Every country has been affected by COVID-19, with nearly a quarter of a billion cases and almost 5 million deaths reported globally as of end of September 2021. Despite the stunning speed with which highly effective and safe vaccines have been developed, new waves of disease are still pushing health systems to the breaking point, increasingly transmissible variants are emerging, some survivors are suffering serious long-term sequelae, and the International Monetary Fund estimates that global economic losses could exceed US$5.3 trillion by 2026, if COVID-19 becomes endemic. Although over 6 billion doses of COVID-19 vaccine have already been administered, and global production is now reaching 1.5 billion doses per month, the world is not positioned to end the pandemic. In areas of high vaccine coverage, there have been massive reductions in serious disease, hospitalization and death but, globally, vaccine access is highly inequitable with coverage ranging from 1% to over 70%, depending largely on a country’s wealth. Consequently, SARS CoV-2 variants continue to emerge, causing surges of disease and slowing or even reversing the reopening of societies and economies.