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London: Creating a vaccine to stop Covid-19 in a matter of months is not the only colossal challenge. The next big test: taking billions of doses to every corner of the world at a time when countries increasingly prioritize their own interests.
A variety of financing tools are being considered to stimulate the production of large quantities of potential vaccines and to ensure that they are equitably distributed. In a deal, developers would agree to provide injections at affordable prices in exchange for funding commitments from governments or other donors.
There’s a lot at stake with the coronavirus that sickens more than 3 million people, even when billions are hiding from the pathogen inside. Health advocates are concerned that wealthier countries monopolize the global supply of Covid-19 vaccines if companies are successful, a scenario that developed during the 2009 swine flu pandemic. Distributing shots widely, they say, is not what Right. It is also crucial to slow the spread of contagion.
“There is a lot of awareness of possible injustice and inequity in the future,” said Gavin Yamey, director of the Center for Global Health Policy Impact at Duke University. “There has been less awareness of the critical notion that you really need to assign the vaccine in a way that makes sense to public health.”
Lack of access to vital medicines and vaccines is a permanent problem for the world’s poor. More than two decades ago, the high price of HIV drugs sparked a protest that millions of people in Africa and other regions who couldn’t afford them died, much later leading to programs to help those populations.
Also read: Bill Gates’ coronavirus vaccine could be ready in 12 months
Fair distribution
With Covid-19, the concern is that rich countries put their own interests ahead of global unity. French President Emmanuel Macron and German Chancellor Angela Merkel joined the World Health Organization last week in calling for a fair distribution of the vaccines.
“It has the potential to get very ugly,” said Michael Kinch, a vaccine specialist and associate vice chancellor at the University of Washington in St. Louis. “There will be a delay between the time we have a vaccine and the ability to protect 7 billion people.”
Still, he said, “there are ways to avoid it,” such as creating manufacturing facilities around the world. The Coalition for Outbreak Preparedness Innovations, an Oslo-based group that funds several experimental coronavirus vaccines, has said that is the goal.
The coalition sees promises in so-called advance market commitments, according to CEO Richard Hatchett. In that type of program, donors pledge funds to guarantee the price of vaccines once they have been developed. CEPI is talking to other organizations, including the World Bank, which is exploring how to establish such agreements, he said.
“The virus does not respect borders and cuts across all classes of society and all age groups,” said Hatchett. “There really seems to be a rapidly evolving consensus around the importance of delivering a vaccine globally to all countries as quickly as it can be made available.”
Advanced purchase
Gavi, the Vaccine Alliance, a group working to prevent disease in poor countries, established a similar agreement to combat Ebola in Africa. The nonprofit signed an advance purchase commitment with Merck & Co., creating a stockpile of used doses in the Democratic Republic of the Congo. Merck initially agreed to provide 300,000 doses of the vaccine available for use in extended clinical trials or in emergencies while development continued.
In a deal with Gavi a decade ago, Pfizer Inc. and GlaxoSmithKline Plc lowered the price of their pneumonia vaccines by until 90% in developing countries, each committing to supply 30 million doses a year for a decade.
Also read: How coronavirus vaccines can reach the market faster with the right incentives
Vaccine manufacturing and supply to meet global demand is expected to be an unprecedented mobilization, according to Joe Cerrell, managing director of global policy and advocacy for the Bill and Melinda Gates Foundation. The cost to ensure the necessary doses could be up to $ 25 billion, he estimated.
“Time is not on our side,” he said by phone. “We don’t have a year or so to figure this out.”
The International Financial Facility for Immunization, which raises money to buy and deliver vaccines through the sale of bonds, is another option that could work with Covid-19, Cerrell said. The group finances programs through Gavi.
Those kinds of tools are “innovative mechanisms for taking long-term promises and converting them into pre-loaded cash,” said Duke’s Yamey. “We are going to need large amounts of money now.”
Vaccine race
Dozens of companies, including Sanofi, Johnson & Johnson, and Moderna Inc., are in the race to find a vaccine, along with researchers from institutions ranging from Oxford University to the University of Queensland in Australia.
One of the largest hunting companies, London-based Glaxo, is speaking to governments on the issue of supply, according to CEO Emma Walmsley.
“We believe this should be a global approach,” he told reporters. “We hope that those talks will continue in parallel and before the data is finalized, and we look forward to collaborating with governments to be part of the solution.”
While a vaccine is a crucial part of the exit strategy, the world lacks a global system to manage distribution in a crisis, said Gayle Smith, who leads the ONE Campaign, an advocacy group. During the flu pandemic more than a decade ago, wealthy nations secured most of the supply before then trying to assign vaccines to the rest of the world, he told reporters this week.
It is important that a vaccine is “equally and equally available everywhere,” he said. “We cannot think of this pandemic as something that simply exists within our own borders.” –Bloomberg
Also read: Total eradication of the new coronavirus is almost impossible. But this is what the vaccine can do.
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