Different universities and pharmaceutical industries have made unprecedented efforts to develop a vaccine(s), which can save lives and reduce transmissions of the high capacity novel coronavirus that has in the mean time caused deaths of around 0.6 million and devastated economic and other aspects around the world. At this moment, eight potential candidate vaccines from several countries including the UK, the USA, China, Germany and Russia Germany are in the second to third clinical trial phase and progressing faster compared to any other pathogen development in history. If things go on the right track, safe and effective vaccine(s) may be ready for use within the next few months, even if the usual vaccine timeline — ranging from research to production — takes around a decade.
But a fair mechanism of production and distribution is very imperative, alongside the development, which itself does not necessarily translate into affordable universal accessibility. As experience shows, some earlier vaccines took years to reach persons who needed owing to a lack of a fair mechanism. For instance, during the 2009 influenza A (H1N1) pandemic, wealthy nations bought virtually all supplies with advanced orders and supplies for low- and middle-income countries were limited, even after the WHO appealed for donations. Yet, regrettably, earlier loopholes in the pay-to-pay approach are not addressed much in terms of the production and distribution of potential COVID-19 vaccine(s). Given that a fair process remains unheeded, repetition of the same is not unlikely at all at this time too.
Well, what can be a fair mechanism of production and distribution of potential vaccine(s)? Obviously, some countries, philanthropist organisations, INGOs, eminent persons and others have already favoured generic production and equitable distribution of required doses across the world at the earliest possible time. Given the importance of saving hundreds of millions of lives across countries, developed, developing and less developed, I think that it is important to allow for mass production across countries without any restrictions and distribution at the lowest possible price to free. Such a mechanism requires sharing of vaccine knowledge, technologies and the complex manufacturing process, rendered as much more difficult than that of any therapeutic drugs, once a safe and effective vaccine(s) is developed.
Obviously, a notable number of countries having well-resourced pharmaceutical industries are able to produce a large volume of doses but many Asian and African countries with less resourced pharmaceutical industries are not and, moreover, there are some country-wide variations in the capacity of timely production. In this respect, some countries having well-resourced pharmaceutical industries can produce extra doses for supplies of safe and effective vaccine(s) to millions of people in those countries which are unable to produce. Of course, an effective global supply and distribution mechanism is crucial for securing safe, quality, effective, affordable and access across countries at the earliest possible time.
But, to this approach, patent rights — or intellectual property rights — may put a challenge that needs to be well-addressed. Usual patent rights provide exclusive rights to the patent owners to make use of a patented product or process which results in overpricing. Since the current pandemic is a global public health crisis, flexible voluntary licensing or the Open COVID Pledge, favoured by the EU and some countries and organisations, is more pragmatic for giving universal access to a generic vaccine(s). Yet, those scientists who will develop a vaccine(s) should be given rewards and, as an acknowledgment of lifesaving innovation, associated pharmaceutical companies and/or institutes need to be given some profits, along with investment costs, with or without buying out the patent rights.
Of course, the distribution of a large volume of doses is a challenging task that entails stronger and more effective global coordination. In this respect, the UN especially the WHO, which already made some efforts including the Access to Covid-19 Tools Accelerator, should actively play coordination roles and provide technical support to vaccination programs in different countries. Also, GAVI, a global vaccine alliance that has established a system and experience in distributing vaccines to many countries in Africa and Asia in the past — especially against Ebola, SARS and some other diseases — and is now dealing with public and private sectors to secure COVID-19 vaccines for low-income countries, needs to act with a more rationalistic plan for fair distribution of vaccines, especially to countries that are unable to produce on their own.
Yet, the development, production and distribution of vaccines across countries require a huge amount of funds — another potential big challenge. Hopefully, leaders of G20, the EU and some other countries, heads of charity organisations and industry chiefs pledged to provide funds, but the amount raised and pledged is not enough and history shows that well-intentioned pledges are not always realised. Also, generating needed funds, which is roughly rendered as $25bn or more, can be difficult at this time owing to vaccine nationalism and pandemic driven economic downturn. But the development of cost-effective vaccine types and financing of national vaccination programs by respective countries based on ability, along with philanthropists, may be greatly helpful for the lowest possible price to free dose(s).
Without a doubt, a fair production and distribution process across countries does not essentially indicate the same within a country. In fact, many countries varyingly have weak distribution channels or vaccination systems because of inadequate healthcare facilities, inefficient supply chains, lack of adequately trained staffs to cover a vast number of persons and many other reasons such as political favouritism, elitism and wide-spread inequality that deserve to be adequately addressed. Optimistically, existing national vaccine program (s) across countries can immensely facilitate but improvements in capacity in terms of the development of capable personnel with training are critical in many countries for safe and quick administration of millions of doses at thousands of accessible facilities.
Yet, prioritisation is crucial for the distribution of doses in the most effective manner. Even if many countries are allowed to produce vaccine(s) and global industries are used to produce extra doses, supplies across countries and distribution within a country will take time. In fact, it is not possible to vaccinate all within one or two months. Thus, some most-at-risk groups such as healthcare providers, persons infected but not cured or immuno-compromised patients, persons with comorbid illnesses and persons who can highly transmit must be prioritised. In this respect, all countries need to have a national framework with a well-prioritisation of groups for equitable distribution, saving lives and reducing transmission quickly.
NB: This article was earlier published in the Daily Sun on August 5, 2020.
