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In the middle of the race for a vaccine against Covid-19, some countries such as the United Kingdom, the United States and Canada have gone ahead and have already begun to vaccinate their populations.
The one of choice so far is the Pfizer / BioNTech vaccine, the first to report efficacy results and obtain a registration from a regulatory agency following standard protocols. Other countries, such as Russia and China, have already started emergency vaccination for part of their population, and immunizers are still under study.
Countries that have signed deals with major pharmaceutical companies are now awaiting the completion of phase 3 trials and the registration of vaccines with their regulatory agencies.
However, according to an article published on Tuesday (15) in the scientific journal BMJ, at least a quarter of the world’s population, or 2 billion people, should not receive the vaccine before 2022.
The study, conducted by researchers from Johns Hopkins University (USA), evaluated the purchase of doses from 13 of the main producers of agreed vaccines until November 15.
According to the results, purchases equivalent to 7.48 billion doses have already been made, enough to immunize about 3.8 billion people, considering that the main vaccines use a two-dose schedule for total immunization.
Of this total, about 51% was reserved for rich countries, including the US and the entire European Union, which account for less than 14% of the world’s population.
The remainder must be distributed to low- and middle-income countries, which represent 85% of the world’s population.
The United States bought 800 million doses, the equivalent of 2.5 doses per person, and is the country with the highest number of cases in the world: a fifth of all cases worldwide.
On the other hand, Japan, Australia and Canada together reserved 1.03 billion doses, although the three countries together represent less than 1% of the total cases of Covid-19 in the world.
Brazil has agreements for, to date, 142.9 million doses, of which 100.4 million are from the agreement with the University of Oxford / AstraZeneca and another 42.5 million from the Covax Facility consortium, of the WHO (World Organization Of the health) . Fiocruz is expected to produce another 160 million doses in the second half of 2021.
The country is negotiating with Pfizer / BioNTech to purchase an additional 70 million doses. The 46 million doses of the agreement between the government of São Paulo, through the Butantan Institute, with the Chinese manufacturer Sinovac, were not included in the account of the Ministry of Health.
In the article account, however, the researchers added the Sinovac doses to the Brazilian account.
Low- and middle-income countries have the fewest reserved doses per capita and should be left behind to receive a vaccine, the researchers say. “Even the WHO has not yet managed to add the $ 5 billion [cerca de R$ 25 bilhões] necessary to guarantee sufficient doses to Covax subscriber countries, ”says Anthony So, lead author of the study and researcher at the Johns Hopkins University Institute of International Health.
Of the 189 countries in the consortium, 97 provided resources to support the consortium, as was the case in Brazil. “The problem, however, is the 92 low- and middle-income countries that have the money raised by WHO to access vaccines. Covax’s goal of making at least 2 billion doses available by the end of 2021 may be compromised if it fails to raise more funds, ”he says.
Thus, the members of these countries can have 60% to 40% of their population without receiving doses even in 2021 considering the most pessimistic scenario, if the rich countries increase their orders already made to companies, and also in the most optimistic scenario, where those same countries that have the most important agreements would make the remaining doses available to Covax.
However, there are at least six companies that have made deals with low-income countries. Among these deals, AstraZeneca / Oxford leads sales to low- and middle-income countries, with more than 2 billion doses already reserved for these populations.
The pharmaceutical company partnered in countries such as India and Russia to make doses available that will then be distributed to other countries that were unable to conclude individual agreements.
The Gamaleya Institute develops its Sputnik V vaccine in association with the Direct Investment Fund of Russia (RDIF) and has already closed agreements for the distribution of 349 million doses outside Russia. One of these countries is Brazil, but the agreements, made with the governors of the states of Bahia and Paraná, are stagnant.
China is the third nation to provide doses to low-income countries. About 135 million doses from the manufacturers CanSino and Sinovac will be distributed to countries such as Brazil, Mexico, Indonesia and Chile.
Another important piece of information cited in the study is about the number of candidate vaccines that each country is betting on. Rich countries such as the United States, Canada, the United Kingdom and the European Union have signed agreements with at least six manufacturers, Japan and Australia with four and Chile with three. Brazil, however, has opted for a single vaccine so far, that of AstraZeneca / Oxford.
The disparity between acquisitions made by rich countries is also reflected in the bets on technologies. While countries like the US, Canada and the UK have opted for vaccines of all kinds, including RNA vaccines, which are more expensive (the unit price of the vaccine dose for Moderna is $ 37 and Pfizer is $ 37). $ 19.5, or approximately R $ 185 and R $ 97.50, respectively), low- and middle-income countries could not buy these vaccines in quantity and closed agreements, mainly, with AstraZeneca, whose unit dose price varies between $ 3 and $ 4 dollars (around R $ 15 to R $ 20).
The authors acknowledge that the study has limitations, such as the fact that the contracts are not public and cannot guarantee that doses will be delivered, but it does provide a picture of the vaccine race, showing how rich countries went ahead to guarantee their doses. and low- and middle-income countries with uncertain access.
“Many of the vaccine candidates may not yet have passed phase 3, and other, more affordable options will emerge over time. But an effective response to the pandemic that has already ravaged more than 73 million people and 1.6 million lives will require greater effort and commitment, especially from rich countries, to ensure a fair and just distribution of the vaccine to all. countries ”, they conclude. the authors.
