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VideoMarch 18, 2021

Are Developing Countries Ready to Rollout COVID-19 Vaccines? | World Bank Expert Answers

COVID-19 vaccination campaigns are well-underway across many developed countries, but many developing countries aren’t yet getting shots into arms. What are some of the key obstacles standing in their way? And what’s being done to help them kickstart safe and effective immunization campaigns? The World Bank’s Global Director for Health, Nutrition, and Population, Dr. Muhammad Pate joins us on Expert Answers.


00:00 Introducing Muhammad Pate & COVID-19 vaccines
00:51 The vaccine situation in developing countries
01:46 Main obstacles to a widespread vaccine rollout
03:13 Helping countries prepare for an effective rollout
05:05 Understanding the readiness assessments
06:16 Higher-order insights and trends
08:01 How all of this work could benefit countries and people
09:24 Thanks Dr. Muhammad Pate!


00:00 [Expert] -Across more than 128 countries, we know that many countries are ready in terms of the coordination and management of the deployment, in terms of even some of the cold chain infrastructure, the financing, the regulatory bit. But there are some gaps.

[Host] -Today on Expert Answers, we're checking in with Dr. Muhammad Pate once more, asking him about the COVID-19 vaccine rollout. Specifically, we're asking him about how ready developing countries are to begin vaccinating their people, what are some of the key obstacles standing in their way, and how are those obstacles being overcome and so that they can mount a safe and effective vaccination campaign.

00:51 [Host] -So Dr. Pate, thank you so much for being here. Here in the past few weeks since the last time we've spoken, vaccines have started to roll out across the developed world. Can you fill us in a little bit about what the vaccine situation is like in the developing countries? Has the vaccine started to roll out across the developing world yet?

[Expert] -Thank you, Paul. I think it's good to see that vaccines are now being delivered to several developing countries over the last couple of weeks. I think that's offering a light at the end of a long tunnel of the pandemic. And this is happening in an unprecedented manner as well, given that within a year from the pandemic, we have vaccines that have been approved and have been administered. Unfortunately, the gap between the high-income countries and the low-income countries couldn't be reduced more than what it has turned out to be. But still, I think many countries are beginning to vaccinate and more to come.

01:46 [Host] -And we've talked in the past about some of these obstacles to rolling out the vaccine more quickly, more widespread, but for folks maybe who haven't caught those episodes, can you remind us a little bit? What are some of the key challenges to getting the vaccine out there further and faster?

[Expert] -Buying the vaccines is an important one. Developing them, innovating them, manufacturing them, delivering them to countries is an important piece. But we know that the other half of the challenge is to ensure in fact that the vaccines reach the people who will benefit from them. So over the last couple of months, I think we focused as the World Bank together with WHO, UNICEF, Gavi, Global Fund, on an effort to help countries get ready to deploy the vaccines, to understand where they are, to assess their readiness, to be able to deploy those vaccines efficiently, effectively, as well as equitably. Based on that assessment, over the last couple of months, across more than 128 countries, we know that many countries are ready in terms of the coordination and management of the deployment, in terms of even some of the cold chain infrastructure, the financing, the regulatory bit. But there are some gaps.

03:13 [Host] -And you're laying down there all the different puzzle pieces that have to come together so that you can get this vaccine out to people. And it sounds like an incredibly complicated undertaking. Talk to me a little bit about the work that your team and the World Bank and its partners are doing to help countries understand all the puzzle pieces that need to come together and get ready to effectively distribute the vaccine.

[Expert] -You know Paul, you see this is an unprecedented deployment of vaccines in ways that we've never done it before. Not only are the vaccines new, but they're also been administered under what is called emergency use authorization or emergency use listing in the middle of a pandemic. And the vaccines have been administered also to adults, to elderly, to those who have comorbidities, and there are limited doses available. So there's a lot of rationing going on. The systems that are in place in many countries to deliver to children are not sufficient necessarily to actually deliver vaccination for large cohort of adults that would require vaccination. So a bit of fresh thinking is needed in terms of designing how to deliver those vaccines.

[Host] -So just to make sure we're understanding what you're saying is we have a lot of experience, that the international community has a lot of experience in vaccinating children, but it's a whole another undertaking to vaccinate widespread adult populations.

[Expert] -Exactly. And that means that we have to be thoughtful in terms of how we organize this in such a way that doesn't also undermine other essential services that need to be delivered. For instance, COVID vaccines are one vaccines but also you need measles vaccines. You need children to continue to be immunized against pneumonia and other childhood preventable ailments. So if you look at the bank's additional financing the way we framed it, it’s – support the COVID vaccine deployment but while doing so also have the external benefit in terms of strengthening national health systems for other conditions that people also suffer from.

05:05 [Host] -Some sort of co-benefits there. You mentioned a few minutes ago the readiness assessments, and to the layman like myself, they're kind of like a report card that you and your team and the World Bank and its partners have been creating to help countries understand the pieces of the puzzle that they need to put into place to get the vaccine out safely and effectively. When you've taken these readiness assessments back to the countries, how have the countries reacted? How are governments sort of taking up your assessments?

[Expert] -You see, at the end of the day, the responsibility for administering the vaccines lies on the governments in the countries. Our approach has been how to organize ourselves as excellent partners to governments and let the governments then be supported to undertake those assessments. Now, the regular assessments across the 10 domains that I mentioned identify critical gaps, and those get fed into their vaccine deployment plans, which then are financed either through the bank's financing or their domestic financing, or other external financing. So at the end of the day, our approach is one that we don't go and do things to countries. We support countries to do what they need to do to deliver the services to their people.

06:16 [Host] -What are some of the big trends? Where are governments needing more of that support? Where do they have sort of things covered?

[Expert] -I think in terms of the coordination and management, the arrangements around it, I think that's pretty much developed in many countries. In terms of the identification of the target populations, many countries have a clear idea depending on their populations what proportions they will like to prioritize over time. The cold chain infrastructure, they have a minimum level of it, but it can be stretched. And that is informing how they allocate types of vaccines for instance around urban areas or rural areas. I think the information systems – trying to have platforms to track let's say who gets called when, and then to be able to go into I think digital platforms are also imagined to be an important element in there. I think the areas that would need a lot more attention – it would be in the safety and surveillance of post-administration, that is in the pharmacovigilance to ensure that if there are adverse events, some of which may be unrelated to the vaccines, that they are picked up and addressed. Issues of communication to the communities, because there's a lot of tendencies towards resistant or hesitancy, vaccine hesitancy that has to be countered by really effective, trustworthy communication channels, so that people understand that these vaccines have been shown to be safe, they are efficacious, and all the wild conspiracy theories that are out there in way be debunked.

08:01 [Host] -And Mohammed, just as we wrap up here, talk to me about how all of this work could benefit countries and people further down the road long after this current public health crisis has ended.

[Expert] -As we invest these billions of dollars in supporting our client countries to deploy the COVID-19 vaccines, we should be also focused on what benefit that would remain post this phase of the pandemic that strengthens their ability to deliver basic services. Whether it's enhanced, capable, trained health workers, whether it's how the health workers are managed, because of good information systems, whether the infrastructure to deliver services, whether the surveillance systems, that will serve us well. On the global level, what is very clear, and what we learned from looking at Ebola and other previous threats, is a globally coordinated response is key.

[Host] -One issue would be that kind of variants could form in developing countries that aren't immunized that could then essentially get passed the vaccine in the developed world. So there's an interest, a self-interest, in every country to sort of cooperate globally.

[Expert] -Yes, it's in everyone's enlightened self-interest to invest in the global public goods to ensure that everyone is protected.

09:24 [Host] -Well, Dr. Muhammad Pate, thank you so much for taking the time to talk to us today.

[Expert] -Thank you Paul. Always good to be with you.

[Host] - A huge thanks to Dr. Muhammad Pate for his time. If you want to learn more about the World Bank Group and our work in helping countries recover from the COVID-19 pandemic, head on over to You can also join us on April 9th for a special event on vaccines as part of the World Bank Group IMF Spring Meetings. You can find all the details for that at You can also email me and the rest of the team. We'd love to hear your feedback, Until next time, goodbye.

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Every episode of Expert Answers sits you down with a World Bank specialist: an expert answers with expert answers. From debt relief to gender equality. From COVID-19 response to inclusive growth, and much more. Our goal is to help you understand some of the biggest issues in international development today by asking our colleagues about what works on the ground and what we can do to meet the biggest global challenges. Watch previous episodes of Expert Answers!