Bell D. auteur aut IRD Brown G. W. auteur aut IRD Oyibo W. A. auteur aut IRD Ouedraogo S. auteur aut IRD Tacheva B. auteur aut IRD Barbaud E. auteur aut IRD Kalk A. auteur aut IRD Ridde Valéry auteur aut IRD Paul E. auteur aut IRD text journalArticle eng text/pdf reformatted digital access COVAX, the international initiative supporting COVID-19 vaccination campaigns globally, is budgeted to be the costliest public health initiative in low- and middle-income countries, with over 16 billion US dollars already committed. While some claim that the target of vaccinating 70% of people worldwide is justified on equity grounds, we argue that this rationale is wrong for two reasons. First, mass COVID-19 vaccination campaigns do not meet standard public health requirements for clear expected benefit, based on costs, disease burden and intervention effectiveness. Second, it constitutes a diversion of resources from more cost-effective and impactful public health programmes, thus reducing health equity. We conclude that the COVAX initiative warrants urgent review. specialized 056 052 4 100096 [6 ] 2023 https://www.documentation.ird.fr/hor/fdi:010088923 10.1016/j.hpopen.2023.100096 [F B010088923] https://www.documentation.ird.fr/hor/fdi:010088923 https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2024-02/010088923.pdf IRD - Base Horizon / Pleins textes 2024-02-07 2025-02-24 fdi:010088923 fre