COVID vaccine rollout and pandemic preparedness assessed in new book, 'Fair Doses'

toggle caption Ben de la Cruz/NPR

The idea was born over drinks at the Hard Rock Hotel in Davos Switzerland, on January 23, 2020.

There was a new virus ringing alarm bells in China, but it hadn't yet become an international concern. It didn't even have a name. Yet Seth Berkley was already thinking about how to protect the world with vaccines against it.

Berkley was the CEO of Gavi, the Vaccine Alliance, a nonprofit group dedicated to expanding access to vaccines around the globe.

He and some of his colleagues at the World Economic Forum didn't know whether it would be possible to come up with a vaccine for the virus that would soon be called SARS-CoV-2. But they figured if scientists pulled it off, the next challenge would be to ensure that every country, regardless of its wealth, would have plenty of vaccines for its citizens.

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At the bar, Berkley and his team outlined what would become COVAX , the international venture to equitably distribute vaccines. The basic idea was to pre-purchase bulk quantities of vaccines from manufacturers who'd announced plans to develop them — before it was clear whether they'd even work — and when they were ready, ship them to countries equitably, based on their population size, not their ability to pay.

Ultimately, COVAX's success was mixed. Between 2021 and 2023, the entity distributed 2 billion doses, but many low- and middle-income countries lagged far behind wealthier ones.

Now, Berkley has written a new book — Fair Doses — that tells the inside st