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Delivery to Ghana opens an ambitious global vaccination drive.

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The global sharing program designed to make vaccine access more equal delivered its first major shipment of doses on Thursday to the West African nation of Ghana, ramping up the largest mass immunization campaign in history.

Today marks the historic moment for which we have been planning and working so hard,” said Henrietta Fore, the executive director of UNICEF. “In the days ahead, frontline workers will begin to receive vaccines, and the next phase in the fight against this disease can begin.”

The first shipment of 600,000 doses was packed up and labeled in India, then flown to Accra, the Ghanaian capital.

Ghana and other West African countries are to begin vaccinations in coming days, according to officials, the first of 92 low and middle-income countries that will receive free vaccines through Covax, a vaccine-sharing initiative.

The goal is for Covax to deliver some two billion doses of Covid-19 shots this year, which officials said would make it the largest vaccine procurement and supply operation in history.

The shipment arrived in West Africa as studies were released suggesting that the spread of the virus in the region has been much wider than official numbers show.

At least one in five people in Lagos, Nigeria, could have had contracted coronavirus by October last year, according to findings just released by the Nigeria Center for Disease Control, an infection rate far higher than the one reported through the national surveillance system. A study in Accra released in November had similar findings.

Many public health officials have criticized the unequal distribution of vaccines — with wealthy nations already delivering tens of millions of doses and acquiring vast reserves for their populations.

For instance, while at least 44.5 million Americans and around 18 million people in Britain have already received a shot, as of last week more than 130 countries had yet to vaccinate a single person. The Ghana shipment covers just 1 percent of the population.

The United Nations secretary-general, António Guterres, said last week that the distributions has been “wildly uneven and unfair.”

And high-income countries are not respecting contracts under Covax and are competing with them, reducing the number of doses the initiative can buy, Dr. Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said on Tuesday.

The pandemic will not end, he added, until everyone is vaccinated.

“This is not a matter of charity,” he said. “It’s a matter of epidemiology.”

Last week, the group of wealthy industrialized nations known as the Group of 7 announced that they would intensify their cooperation with the international vaccination drive and raised their overall commitment to the effort to $7.5 billion.

But Dr. Tedros said that there remained a financing gap of $23 billion.

President Emmanuel Macron of France called for even more urgent action on Friday, saying Europe and the United States should send up to 5 percent of their vaccine supplies to developing nations.

But even if things go according to plan, vaccinating the vast majority of the world’s most vulnerable people this year will be a daunting challenge.

Ghana, a nation of more than 30 million people, will get enough vaccines to cover only about 20 percent of its population by the end of 2021. It will have to separately buy millions more doses.

Poorer countries do not pay to purchase vaccines and injection devices under Covax, at least for up to 20 percent of the population. But they do have to pay the costs of delivery within the country.

To receive vaccines, countries had to submit plans saying who they wanted to immunize, how they would go about it and how they would monitor vaccinations. They also had to sign an indemnity agreement with the vaccine manufacturer.

“No country was prioritized,” said Benjamin Schreiber, UNICEF’s coordinator for the Covax program.

Four countries eligible to apply for vaccines under Covax did not do so: Burundi, Eritrea, Madagascar and Tanzania.


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