The head of the World Health Organization earlier this year called for an urgent push to hit that target by the end of September. But more than 55 countries remain short of the goal, illustrating the problems that the Covax distribution program has faced in its bid to roll out vaccines to every corner of the planet.
Covax earlier this month cut its 2021 supply forecast, hobbled by production delays, export bans and moves by wealthy countries to protect their own people first. Partners in the program have called on countries that already have enough doses to accelerate donations and give up their place in the queue, and urged companies to be more transparent about their supply arrangements.
"Manufacturers are making a choice not to ship to Covax, and high-income countries are making a choice not to get sufficient doses into these places fast enough," Bruce Aylward, a senior adviser to the WHO, said in an interview. "There's no way to sugarcoat it."
Health advocates worry that the slow pace of deliveries around the world will prolong the pandemic and increase the risk more worrisome variants will emerge. When supplies to lower-income regions begin to pick up, getting the inoculations to people is another challenge.
In May, WHO Director-General Tedros Adhanom Ghebreyesus called for a "sprint to September" to vaccinate 250 million more people in low- and middle-income countries in just four months. The goal is to reach at least 40% by the end of the year and 70% of the world's population by the middle of next year.
While Covax has struggled to access doses, many rich countries have raced ahead. Less than 4% of people in low-income countries are vaccinated with at least one dose, compared to about 61% in high-income countries, UN data show.
"Missing this target should be the turbocharger to bring attention to this issue," Aylward said.
Many of the countries below 10% aren't even close, according to the Bloomberg Vaccine Tracker, with large parts of sub-Saharan Africa below 1%. About 56% of the U.S. is fully vaccinated. The U.K. is at 67%, and Canada is at about 71%, while Portugal, at 84%, has the highest percentage of the fully vaccinated among countries with populations of more than 1 million.
Covax, meanwhile, has fallen short of its targets so far, delivering just 311 million doses to more than 140 countries as of Sept. 27. The effort has been hamstrung by delays in shipments from a key manufacturer of the shots, the Serum Institute of India. Earlier this year, India halted exports to tackle a devastating outbreak at home, yet the country is now expected to restart shipments to Covax from the quarter beginning in October.
Covax also pointed to challenges at manufacturing sites that have affected supply of the Johnson & Johnson and AstraZeneca vaccines.