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AAs wealthy governments compete to secure the supply of Covid-19 vaccines, nearly a quarter of the world’s population, mainly in low- and middle-income countries, will not have access to a vaccine until 2022, according to a new analysis.
As of mid-November, high-income countries, including the European Union bloc, reserved 51% of almost 7.5 billion doses of different Covid-19 vaccines, although these countries represent only 14% of the world’s population. Meanwhile, only six of the 13 manufacturers working on Covid-19 vaccine candidates have reached deals to sell their injections to low- and middle-income countries.
The analysis, which was published in the BMJ, noted that access “varies markedly” between these countries. For example, the US booked 800 million doses, but it accounted for a fifth of all Covid-19 cases globally. In contrast, Japan, Australia, and Canada reserved more than 1 billion doses, although these three countries combined did not account for even 1% of all current cases.
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Viewed another way, projected vaccine courses per capita by country show that Canada, followed by Australia, the UK, Japan, the European Union and the US, have booked at least one vaccine course per person. Canada has reserved 9.5 servings, or more than four courses, per person. In contrast, low- to middle-income countries, such as Brazil and Indonesia, booked less than one course for every two people.
Meanwhile, only high- and upper-middle-income countries have been able to procure mRNA vaccines, in particular from the association Pfizer (PFE) and BioNTech (BNTX), as well as Moderna (MRNA). The Pfizer / BioNTech vaccine has ensured an emergency in the US and other countries. But both it and the Moderna vaccine require cold chain distribution and storage, which means they won’t be readily available in countries with limited infrastructure.
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“High-income countries have sought to secure the future supply of Covid-19 vaccines, but they have left much of the rest of the world with uncertain access. Those hopes are centered today on a handful of lead vaccine candidates, some of whom may still falter or fail, ”the authors wrote.
However, some contracts have not been disclosed or are heavily drafted, making it difficult to identify supply priorities. The authors argued that greater transparency about agreements with manufacturers, as well as the underlying costs of R&D, public sector financing, and pricing agreements is needed to achieve more equitable access.
“Such limited transparency will fuel concerns about vaccine nationalism, and planning and accountability to ensure wider access to Covid-19 vaccines could be seriously hampered,” the authors warned.
The situation is exacerbated by different allocation priorities in each country and region, according to another analysis in the same issue of The BMJ. For example, if vaccines are preferentially assigned to priority workers to help maintain social functions, the global target population is 258.3 million people.
The analyzes come amid growing concern over access to affordable Covid-19 vaccines now that distribution of the Pfizer / BioNTech (BNTX) vaccine has begun, the first to gain regulatory clearance in the US. Expectations that more vaccines will still be available in the coming months are rising, as some governments and consumer groups are pushing harder for greater access.
For example, 100 advocacy groups, academics, and health experts from around the world urged CEOs of 15 vaccine manufacturers in the US, Europe, China, and Russia to commit some of their production to low-income countries and media. They also asked companies to disclose test results, various costs, prices, advance purchase commitments, and resources received from public and charitable sources.
One reason for such letters is that an ambitious program organized by the World Health Organization called COVAX, which hopes to provide vaccines to 92 low- and middle-income countries, has not met all of its goals. Until last month, the European Commission, the Bill and Melinda Gates Foundation and others pledged $ 2 billion. But another $ 5 billion is still needed to fund the 2 billion doses planned by the end of 2021.
As the study authors noted, by combining resources and candidate vaccines, COVAX can provide access to a diversified pool of potential vaccines and economies of scale. But there are concerns that some countries may “double-dip” or purchase supplies through COVAX and individual agreements. COVAX, by the way, is run jointly with the Gavi Vaccine Alliance and the Coalition for Outbreak Preparedness Innovations.
To date, the number of confirmed purchases of Covid-19 vaccines worldwide has amounted to 7.4 billion doses, according to Duke’s Center for Global Health Innovation. Of these, high-income countries purchased 3.9 billion doses, upper-middle-income countries purchased 1 billion doses, and lower-middle-income countries purchased 1.8 billion doses. Low-income countries bought no. COVAX secured 700 million doses.
However, access anxiety is something of a moving target.
Earlier this week, the Canadian government pledged to provide $ 380 million to various global initiatives designed to provide equitable access to Covid-19 diagnostics, therapies, and vaccines. Canada has also reportedly been in talks to donate excess vaccine doses, but no pledges or details have been made public.
“As uncertainty about which vaccines will succeed and which will not diminish, Canada’s commitment to ensuring an effective global response will be tested,” wrote Anthony So, one of the study’s authors and a professor at the School of Public Health. Johns Hopkins Bloomberg. us.
“How and when will you share the effective Covid-19 vaccines you have acquired with those who are worse off in the pandemic or most in need of even the first round of doses? The same question may face a host of other high-income countries that have signed bilateral agreements with vaccine manufacturers: expansion at home or distribution abroad.
“Investing and coordinating globally through COVAX helps address this challenge, but the United States and Russia have refused to participate,” he continued. “Therefore, Canada’s commitment to develop a mechanism for equitably reallocating vaccine doses, through COVAX, through exchange or donation, sets an important first step for the global community to follow.”
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