“Few nations have taken steps to address vaccine uncertainty and hesitancy”

July 9, 2021 0 By FM

Anjali Balakrishna currently serves as the Program Director for COVID Collaborative in the US, a national effort that has brought together leading experts in health, education and the economy from the US.

COVID Collaborative recently grabbed headlines urging the Group of Seven (G7) leaders to share at least 1 billion vaccine doses, and aim for 2 billion, with low- and middle-income countries by the end of 2021 to tackle the COVID-19 crisis. 

Anjali joined the effort after spending 10 months in India serving as an American India Foundation William J Clinton Fellow and Chief of Staff for Frontier Markets, a social enterprise focused on empowering rural communities and rural women through the distribution of clean energy solutions.

An emerging leader in the social and environmental sectors with nearly a decade of experience across non-profit, public policy and social enterprise initiatives, Anjali holds a BA in American Studies with Distinction from Yale University. 

In an interaction with FM, Anjali highlights the need to get as many people vaccinated as quickly as possible against the pandemic. 

Edited excerpts: 

How can G7 nations play a key role in enhancing the access to, and the equitable distribution of, COVID-19 vaccines globally?

Per the open letter published by COVID Collaborative, Center for Global Development, Center for Strategic & International Studies, and three units of Duke University, we believe that G7 leaders and member states have the vaccine expertise and manufacturing capacity to accelerate global access while meeting their own domestic needs. We lay out five ways that nations can do this: 

1. Establish a G7 Vaccine Emergency Task Force, open to additional nations and organizations, to provide transparency, predictability, and accountability to the global sharing of vaccines and the vaccine marketplace

2. Develop and commit to a path to share at minimum 1 billion doses, with the aim of 2 billion doses of G7-authorized vaccines before the end of 2021, and ensure the availability of enough doses to enable broad vaccination in every country as soon as possible in 2022 

3. Implement a coordinated G7 strategy to immediately increase production of high-quality, well-regulated vaccines, with the goal of further increasing access to these vaccines across the rest of the world

4. Accelerate the development of high-quality globally distributed manufacturing capacity by bringing together public and private sector stakeholders and using voluntary licensing agreements; and 

5. Increase bilateral and multilateral technical and financial support to low- and middle-income countries to enhance their vaccine distribution and delivery capabilities, and address vaccine hesitancy with three goals: achieve demonstrated national vaccination preparedness in each country by the end of 2021; strive for at least 60%, and ideally 70%, vaccination in every country in 2022; and avoid significant excess vaccine stockpiles ahead of pandemic control in all nations.


The open letter to G7 leaders says the alarming gaps that currently exist in the pandemic vaccine coverage are not just a supply problem but also a massive distribution and delivery challenge. Can you elaborate on this point?

We see delivery capabilities and vaccine hesitancy, not supply, as the critical bottleneck to vaccinations in most low- and middle-income countries within the next 6 months. Vaccine readiness assessments in 128 countries have revealed that only 30% of them have processes to train the number of vaccinators required, and even fewer have adequately taken steps to address vaccine uncertainty and hesitancy. We anticipate that if these challenges aren’t addressed, by the fourth quarter of 2021, there will be a surplus of vaccines globally.

Some nations in the G7 have not yet started discussing the redistribution of their excess vaccine stockpiles. Maybe, they are keeping it as a reserve for a potential future eventuality. How will you tackle this issue? 

In our letter, we call for G7 nations to develop and commit to a path to share at a minimum 1 billion, with the aim of 2 billion doses, of authorized availability and ensure that there is sufficient supply for broad vaccination in every country as soon as possible in 2022. Our analysis finds that after population coverage with and
without the need for an additional booster, nations will have access to 1-2 billion additional doses. Meeting the global vaccination need will require more than the redistribution of excess stock. It will require a coordinated G7 strategy to immediately increase the production of the vaccine, as well as G7 support to establish new, high-quality vaccine manufacturing capacity in Africa, Asia outside of India, and Latin America.  


The coalition’s idea is to strive for immunizing upto 60-70% of people in each nation by next year. Do you think it is an achievable target considering the current supply constraints and rapid spread of the virus variants?

We believe it is important to set a clear target for effective vaccination across low- and middle-income nations. The 60-70% target is an ambitious target that will be more constrained by delivery and demand factors than supply, given the projections mapped out in the open letter. We must work as a global community to get as many people vaccinated as quickly as possible.  


India has set a highly ambitious goal of vaccinating its nearly 1.4 bn-strong population by the end of this year
largely relying on indigenous capacities. Many people believe that the targets are quite optimistic without generous contributions from imported vaccines. Your comments?

This is indeed an ambitious vaccination target, particularly after a devastating second wave of the virus. It is difficult to comment on the feasibility of the goal. It is possible that India has the manufacturing capability to produce the number of doses required, but this would likely involve keeping doses in-country instead of
selling to other nations. Further, the distribution and uptake challenges facing other low- and middle-income nations challenge India’s goal as well—particularly with the healthcare infrastructure challenges in rural areas.