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As The global race for a Covid-19 vaccine intensifies, there is a question that Jane Halton and her team keep asking again and again: if successful vaccines emerge and what happens, what can be done to ensure that they are not simply targeted at those with deeper pockets?
If market power is allowed to dictate access, how can the protection of the most vulnerable to Covid-19 be ensured?
“We are very aware of this and it is literally a topic that is debated on a daily basis,” he tells The Guardian. “Because for us it is unacceptable that there is not fair access to a successful vaccine in the entire world population.
“The idea that it’s about going to the highest bidder for us is totally unacceptable.”
Halton, a former secretary for Australia’s health and finance departments, is chairman of the coalition of epidemic preparedness innovations, a global body that plays a critical role in financing and coordinating the development of the Covid-19 vaccine.
One of its founding goals is to ensure that vaccines, once developed, are fairly distributed.
The world has seen what happens when the market is left to dictate the distribution of the vaccine. During the H1N1 pandemic in 2009, Rich nations negotiated large advance orders for the vaccine, effectively crowding out poorer countries.
The Ebola crisis in West Africa, an outbreak that killed 11,325 people, exposed its own market failure.
Despite the fact that the death toll in West Africa grew and grew, the big pharmaceuticals couldn’t see a way to recoup the considerable losses they would face trying to find a vaccine.
The leader of the British Ebola response, Adrian Hill, said there simply was no “big market” to make it worthwhile for massive corporations.
“There was no business case to make an Ebola vaccine for the people who needed it most,” he said.
It was out of that failure that the coalition for innovations in preparation for epidemics emerged.
“The world’s response to this crisis was tragically short,” he says, explaining his background. “A vaccine that had been in development for more than a decade was not implemented until more than a year after the epidemic.
“That vaccine was shown to be 100% effective, suggesting that much of the epidemic could have been prevented. It was clear that we needed a better system to accelerate the development of vaccines against known epidemic threats. ”
But Covid-19 presents it with a test like no other. An article published in The Lancet last month warned of the significant possibility for wealthy countries to monopolize the global supply of Covid-19 vaccines.
“This risk is real,” the newspaper warned. “Such a result would result in a suboptimal allocation of an initially scarce resource.”
There should be no division between those who have and those who do not have
Halton predicts that the pressure to ensure access to successful vaccines will be “astronomical.”
“One of the things that worries me is the nationalism of vaccines and I’ve started using that terminology when I talk to people,” he says.
“We have been worrying about this problem for months … What is a mechanism to guarantee equitable access?”
An estimated one billion people worldwide are vulnerable to Covid-19. They fall into a number of categories: immunocompromised, those with comorbidities, aging, and front-line medical personnel.
“So that tells you that you need a lot of vaccine to protect even the most vulnerable in our society,” says Halton.
It is a problem that the World Health Organization is also urgently working to solve. This week announced that it planned to design mechanisms to guarantee an equitable distribution.
“As we search for vaccines, unless we break down the barriers to equitable distribution of products, whether vaccines or therapeutic products, we will have a problem, so we must address the problem in advance,” said WHO Director-General Tedros. Adhanom Ghebreyesus said.
“There shouldn’t be a division between the haves and the have-nots.”
For private companies, the development of vaccines is considered risky, lengthy and enormously expensive.
Companies face the possibility of spending extraordinary amounts to develop vaccines, with a low probability of success.
“As a company, you are not going to spend the hundreds of millions and sometimes billions of dollars it takes to develop a vaccine,” says Halton. “One, because you think your chances of being successful are around 5%. [Second]Because you don’t even think that there will be a market for it.
“So this part of the market failure is completely understandable. And that’s why [the coalition for epidemic preparedness innovations] was created “.
He believes he needs $ 2 billion to develop three candidate vaccines in the next 12 to 18 months. He has raised almost half of that.
The $ 2 billion does not include manufacturing or delivery costs.
The coalition’s work emphasizes speed. Each stage of the vaccine development process is compressed. Halton says the speed at which Covid-19 vaccines are developed is unprecedented.
One of the coalition’s projects is The funds are at the University of Queensland, where researchers are testing a molecular clamp technology that they hope can help neutralize the virus.
The coalition asked UQ researchers to start work on a Covid-19 vaccine in January. In three weeks he had produced the candidate who was now being tested.
“Like all researchers looking at their baby, they are optimistic,” she says. “All I can say is that I hope they are right. I really hope they are right. It is very difficult for me to form a judgment on the probability of success.”
More generally, she remains optimistic.
“I think when we look at all the work that is going on around the world about vaccines, I am hopeful that we end up with not just one successful candidate, ideally we would have three,” he says.
“I have said it publicly several times: I hope for the best but prepare for the worst. And if you hope for the best, what you would do is have three successful candidates. ”
