It could be too late for any kind of fair distribution of coronavirus vaccines because of the deals already made by rich countries, according to Mark Suzman, chief executive of the Bill & Melinda Gates Foundation. Despite the unprecedented pace of scientific progress on the development of vaccines, he said it remains “really, really complicated” to ensure they are produced and distributed fairly. Suzman announced on Wednesday that the foundation is to give an extra $250m (£188m) to support the research, development and equitable delivery of tests, treatments and vaccines against coronavirus, bringing its total commitments to tackling the disease to $1.75bn. Rich countries with just 14% of the world’s population have secured 53% of the most promising coronavirus vaccines, according to an alliance of campaigners which this week warned that deals already done could leave nine out of 10 of the world’s poorest unvaccinated next year. Canada has secured enough doses to vaccinate its citizens many times over. Funding from the Gates Foundation has come at a pivotal moment, Suzman said. The first vaccinations began in the UK this week, while US regulators appear ready to approve emergency use of two vaccines. A second wave of vaccines is in advanced trials. Asked if deals done by western governments with vaccine companies meant it was already too late for an equitable rollout, Suzman told the Guardian: “At the moment, as you say, it definitely is a risk and that’s why we think it’s so important to be taking action now.” In August, the Gates foundation provided $150m to the Serum Institute of India and the Gavi vaccines alliance to source 100m Covid-19 vaccine doses as early as 2021. Suzman said that while $1.75bn was a “very significant” sum, it was a fraction of what was needed for poorer countries. The money was a “catalyst” he said, and called for increased contributions as the “best vehicles for poor countries to be able to access vaccines in the same way that wealthy countries are doing”. The World Health Organization has overseen the creation of Covax, the global initiative that aims to distribute about 2bn doses to 92 low- and middle-income countries at a maximum cost of $3 a dose. Covax Advance Market Commitment, which finances vaccine procurement for low- and middle-income countries, has raised $2.1bn, but a further $5bn more is needed, he said. President Trump refused to join the collaboration, but Suzman said he hopes the Biden administration will reverse that position. A report published last month suggested that, because of advance purchasing agreements by wealthy countries, poorer nations may not get access to a vaccine until 2024. Suzman said the Pfizer/BioNTech’s vaccine “was always going to be challenging” to distribute globally because it is a novel type of vaccine, and because of the need for cold storage, which a lot of countries lack. But he was hopeful the second wave of vaccines would be cheaper, easier to manufacture and distribute at scale, and much more thermostable. “Our holy grail is cheap, effective and ideally single dose,” he said. In September, research funded by Gates found that if the first 2bn doses of vaccines were distributed globally, twice as many lives would be saved than if wealthy countries hoarded them.