them have made commitments through the COVAX Mechanism, and a further six are beneficiaries of COVAX AMC. In this context, the region has diversified its options among vaccines from the United States, Europe, Russia, China and India. Although the region has improved its relative position on advance vaccine procurement, there is still egregious inequality of access, in terms of both the purchase of vaccines and the distribution of doses. Moreover, the heavy reliance on the COVAX Mechanism by some of the region’s countries leaves them potentially vulnerable in the event of distribution delays.
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