Shunned by rich countries and failing to meet the needs of the poorest, a program co-led by the World Health Organization for ensuring the fair distribution of COVID-19 vaccines is planning a shake-up, internal documents show.

The COVAX program is far short of its target of delivering 2 billion doses by the end of the year but does expect a big increase in supplies by early 2022, and it wants to make sure that those, at least, reach the countries in direst need.

COVAX's initial lofty ambitions to act as a clearing house for the world's vaccines, collecting from the manufacturers in the most developed countries and quickly distributing to those in the most urgent need, have fallen flat.