Factors that may have impacted access to COVID-19 vaccines | Factors that helped or hindered ACTA in COVID-19 vaccine procurement | Anti-corruption mechanisms | ||
---|---|---|---|---|
International | National (Nigeria) | Help | Hinder | |
Limited testing capacity led to underestimation and underpreparation for procurement needs[24] | Vaccine card racketeering: Due to lack of trust in COVID-19 vaccines, people avoided vaccines but paid bribes to get vaccination cards [28] No evidence was available to prosecute people who were reported to collect bribes for vaccine cards [28] | Shared financing and improved regional capacities for manufacturing, regulation, and procurement of tools allowed equitable and effective access to vaccines and other medical products [27] | Information around funds, disbursements, and contracts was lacking [31, 32] Financial incentives for lack of distribution logistics slowed distribution of vaccines [24] Opaque contracts were used when officials from low-income countries purchased vaccines [10, 34] Existing efficient procurement and distribution protocols were abandoned to set up new special procurement and distribution committees [2] | Prioritizing at-risk (e.g., the aged, communities with high prevalence rates) and critical groups (e.g., health workers) and proper management of the process ensures that the right people get the vaccine |
High demand for vaccine but low supply may have encouraged theft and diversion [2]; Health services, logistics and distribution systems were already weak [10] | Access to information regarding how funds are received and distributed was lacking [31] | Creation of an International Pandemic Financing Facility raised additional reliable financing [24] | Exploitative vaccine manufacturers may use their product advantage during emergencies to exploit weaker countries in their aggressive pursuit for profit [47]) | Global partners foresee tactical challenges and work to avert them. For example, UNICEF pushed to secure 65,000 solar cold-chain fridges for lower-income countries[43] |
Existing design of vaccine distribution systems are focused on child vaccination, not massive roll outs [43] Equipment required for COVID-19 vaccine storage may differ from existing infrastructure [43] | Weak health leadership meant less readiness and poor vaccine decision-making [27] Procurement processes were hastened and procedures were waived [25] | Strengthening oversight and monitoring functions by involving local activists, anti-corruption agencies, and NGOs helped in tracking and monitoring progress with vaccines [2, 20, 36, 37]( | Fake vaccines may emerge in countries with weak regulatory systems [43] Vaccines were politicized/weaponized (e.g., Russian Sputnik V vaccine was critiqued for hasty processes in getting through the scientific testing and approval process without having traceable anyway to verify if the right things were done) [42] | Oversight functions were strengthened by involving critical stakeholders, such as country activists, NGOs, and anti-corruption agencies[20, 37] National frameworks and Technical Working Groups for procurement and distribution were developed [10] |
Different country systems (private vs public) may affect vaccine distribution | Arbitrary spending of other health and non-health COVID-19 resources impacted trust on government COVID policies [25] | Deploying digital platforms allowed effective monitoring of procurement and distribution processes [32] | The complexity of COVAX governance structures allows more powerful or wealthier countries and manufacturing companies to have their way and dictate who gets vaccines and when[17, 33, 34] | Efficient procurement and distribution guidelines and operating procedures that functioned pre-pandemic were maintained [32] |
Vaccine manufacturers and actors interested in accountability and transparency did not have access to the same information which meant that deeper assessment of the issues cannot be made[18] | Â | Â | Â | Stakeholders insist on technology transfer and waiving of intellectual property rights of vaccine manufacturer during pandemics [20, 35] Blockchain technology can be used to enhance the procurement and distribution processes [43] |
Inadequate communication between government/health parastatals and the general public could trigger stigma and other hesitancy that impact vaccine adoption [44, 45] | Â | Â | Â | Government and other concerned stakeholders should insist on transparency and publicizing information about vaccine contracts and specific actors [32, 46] |