Cease-fire on the Vaccine Front!

Early last month, the World Health Organisation (WHO) got 156 member countries of the United Nations to form a coalition and agree to a “landmark” deal to enable distribution of any new coronavirus vaccine to protect vulnerable healthcare systems, frontline health workers and those in social care settings that will serve at least 3 per cent of participating countries’ populations.

The Covid-19 vaccine allocation plan, Covax, which is co-led by the World Health Organisation, aims at ensuring that the results of research, purchase and distribution of any new vaccine reaches the world’s richest countries as well as those in the developing world.

Sixty-four higher income economies have already joined Covax, which includes commitments from 35 economies as well as the 27 EU member states plus Norway and Iceland. 

The European Commission has committed to procure doses on behalf of the 27 EU member states plus Norway and Iceland. WHO expects 38 more countries to join the coalition in the coming days.

The first useful vaccines emerging for commercialisation may be in short supply, and approved vaccines will initially be made available to a targeted 3 per cent of the population of participating countries, raising this to 20 per cent over time. 

The target for vaccine supply under the Covax scheme is 2 billion doses by the end of 2021. At $25-30 per dose, this would cost anywhere between $50 billion and $60 billion, added to direct purchases by patients and hospitals, this could keep vaccine makers engaged for years.

At this rate, covering at least half of the world's 8 billion population with a single dose of any safe effective vaccine would cost $100 billion to $120 billion and double that amount if two doses are required.

India’s own vaccine manufacturer Serum Institute of India (SII), which is producing the potential coronavirus vaccine developed by Oxford University, is expecting a Rs80,000 crore order from the government.

SII has signed an agreement to manufacture the potential vaccine developed by Jenner Institute of Oxford University in collaboration with British-Swedish pharma company AstraZeneca.

Earlier, SII had announced that it will make the Oxford vaccine available at $3 for low- and middle-income countries, including India.

Governments, vaccine manufacturers, care organisations and individuals have so far committed $1.4 billion (£1.1 billion) towards vaccine research and development to various major vaccine manufactures, mostly pharma MNCs.

Covax, according to Tedros Adhanom Ghebreyesus, head of the UN health body, represented the “world’s largest and most diverse portfolio of Covid vaccines” in which several vaccine makers are participating.

He, however, said the scheme will ensure vaccines for “some people in all countries and not all people in some countries,” adding that countries should focus on reducing mortality and protecting the health system for the present.

While the better vaccines would find markets across the world, lesser ones would also get takers at reduced prices as, according to the WHO document, under the Covax scheme “all countries should gradually receive tranches (of vaccine) to cover each subset of their target groups … until they can cover 3 per cent of the population. This would make the global fight against Covid a long-drawn process.

Set up to counter the increasing fight for a larger share of the vaccine market, or the so-called “vaccine nationalism” in the midst of the pandemic, Covax is being led by the WHO, Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness and Innovations (Cepi) to ensure the “equitable access and allocation of Covid-19 health products”, including vaccines.

WHO and Covax, however, are constrained by the demands of market mechanism and the need for researchers and manufacturers to promote the business of healthcare, which drives the vaccine industry.

In his opening remarks at a media briefing on Covid-19 on 21 September, WHO Director-General Dr Tedros Adhanom Ghebreyesus said at least $15 billion is needed immediately to maintain momentum and stay on track for the ambitious timelines.

At the same time, he said. “We have no guarantee that any single vaccine now in development will work. The more candidates we test, the higher the chance we will have a safe and efficacious vaccine. But vaccine makers are undeterred, considering the immense gains.

Perhaps the biggest gainer in the pandemic is the People’s Republic of China as it made an early restart of economic activities much before other countries thought of easing lock-down restrictions.  

Beijing made hay selling masks, personal protection equipment and medicines to countries all over the world.

Chinese researchers also came up with an early vaccine that saw Zhong Shanshan, who holds a controlling stake in newly-listed Beijing Wantai Biological Pharmacy Enterprise make a $20 billion windfall.

His controlling stake in the firm saw his overall wealth jump as much as $20bn by August.

Zhong Shanshan’s net worth reached $58.7 billion on 23 September, making him Asia’s second-richest person, behind RIL’s Mukesh Ambani, and is the 17th wealthiest in the world, ahead of Charles Koch and Phil Knight.

The pharma company says it has partnered with two universities to develop the candidate vaccine to fight Covid-19.

China also claims to have the "understanding and support" from the World Health Organisation before starting a controversial emergency use programme for its Covid-19 vaccine candidates, a Chinese health official said.

China has been administering coronavirus vaccines to hundreds of thousands of people since July.

Chinese government says it has approved an emergency use programme before the safety and efficacy of the vaccine have been fully proven by clinical trials.

"After the approval, we communicated and informed the relevant representatives from the WHO office in China and gained the understanding and support of the WHO," Zheng Zhongwei, an official with China's National Health Commission, told a news conference.

China says it currently has 11 vaccines in clinical trials and four in Phrase 3 trials. Globally, there are 38 vaccines in human trials, among which nine have reached the last stage of testing, according to the WHO.

The vaccines, which have not completed Phase 3 trials, were developed by the state-owned China National Biotec Group Corporation, known as Sinopharm.

In a statement posted on Sinopharm's website last month, the company said its two vaccine candidates had been administered "hundreds of thousands of times" under the emergency use programme approved by the government.

The vaccines were used on medical professionals, diplomats deployed to high-risk countries, and state-owned company employees working overseas under China's Belt and Road Initiative, according to the firm's general counsel Zhou Song.

Almost 200 vaccines for Covid-19 are currently in clinical and pre-clinical testing. The history of vaccine development tells us that some will fail, and some will succeed, he said.

The Covax facility enables governments to spread the risk of vaccine development and ensure their populations can have early access to effective vaccines, he added. 

A statement attributed to a former head of the World Health Organisation gives a better idea of the healthcare market mechanism. According to Gro Harlem Brundtland, spending $5 (£3.90) per person annually on global health security over the next five years could prevent a future “catastrophic” pandemic. 

It would cost the world around $40 billion annually, but that amount would be a huge saving on the $11 trillion response to Covid-19, said Brundtland, who had sounded alarm over the threat of a fast-spreading deadly pandemic last September.

The costs are based on estimates by McKinsey & Company, which found the average annual costs to prepare for pandemic over the next five years would be equivalent to $4.70 per capita.

Brundtland, co-chair of the Global Preparedness Monitoring Board (GPMB) and a former prime minister of Norway, sees it as a collective failure to take prevention and response seriously and to prioritise it. “We are all paying the price,” she said.

“We knew it was a real threat, which is why we called the alarm,” Brundtland said. “We saw the preparedness was far from what it should have been at that time.”

Coronavirus has provided a harsh test that proved them right, she said. “Because what we are in the middle of can happen again. We need to be better prepared.”