LONDON (AP) – As the race for a vaccine against the new coronavirus intensifies, wealthy countries are rushing to pre-order the inevitably limited offer to ensure their citizens are immunized first – leaving big questions about whether developing countries are more likely get a vaccine the pandemic ends.
Earlier this month, the United Nations, the International Red Cross and the Red Crescent and others said it was a “moral imperative” that everyone have access to a “popular vaccine.” But such grand statements are unenforceable, and without a detailed strategy, vaccine allocation could be extremely messy.
“We have a beautiful picture of everyone getting the vaccine, but there is no roadmap on how to do it,” said Yuan Qiong Hu, a senior legal and policy adviser at Medicins Sans Frontieres in Geneva. She said that there are many problems to be resolved to manage distribution and that few measures have been taken.
In the past, Hu said, companies have often applied for patents for almost every step of vaccine development and production: from the biological material such as cell lines used to the preservative needed to increase vaccine doses and even how shots are administered.
“We cannot afford to face these different layers of personal rights to create a ‘folk vaccine’,” she said, insisting on “very open conditions” so that every manufacturer capable of doing so , can produce a vaccine once it has been proven effective.
Ghanaian President Nana Akufo-Addo spoke at a vaccination summit earlier this month that addressed the thorny issue of fair distribution earlier this month.
“The worldwide spread of COVID-19 has told us in no uncertain terms that disease knows no borders and that no country can afford to do it alone,” he said. “Only a people’s vaccine with equality and solidarity at its core can already humanity from the virus … A daring international agreement cannot wait for that.”
Worldwide, about a dozen potential COVID-19 vaccines are in an early testing phase. Some may go into late-stage testing later this year, if all goes well, but it is unlikely to be licensed until early next year at the earliest. Still, many wealthy countries have already ordered some of these experimental shots and expect delivery before they get marketing approval.
Britain and the United States have deposited millions of dollars into various vaccine candidates, including one developed by Oxford University and produced by AstraZeneca. In return, both countries are expected to be given priority; the UK government stated that if the vaccine proves to be effective, the first 30 million doses will be for the British.
Separately, AstraZeneca signed an agreement to make at least 300 million doses available to the United States, with the first batches delivered as early as October. In a briefing Tuesday, senior officials from the Trump administration said there will be a cascading system for determining who will be offered the first vaccine doses in America. Levels probably include groups most at risk of serious illness and workers who provide essential services.
The European Union moved last week to take care of its own provision. On Saturday, AstraZeneca signed a deal with a vaccine group forged by Germany, France, Italy and the Netherlands to secure 400 million doses by the end of the year.
Among the various global efforts being made to try to ensure that developing countries do not lag behind is a ‘market progress’ from the vaccine alliance GAVI, which aims to convince producers to earn enough for both rich and poor countries.
That could “prevent countries from trying to invest,” said Seth Berkley, CEO of GAVI, who used the approach to protect Ebola and pneumonia vaccines for a global market. “Because if you invest in one or two vaccines, the chance that those vaccines work is of course pretty small. And so yes, you can hit the jackpot and have a vaccine that works. But maybe you don’t get a vaccine and you are left behind. ‘
Two global vaccine groups have signed a $ 750 million deal with AstraZeneca to supply 400 million doses by the end of 2020. The Anglo-Swedish pharmaceutical giant has also agreed to license its vaccine to the Serum Institute in India to produce 1 billion doses.
Dr. Paul Stoffels, Chief Scientific Officer of Johnson & Johnson, said the company plans to make its coronavirus recording for poor countries at a non-profit price, due to the complexity of the technology and expertise required. Likewise, AstraZeneca’s CEO, Pascal Soriot, has pledged to make the vaccine available during the nonprofit pandemic.
The World Health Organization and others have called for a COVID-19 “patent pool” where intellectual property rights would be surrendered so that medicines could freely share data and technical knowledge. Numerous countries, including Australia, Brazil, Canada and Germany, have already begun to review their licensing laws to allow them to suspend intellectual property rights if the authorities decide that the pandemic has an overwhelming need.
But the industry’s response was lukewarm.
Executives at Pfizer and some other major drug manufacturers say they are opposed to the suspension of patent rights for potential COVID-19 vaccines.
While vaccine stocks exist for diseases such as yellow fever, cholera and meningitis, they are only needed for a few developing countries during acute outbreaks. There is no precedent for distributing vaccines that every country in the world would undoubtedly need.
“We cannot rely solely on goodwill to ensure access,” said Arzoo Ahmed, of the UK’s Nuffield Council on Bioethics, noting that precedents of how innovative drugs are distributed are not encouraging. “With HIV / AIDS, it took ten years for the drugs to reach people in low-income countries. If that happens with COVID-19, it would be very worrying. ‘
Other experts pointed out that billions of dollars are being spent on each stage of vaccine development, but that there is little overview of how resources are spent and that there is little guarantee that those who need them most will have the opportunity .
Suerie Moon, co-director of the Global Health Center at the Graduate Institute Geneva, said it is unclear how vaccines intended for developing countries are actually distributed. “We don’t know what the process will look like or how transparent it will be,” she said.
Dr. Soumya Swaminathan, WHO chief scientist, said the UN health service is currently working on developing an ‘allocation framework’ for how coronavirus vaccines should be distributed. But this guidance would not be binding.
“We don’t want to get into a situation where there are doses of vaccine, but they are only available for some countries,” she said. “We need to have a consensus on that so that we can agree to share the vaccine in a way that protects the most vulnerable.”
Larson reported from Washington. Associated Press writers Danica Kirka in London, Lauran Neergaard in Alexandria, Virginia and Linda A. Johnson in Fairless Hills, Pennsylvania contributed to this report.
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