NEW YORK – As richer governments invest billions of dollars in their own vaccines opposed to COVID-19, civil servants warn that “vaccine nationalism” may leave poorer countries behind. A new global COVAX vaccine center can offer hope to ensure that the world’s most vulnerable people get the vaccines once they become available.
The facility is jointly administered through Gavi, WHO and the Coalition for Innovations in Epidemic Preparedness, and calls on countries to jointly distribute COVID-19 vaccines over the long term.
“COVAX is the only global solution in fact capable of completing the acute phase of the COVID-19 pandemic. It does this by ensuring fair and equitable access for all countries, thus avoiding the mistakes of the afterlife when a small number of countries have been able to guarantee a disproportionate amount of global supply,” a Gavi spokesman wrote in an email to Devex.
“But it will only succeed if we start making an investment in production now, so that vaccines are in a position to be shipped the day approval is obtained.”
It won’t be an easy task. In addition to getting good enough funding, the establishment will face many complex policy decisions: which vaccines are funded by countries preventively, knowing that not all candidate vaccines will pass the effectiveness and protection test? And who will be the first to get a vaccine once it’s available?
“Donor countries lead by example and invest cash in liquidation. There are many decisions to make and those decisions cannot be made until we know the length of the pool of resources,” Path CEO Nikolaj Gilbert told Devex in a recent interview.
“There is much to be done to make this vision a reality. But I think it’s a wonderful vision and we want it now. Clearly, we are doing everything we can to achieve it. But the world will have to remain engaged in the long-term, this, ” continued Gilbert.
Gavi announced the installation of COVAX as the “cornerstone of a global mechanism for making certain COVID-19 vaccines equitable in the long term” at its replenishment assembly in June.
The facility acts as a threat control mechanism designed to increase the chances of good luck of a vaccine, or vaccines, which can occur in giant quantities in a time after regulatory approval. Participating governments jointly invest in nine candidate vaccines, such as a pre-marketing commitment, or CMA, and agree to distribute vaccines equally among their countries. Health personnel will be given the first priority and access to 20% of the maximum vulnerable population in the participating country will be extended.
Some 92 low- and middle-income countries can access vaccines at no fees through COVAX, Gavi’s board of directors announced last July. Another 81 high- and middle-income countries have expressed interest in installing self-funded members, making invoices in advance that will be essential to fill COVAX coffers.
The point of interest shows that countries perceive the quality of the facility, according to Gavi’s spokesman.
“It is also a sign that countries see that equitable access is not only the right thing to do, but that we are all interested. It is pushing for as many countries as you can imagine to join the Mechanism and finance the COVAX AMC. We want to paint together, ” said the spokesman.
COVAX will want $2 billion in initial investment through the end of the year to secure doses to low- and middle-income eligible countries, according to Gavi. To date, the facility has raised $600 million. Another $3.4 billion would then be to acquire about one billion doses until the end of 2021.
“There will be a lot of mess between those vaccine wallets. If we are lucky, there will be one or two that CEPI has in the portfolio that will succeed … So we have to take that resolution to say, OK, are we? Go ahead with all this? Five of them? Seven of them? And who are these other people who will make these resolutions? Gilbert said.
But a reaction to fully vaccinate in opposition to COVID-19 is expected to take years and will require billions of doses, according to Peggy Hamburg, Gavi’s board member. Hamburg spoke at a webinar in August organized through the Center for Strategic and International Studies on COVAX facilities.
“It all sounds good, but it takes resources, in dollars, but also politicians and humans, to estimate the goals,” Hamburg said. “This is a critical investment gap.”
WHO leader Tedros Adhanom Ghebreyesus has asked the richest countries to register for the establishment before the August 31 deadline set up through the fitness organization.
A handful of rich countries such as Canada, New Zealand, Singapore, Saudi Arabia and the United Kingdom have agreed to join. But the United States and China, two of the largest vaccine manufacturers imaginable, are remarkably absent.
While the European Union, the United Kingdom, Switzerland and the United States have concluded their own agreements with pharmaceutical corporations approaching vaccines, Tedros called for vaccine nationalism at a press conference in mid-August.
“Sharing limited materials strategically and globally is in fact in the country’s national interest,” Tedros said.
There are more than 160 vaccine applicants in development, most of whom are not yet in human trials. “If we’re lucky, there’ll be one or two on the project that they’re going to succeed,” Gilbert said.
A joint investment in more vaccines may increase the chances of supporting a vaccine that will be effective. According to a study by Kendall Hoyt, an assistant professor at Geisel School of Medicine in Dartmouth, avoiding vaccine bidding wars in the meantime can reduce the cost of buying through a thing of 13.
“Competition is a kind of classic way to generate innovation, however, it can simply obstruct efforts to expand a COVID vaccine and make it available,” Hoyt said at the CSIS webinar.
But even if a sufficiently good investment is provided to COVAX facilities and successful vaccine applicants are selected, many key questions remain unanswered.
“Who gets the vaccines in the countries?” Gilbert asked. “Who gets that 20%? Moreover, in each and every country in the world, who decides? But also, how is the country lightly distributed, without relying on the political timetable or dynamics of that country? And that’s some other challenge you want to meet.”
Initially, the source of effective COVID-19 vaccines will be sufficient to meet the main demand, in component due to the production time required to produce billions of doses.
“You underestimate the shortage of COVID-19 doses, which will make it much more political. Geopolitics will play, cash will play. You know the story. It’s not going to be pretty, what’s going to happen,” Gilbert said. .
But the facility still gives hope as a style of global cooperation and progress in vaccine progression and distribution, according to Gilbert.
“If we can have that spirit when it comes to accessing each and every user in the world in a similar way, then yes, then we will do it,” Gilbert said.