The successes of the trials by Pfizer Inc. and Moderna Inc. have fueled hopes that a Covid-19 vaccine will soon arrive. But much of the world, outside of wealthy nations like the United States, has the opportunity for another company to escape the crisis.
Findings from the final stage of AstraZeneca Plc’s vaccine studies will be published shortly, and the risks to low- and middle-income nations are immense. The injection developed with the University of Oxford represents more than 40% of supplies going to those countries, according to agreements with London-based research firm Airfinity Ltd.
The Astra vaccine costs a fraction of the price set by Pfizer and will be manufactured in several countries, from India to Brazil. It should be easier to deploy far and wide than other outlets that need to be stored in extremely cold temperatures. But if UK partners cannot match the high levels of efficacy that Pfizer and Moderna delivered or implement their inoculation quickly, the pandemic could continue to spread death and disease in countries that depend on it.
“The stakes are high with the Astra vaccine,” said Suerie Moon, co-director of the Center for Global Health at the Graduate Institute for International and Development Studies in Geneva. For low-income countries, “it’s huge.”
Pfizer applied for an emergency use authorization in the US on Friday and can begin implementation in mid-December. While rich nations are in a position to receive the first supplies of Pfizer and Moderna injections thanks to the significant quantities they have procured ahead of time, most regions rely heavily on companies that follow pioneers, especially AstraZeneca, Novavax Inc. and Johnson and Johnson. Supplies are likely to struggle to keep up with demand in the months after vaccines arrive, raising concerns about global access.
Higher population
“The vast majority of the world’s population lives in low- and middle-income countries,” said Mark Eccleston-Turner, a specialist in infectious disease and law at Keele University in England. “It is not just a problem for the people there, far from us. It is a problem for most of the people in the world.”
A global program called Covax has made progress in an ambitious effort to deploy future vaccines equitably around the world, getting dozens of countries to join and securing deals for 700 million doses so far.
AstraZeneca reached an agreement to supply the initiative, while a collaboration that included the Serum Institute of India agreed to accelerate the production of Astra or Novavax injections for low- and middle-income countries, with a maximum price of $ 3 per dose, with the option to insure more. A Covax pact with Sanofi and its partner GlaxoSmithKline Plc followed last month.
The program, led by the World Health Organization, the Coalition for Innovations in Epidemic Preparedness and Gavi, the Vaccine Alliance, expects more agreements in the coming weeks. Pfizer and BioNTech, along with Moderna, are still in talks with Covax.
AstraZeneca has undoubtedly been the most active in reaching supply agreements. Of all the volumes committed globally, nearly a third – around 3.2 billion doses – will come from the UK company, according to Airfinity. More than 50 low- and middle-income countries would receive the Astra and Oxford vaccine, in regions such as Latin America, Africa, the Middle East, Asia and Eastern Europe, along with wealthy governments as well, the research group found.
If the vaccine is successful, meeting that demand will not be easy. In the UK, shortage of injection supplies expected by the end of the year casts doubt on how quickly AstraZeneca will be able to immunize the public. However, the company has said that it is confident that it can start delivering hundreds of millions of doses continuously once it gets approval.
Price advantage
One of the key factors behind dependence on the Astra-Oxford vaccine is the initial price. Astra has said that it will not make a profit during the pandemic and that the vaccine will cost between $ 4 and $ 5 a dose, although health advocates worry about what that company and others will charge when the crisis is deemed to be over.
The United States agreed in July to source the Pfizer and BioNTech vaccine in a deal that sets the price at $ 19.50 per dose, or $ 39 for a two-shot vaccine, a level that BioNTech said could become a benchmark for developed nations. Moderna said it is charging $ 32 to $ 37 per dose for smaller offers and less for larger purchases.
“Those prices run the risk of putting vaccines out of reach for much of the world,” said Margaret Wurth, senior researcher at Human Rights Watch in New York.
Astra-Oxford also has advantages beyond cost when it comes to implementation in low- and middle-income countries. The global reach of the manufacturing alleviates concerns about countries restricting exports, and the product should be easier to transport and store, according to Eccleston-Turner, the Keele expert.
It is important that the puncture is kept at refrigerator temperatures, while those from Pfizer and Moderna, based on the novel messenger RNA technology, require freezing for longer term storage and transport.
That’s why so many countries eagerly await Astra’s results and focus on the next candidates, including those from China. Russia also plans to produce the Sputnik V vaccine in other countries such as India and Brazil.
“All the rich countries are now quite well positioned,” said Moon, the health specialist in Geneva. For developing countries, “it’s not like they’ve just sat around saying we’ll see what comes of it. They’ve been aggressively pursuing what they can with the means at their disposal.”
(Except for the headline, this story has not been edited by NDTV staff and is posted from a syndicated channel)
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