At Prime Minister’s Questions today, Boris Johnson told MPs: “We are in the lead in promoting and not just inventing vaccines, but in making sure the poorest and neediest around the world get those vaccines.”

Over the course of the Covid-19 pandemic, the UK government has made various commitments to make vaccines that guard against the disease available in the developing world.

But some of the promises appear to contradict each other, and it is proving very difficult to get straight answers on how the government intends to honour them.

The analysis

The UK government first announced back in May that it was going to give £84 million to researchers at Oxford University who were working on coronavirus vaccine.

From the outset, the plan was to “make the vaccines available to developing countries at the lowest possible cost”.

Six months on, and it looks like the Oxford team has now come up with a vaccine that works (subject to regulatory approval).

And AstraZeneca, the pharmaceutical giant backing the project, will make it available at a considerably lower price than other potential vaccines, potentially saving many lives in low-income countries.

It looks like other aspects of the plan have changed over time, although government departments have been reluctant to answer detailed questions on this when contacted by FactCheck.

In May, the plan was for AstraZeneca to manufacture 100 million doses in total, 30 million of which would be for use in the UK by September this year (a deadline that proved to be overly optimistic).

By August, Professor Jonathan Van-Tam, the deputy chief medical officer, was writing to MPs saying AstraZeneca was “aiming to deliver up to 15 million doses to the UK in 2020”.

It’s not clear why the number of doses suddenly fell by half and again, our questions on this have gone unanswered.

The UK government’s line now is that it “has secured access to 100 million doses of the Oxford/AstraZeneca vaccine for use across the UK”.

This sounds like the original plan to give most of those 100 million doses to people in the developing world has been dropped.

It may not matter as much now, because AstraZeneca has said that it will manufacture much more than 100 million doses of the Oxford vaccine in total.

The company in fact aspires to make 3 billion doses by early next year – enough to vaccinate about 20 per cent of the whole population of the world, assuming everyone needs two doses, as clinical trials suggest.

But there’s an obvious danger: if all the initial production run is bought up by richer countries, poorer ones might have to wait for months or years, if they can afford it at all, with an obvious cost in human life.

Enter Covax

An international protocol called Covax was set up earlier this year to guard against exactly this danger.

Covax is run by the World Health Organization, Gavi – an international organisation that aims to improve access to vaccines in poorer countries – and the Coalition for Epidemic Preparedness. Britain is a major financial contributor to Gavi and CEPI.

While the details are complicated, the aim of Covax is clear: to prevent a situation where the rich countries hoover up all the vaccines on the market and the poorer ones are forced to wait or miss out altogether.

The Covax documents state: “It is crucial that all countries have timely access to vaccines as they become available.

“The fair allocation of vaccines will combine the principle of fairness to meet the basic needs of all countries at the same time in the initial stages (that is, based on proportional allocation), as well as the principle of equity to account for differences in risk profiles across countries.”

Britain signed up to Covax on the last possible day in September, then announced it was donating £500m to the project in aid money.

Most other countries are members, with the notable exceptions of Russia and the United States. But the exact nature of the commitment each country has made to Covax is not clear.

While Covax is all about making sure all countries have equal access to vaccines at the same time, the British government has stuck to its repeated commitment that people in the UK will get the Oxford vaccine ahead of people in other countries.

At a media briefing earlier this month, FactCheck asked Kate Bingham, the head of the UK’s Vaccine Taskforce (VTF), about Britain’s commitments to help supply vaccine to the developing world. The positive results of the Oxford vaccine trials had not been reported at the time.

Miss Bingham gave us this written reply: “IF – big IF – the UK has surplus vaccines then the government will need to decide how to distribute this excess such as contributing these to Covax. NB need to assess what level of revaccination is needed to maintain protective immunity. This is not VTF decision.”

We asked the people running Covax if this “UK first” approach means Britain is breaking its commitment to the principle of ensuring vaccines are available to everyone at the same time. No one has replied to our questions.

When we pushed the World Health Organization on Covax last month question last month, a spokesman said some of the details were “still being worked out”.

“The more countries who contribute to the goal of enabling equitable global access to vaccines, the better.

“Precisely how we balance the allocation of doses from the Facility with those already secured outside Covax is still being worked out and is of course in part dependent on which vaccine is proved successful and when.

“These decisions will be governed by the principle of fair access to vaccines and the overall aim of Covax which is that no country should be left behind.”

This leaves it unclear whether richer countries like Britain (and many others) who pre-ordered vaccines before joining Covax will be expected to donate vaccines to poorer nations to ensure “fair access” in the early stages.

A government spokesman said: “The Prime Minister has made clear that equitable access is an integral part of the UK’s approach to vaccine development and distribution, and that world leaders have a ‘moral duty’ to support these efforts.

“The UK has made one of the largest donations to COVAX, a global initiative with a target of delivering 2 billion doses of Covid-19 vaccines around the world by the end of 2021, and has pledged up to £548m to COVAX Advance Market Commitment to support lower and middle-income countries to access vaccines that are developed.”

Verdict

Boris Johnson was right to say that Britain is at the forefront of vaccine development. A vaccine developed by Oxford University has been shown to be effective in clinical trials and is likely to be made available cheaply.

But questions remain over how the UK government will go about, as the prime minister said, “making sure the poorest and neediest around the world get those vaccines”.

The government has signed up and donated £500m to an international project designed to make sure all countries get equal access to vaccines at the same time. But it has also said it wants British people to get the Oxford vaccine first.

It’s hard to understand how ministers will balance those two competing principles, and there have been few straight answers from the government on this question.