Study of the COVAX Facility and Advance Market Commitment
The COVAX Facility and Advance Market Commitment (AMC) was a global first spurred by an unprecedented context. 3ie worked with a consortium led by Itad to conduct a baseline review and formative study of the design, implementation and emerging results of the COVAX Facility and AMC to support accountability and learning for course correction. The evaluation provides a key data point for global health actors, including Gavi, to strengthen global readiness to respond to future pandemics.
COVAX Facility and AMC Formative Review and Baseline Study
The COVID-19 pandemic has reminded us that the window of opportunity for scaling up vaccination in a pandemic is very short. The recommendations presented in this report focus on how a future initiative can learn from the COVAX Facility experience and respond effectively in the first 24 months of a pandemic or within the first 12 months of a global vaccine roll-out. Read full report
COVAX is the vaccines pillar of the Access to COVID-19 Tools Accelerator (ACT-A), co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO), alongside key delivery partner UNICEF. In July 2020, the Gavi Board approved Gavi as the legal entity to administer the COVAX Facility, a global mechanism to pool resources and demand for COVID-19 vaccines with the goal of accelerating the availability of and equitable access to safe and efficacious vaccines. The Gavi Board also approved the establishment of the Gavi COVAX Advanced Market Commitment (AMC), a financing mechanism to accelerate and reserve COVID-19 vaccines to ensure that low-income and lower-middle-income economies have access to COVID-19 vaccines at the same time as wealthier economies.
Gavi commissioned the formative review and baseline study as an initial phase in ensuring the successes, challenges and lessons from inception through the end of 2021 of the COVAX Facility and AMC were independently evaluated and documented. The Formative Review and Baseline Study have a dual focus on accountability for emerging results and learning for course correction and strengthening global readiness to respond to future pandemics. Following an initial evaluability assessment and evaluation design led by Itad, this phase of evaluation was organized across four evaluation modules: Module 1: Right things (design); Module 2: Right ways (implementation); Module 3: Right results; and Module 4: Learning.
Module 3: Right results
As the leader of this module, 3ie built on the work of other modules (elaborated below) and assessed the extent to which the emerging evidence suggested intended and unintended outcomes and goals were (or were likely to be) achieved and how the COVAX Facility and AMC contributed to them. The module also highlighted the barriers and enablers to the achievement of results during the evaluation period. In addition, 3ie carried out one of the six country case studies, the India case study, to inform all the modules in this evaluation.
The module analyses outcomes like quantity of vaccine supplies to AMC and Self-financing Participant (SFP) countries, their timing, vaccine coverage, and impacts like vaccine coverage of targeted high-risk groups.
Other modules of the evaluation:
Module 1: Right things (design). An interrogation of whether the COVAX Facility and AMC and its components were and remain relevant to the problems they were designed to address.
Module 2: Right ways (implementation). A formative, learning-focused assessment of implementation progress for each of the operational (e.g., management structures, governance, risk management, costs and stakeholder engagement) and programmatic areas (e.g., resource mobilization, market shaping, procurement and delivery, equitable allocation and vaccine delivery support) of the Theory of Change.
Module 4: Learning: A summary of lessons learned, building on the findings of earlier modules, and prioritizing them to provide independent, evidence-based, clear and use-focused recommendations to Gavi for the purposes of course correction on ongoing implementation of the COVAX Facility and AMC; and share critical insights and evidence for Gavi’s (5.1) strategy.