Yeukai Mukorombindo
vaccine distribution

Background context 

The WHO and partners recently released guidance on COVID-19 vaccination planning and deployment for national governments. It is clear from the guidance issued by the WHO that in order for vaccines to be equitably and efficiently distributed, governments cannot do it alone. They will need to work in collaboration with scientists, businesses, unions, civil society, philanthropists,  global health organizations and global funders. They will also need to be transparent and inclusive in the design and implementation of vaccine strategies and resources. Transparency, accountability and participation (TAP) are potential tools that can improve the effectiveness, results, and equity of vaccination plans.

As part of facilitating learning and  knowledge exchange on vaccine distribution in Africa through Covid Transparency Accountability Participation (CTAP) project & Account4Covid initiative, this is document is crowdsourcing a list of questions from health experts/professionals as well as civic actors to help inform meaningful discussion/engagement between citizens and their governments on procurement and distribution of the COVID vaccine. The goal is to providing some guiding questions to help citizens and civic actors more effectively advocate for government gaps and weaknesses in the vaccine distribution plan. 

These questions can be further supported and supplemented by Covid-19 public resource management questions developed by the Public Service Accountability Monitor (PSAM). Additional support can also be found in th WHO’s Vaccine Introduction Readiness Assessment Tool.  

Ask your government the following Questions on the 3 Vs: Vaccines, Vaccinators & Vaccinees


Questions about acquiring vaccines

  1. Is the government planning on developing or procuring a vaccine? If yes, how much money has been allocated to either the development and/or procurement of the Covid vaccine?
  2. If the government is not planning on developing or procuring a vaccine, what is the government’s plan to obtain the vaccine for its citizens? What vaccine deals have the government made? How many of these deals are donations and how many of these are contractual? 
  3. Will you commit to creating a public database of all contracts for funding related to Covid-19 vaccine research, development, manufacturing, or distribution?
  4. COVAX is the initiative for global access to coronavirus vaccines which is led by the World Health Organisation, the Coalition for Epidemic Preparedness Innovations (CEPI) and Gavi recently announced its plans to distribute 330 million vaccines. The African Union has secured a provisional 270 million COVID-19 vaccine doses for member states to supplement the COVAX programme.  Has the government made arrangements   to participate in these COVAX & African Union vaccine programs?  If so, what is the nature of these arrangements? Where can citizens access information on vaccine arrangements and contracts?
  5. Is the government planning to invest public resources towards establishing and/or strengthening the country’s capability to produce its own vaccines? Where can citizens go to access that information and participate in formulating a future vaccine preparedness plan? 
  6. Does the government plan to use  emergency use authorization and/or public resource exceptional approval/waiver mechanism to assist with fast tracking vaccine procurement? If yes, what plans/processes does the government intend to implement to prevent abuse/misuse of vaccine?


Questions about the vaccine roll out


  1. Does the national and/or sub-national government have a national/regional vaccination implementation plan? Where can citizens access the plan?
  2. How can citizens participate in the formulation of the vaccine roll out plan and/or monitor the roll out of this plan? 
  3. How much money has been allocated to support the implementation of this plan?
  4. Has the government established a National Coordinating Committee for vaccine distribution? Who are members of this committee and what are their roles and responsibilities? 
  5. How does this committee plan to engage citizens, share information and answer questions about the national vaccine roll out?


Implementation (Vaccinators – personnel administering the vaccine)

  1. Which health care professionals and institutions will be administering the vaccine? Are there sufficient health personnel to administer the vaccine? How much funding has been set aside to increase the number of vaccinators?
  2. Does the government plan to establish vaccination sites/centres?
  3. How much funding has been allocated to these institutions/vaccination sites? How much funding has been set aside to supply these vaccination centres with sufficient medical equipment for administering the vaccine? Ie masks, syringes, PPE etc…?
  4. Where can citizens find out information about contracts issued to vaccinators and other companies to deliver Covid 19 immunization goods and services?   
  5. Do we have sufficient health care workers and centres to support the rollout at the national and sub-national level? If not what is the government’s plan to ensure that hospitals and vaccine centres are adequately staffed and resourced?


Implementation (Vaccinees – people receiving the vaccine)

  1. Who does the government intend to prioritize immunizing first? Where can citizens find vaccination eligibility criteria?
  2. What mechanisms have national and local governments put in place to ensure that the wealthy/politically connected do not violate the eligibility criteria or “jump the vaccine line?”
  3. Does the government intend to report demographic data on the number of people being vaccinated? Where can citizens access such information?
  4. Does the government plan to run a Covid-19 vaccination campaign to fight misinformation and encourage citizens to get vaccinated? If so, how many funds have been allocated towards promoting Covid-19 vaccination?
  5. Politicization of vaccine distribution, state capture, using vaccine to punish and harass political opponents and people’s political choices. 
  6. Equity – who gets the vaccine? And who gets it first?


Other advocacy questions(*) to Ask COVAX/the WHO/the CDC and the the COVID-19 African Vaccine Acquisition Task Team (AVATT)

  • Will you be transparent about your allocation frameworks and publish how you are going to allocate vaccines to different countries?
  • Will you commit to publishing all agreements with vaccine developers and manufacturers?
  • Will you publish attached conditions to their funding related to technology transfers; open and non-exclusive licensing; and transparent and affordable pricing, verifiable by independent third-party audits that are made public?
  • Will you attach concrete conditions to all vaccine funding to ensure vaccines are priced transparently, and to prioritize affordability and minimize any debts for low- and middle-income countries and not profits for vaccine-developers?

Will you support and sign the COVID-19 TRIPS waiver which would temporarily waive patent rights to facilitate increased production volume of the COVID-19 vaccine and more widespread manufacturing worldwide.



(*) Questions taken from Health Justice Initiative Account4Covid webinar presentation by Dr Marlise Ricther, 30 March 2021 Human Rights Watch Report,  Whoever Finds the Vaccine Must Share It: Strengthening Human Rights and Transparency Around Covid-19 Vaccines