| A string of nations across Africa and Asia have run out of Covid-19 vaccines or are on the brink of doing so, just months after receiving first shipments from Covax, the global program meant to equitably distribute the lifesaving shots. A World Health Organization adviser this week said that of 80 lower-income countries across the globe that have received vaccines through the effort, about 40 are either out of doses or on the verge—and it's unsure when donations from wealthy countries will arrive. "Well over half of countries have run out of stock and are calling for additional vaccine," says the adviser, Bruce Aylward. "But in reality it's probably much higher."  Shipments of vaccines from Covax arriving in the Ivory Coast, Ethiopia, Somalia, El Salvador and Mexico. Photographer: Clockwise from top left: WHO, Tiksa Negeri/Reuters, Henny Romero/Reuters, Feisal Omar/Reuters, Jose Cabezas/Reuters, Diomande Ble Blonde/AP Images The implications are serious: There's a risk new problematic variants will emerge that could reignite infections or put already vaccinated people back at risk. Countries without rich health budgets could be forced onto the more-expensive private market. And vulnerable populations of older people and health workers could be left only partially vaccinated while awaiting the delivery of second doses. Ghana has used more than 90% of its doses. While it has signed pacts with a number of suppliers, like Russia's Sputnik V, supply challenges have hampered deliveries. Gambia has run out of AstraZeneca shots and is looking to start using China's Sinopharm next month. Vaccination has slowed to a crawl in Bangladesh, where the government has turned to China and Russia to secure more supplies. In Nepal, supply shortages have slowed the vaccine program, and the country has managed to fully vaccinate less than 3% of the population. "Vaccination to the entire population is a dream that is quite far off," says Tara Nath Pokhrel, the family welfare director at Nepal's health ministry. As the world tries to defeat Covid, it's important that supply uncertainty doesn't undermine confidence in vaccine programs, that they have a global reach and that full doses can be administered. If not, we risk prolonging the pandemic.—Corinne Gretler and Jamie Paton | 
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