Can Europe stop the deadly threat of vaccine nationalism?

Yesterday, the President of the European Commission, Ursula von der Leyen, Announced the support of the European Union to the Center for Global Access to COVID-19 Vaccines (COVAX) with a contribution of 400 million euros for the advance purchase of future vaccines for the benefit of developing countries. It is a much needed act of leadership that I hope the rest of the G20 will follow.

Positioned as the multilateral response to the growing wave of vaccine nationalism, COVAX was launched to ensure equitable access, for everyone, everywhere, to affordable COVID-19 vaccines. It frames equitable access as a two-step process: First, regardless of nationality, priority must be given to healthcare workers and the most vulnerable, such as the elderly and people with pre-existing medical conditions. It makes sense for a front-line Togolese nurse to have access to a young, healthy European citizen working in an office. Second, recognizing that it will take time to increase manufacturing capacity to ensure access for all, participating countries should initially receive sufficient vaccine doses to cover the minimum proportion of their population deemed necessary (between 10 and 20 %) to cause the pandemic. to a much more manageable state globally.

To achieve such an equitable distribution, COVAX intended to negotiate on behalf of all participating countries, rich and poor alike, the advance purchase of two billion doses of vaccine and, in the process, encourage manufacturers to invest in production capacity, thus reducing the duration. time it would take to make vaccines available on a large scale. Although these doses are not close enough to serve the planet’s 7.8 billion inhabitants, many experts consider that these doses are sufficient to contain the pandemic, provided they are distributed equally in all countries. Bottom line: not everyone needs to get a vaccine at the same time to end the pandemic.

For poor countries, COVAX represents possibly the only real option to gain access to vaccines. Richer countries, by contrast, face two routes: pursue their own bilateral agreements with pharmaceutical companies to ensure immediate supply for all their citizens, or join COVAX, prioritizing health workers and the most vulnerable. Adopting COVAX may seem politically difficult to bear as it requires limiting initial doses to priority populations. But the case for investing in COVAX goes beyond upholding fairness and justice, once the tax implications of a go it alone mentality that leaves the poorest nations behind are taken into account.

The costs associated with equitable distribution in all countries, even if it means limiting immediate access to priority populations, are ultimately much less than the cost of letting a global pandemic continue to rage (a result more than likely if some rich countries buy all available vaccine to the exclusion of others). The G20 countries alone have already mobilized more than $ 10 trillion in fiscal stimulus to address and mitigate the consequences of the pandemic, roughly three and a half times what the world spent on the entire response to the global financial crisis. The cost to meet all of the Covax facility goals: $ 18.1 billion (a fraction of the estimated $ 500 billion in ongoing monthly economic losses). Unfortunately, it seems that very few countries are willing to contemplate an approach that truly prioritizes equitable access, a calculus divorced from the ongoing cost of the global pandemic, the effects of which will affect us all.

The topics about equitable access have given way in recent months to a race by rich countries (Japan, the United States, the United Kingdom, Australia, Canada and even many in the EU) to seize all the available doses, in some cases ensuring as many as three, four or even five times more doses compared to their total populations. Realpolitik is alive and well, even if it means we can all pay more for it in the long run.

In truth, aware that none of these bilateral agreements are for vaccines that have not yet been found viable, many of these countries have also expressed interest in joining COVAX. After all, joining COVAX increases a country’s likelihood that some of its most vulnerable populations will be able to gain early access to one or more safe and effective vaccines (especially since Covax boasts of providing “access to the most biggest in the world [vaccine] candidates ”).

However, so far, only the European Union has backed their interest with serious funding.

By not fully committing to COVAX, the rest of the G20 and other wealthy nations are threatening to undermine their ability to pre-purchase vaccines on a large scale; a challenge that is only compounded by competition with bilateral agreements. The more richer countries join, the greater the bargaining power to ensure the right conditions and the lowest possible price per dose for everyone, regardless of income or location.

Hopefully the rest of the G20 will soon follow the lead of the EU. In the process, they will have to find a way to untangle the mess left by the race toward vaccine nationalism in recent months. Key questions include:

• What to do with pre-existing pharmaceutical offers entered by countries that now want to join COVAX? No government will want to pay twice for the same vaccine: once bilaterally and once through COVAX. The strong EC backing of COVAX, despite the European bilateral agreements, suggests that their previous agreements will be respected and they will only pay for the candidate vaccine they do not have access to. Being clear about this can make it palpable for countries to step off the edge and embrace COVAX.

• Can countries invest in COVAX and continue to make deals on the sidelines? As countries continue to pursue bilateral agreements while investing in COVAX, they should coordinate to prevent prices from rising and undermining the very idea of ​​COVAX and a multilateral approach. Additionally, any of the agreements should require pharmaceuticals to reproduce exactly the same or better terms under COVAX, provided it makes economic sense to do so.

• Who exactly should be prioritized? Is it someone with medical training or who works in a hospital? Who is considered a priority health personnel in a country where there are hardly any doctors? Should a country with a large number of elderly have access to more doses than one with a much younger population beset by other health burdens? What about essential workers, for example those who work in the port of a country that depends on food imports? Equitable access sounds good, but the devil is in the details and this detail needs to be agreed upon and made available to the public to ensure that vaccines are truly distributed fairly.

• By last, How do we ensure that countries comply and adhere to the plan once they receive vaccines, vaccinating doctors before members of the ruling party, for example? This is not a national, sovereign decision, but a global responsibility because we will not be safe anywhere if a country disgraces itself in distribution and leaves out those who are most at risk.

The benefits of COVAX’s success should make joining and funding it a no-brainer. It is the only truly global and coordinated plan to protect the majority of populations at risk, end the pandemic for all, and ultimately end the horrendous economic destruction it has caused.

As rich countries gradually realize, much more slowly than they should have, that the only way to end the pandemic is together, they should quickly curb vaccine nationalism and match Union investment European in COVAX.

The alternative is to follow a well-traveled path throughout history.

As Thucydides said long ago, “the strong do what they can and the weak suffer what they must.” Only this time we all suffer.