Estimating the delivery costs and financing gap for COVID-19 vaccine delivery in 133 LMICs

A report estimating the cost of delivering COVID-19 vaccines to 70% of target populations in 133 low- and middle- income countries has been released by the COVAX Readiness and Delivery Working Group on Delivery Costing, authored by experts from UNICEF, Bill & Melinda Gates Foundation, Dalberg, and the Harvard T. H. Chan School of Public Health.

Using global level assumptions, the total cost of delivering COVID-19 vaccines was estimated at between US$ 2.7 billion and US$ 8.4 billion, depending on scenarios varying the proportion of staff reallocated to the COVID-19 vaccine delivery effort and the proportion of doses delivered at fixed sites and through outreach. If an equal number of doses are delivered at fixed sites and through outreach, the estimated cost per dose delivered ranges from US$ 1.16 to US$ 2.64 as the proportion of existing staff reallocated for COVID-19 vaccine delivery decreases from 10% to 0%-5%. If 10% of existing staff were reallocated and fixed sites were leveraged to deliver 85% of doses, the resulting cost per dose delivered was estimated at US$ 0.84.

The total financing gap between the predicted delivery costs and external financing commitments for COVID-19 vaccine delivery across the 133 countries was estimated at between US$ 1.3 billion and US$ 6.9 billion depending on the scenario. Note that the delivery costs and financing gaps are changing constantly in line with additional people being vaccinated and funding being allocated and spent.

These values represent the aggregate estimates and costs will likely vary across different settings depending on the strategies used to reach target populations, geographic factors, local prices and other considerations. The delivery cost estimates in this report are revised from previous figures released in February 2021. This updated analysis incorporates more countries, assumes a coverage level of 70%, covers the time period from Q4 2021 to the end of 2022, integrates human resource surge and opportunity costs, uses updated unit price estimates and has a feature for including booster doses, with the number of people vaccinated so far per country subtracted.

The funding and funding gap analysis does not include information on government or domestic resources that have been mobilized for COVID-19 vaccine delivery. The country specific funding gap analysis is illustrative only as the funding picture changes over time, and the delivery costs are pulled from a global model and not based on country-specific delivery strategies and approaches.