Coronavirus vaccines remain out of reach in the poorest countries, the head of the World Health Organisation says in a report marking the first anniversary of the COVAX dose-sharing facility.
WHO director-general Tedros Adhanom Ghebreyesus has repeatedly denounced inequities in vaccine distribution and urged wealthier countries to share excess doses to help inoculate health workers in low-income countries.
More than 3 million people have died in the pandemic worldwide.
"Nearly 900 million vaccine doses have been administered globally but over 81 per cent have gone to high- or upper middle-income countries, while low-income countries have received just 0.3 per cent," Tedros said about the ACT (Access to COVID-19 Tools) Accelerator set up a year ago.
He told a briefing he was concerned about the rising caseload in India.
India reported the world's highest daily tally of coronavirus infections for a second day on Friday, surpassing 330,000 new cases, as it struggles with a health system overwhelmed by patients and plagued by accidents and lack of medical oxygen.
"The situation in India is a devastating reminder of what the virus can do," he told a virtual briefing.
French President Emmanuel Macron said that one in six Europeans had been vaccinated, one in five in North America but just one in 100 in Africa.
"It's unacceptable," he said.
South African President Cyril Ramaphosa called on pharmaceutical companies to transfer mRNA vaccine technology to low- and middle-income countries "free of intellectual property barriers".
"Let us together challenge vaccine nationalism and ensure that protecting intellectual property rights does not come at the expense of human lives," he added.
"Continued lack of financial support for the ACT Accelerator poses a major obstacle for its ability to deliver at scale" Dag Ulstein, Norwegian minister of international development, told the same briefing.
COVAX, which has shipped 40.5 million doses to 118 countries so far, aims to secure 2 billion doses by the end of 2021.
On Thursday, COVAX, co-run by the Gavi Vaccine Alliance and the WHO, said it was seeking to bolster its supplies of vaccines for poor countries from new manufacturers as it aims to mitigate supply problems of the AstraZeneca vaccine from India, its main shot so far.
"Low-income countries test less than 5 per cent as much as high-income countries, and the majority of countries still have trouble accessing sufficient oxygen and dexamethasone," Tedros said.
He was referring to an inexpensive steroid found to help patients suffering severe COVID-19, the only WHO-approved treatment for the disease.