A cooperative solution to the pandemic crisis

By Seth Berkley, Richard Hatchett & Soumya Swaminathan

Every day the Covid-19 pandemic costs the world thousands of lives and billions of dollars. The most efficient way to end the crisis is to manufacture a safe and effective vaccine in large quantities and distribute it worldwide. To avoid unnecessary delays, governments should seize this moment, as researchers develop the right formula to prepare the ground for rapid production and wide and equitable distribution.

The Covid-19 Global Vaccine Access Fund (Covax) is based on this principle. It was created by Gavi (World Alliance for Vaccines and Immunization), the World Health Organization (WHO), and the Coalition for Innovations in Epidemic Preparedness. The platform that seeks to distribute at least 2 billion doses of the vaccine by the end of 2021.

The doses —which will be divided equally among the participating countries, regardless of their ability to pay— will cover approximately 20% of their population.  enough to protect vulnerable and high-risk people, and healthcare workers on the battlefront worldwide. (Doses would also be stored to control an outbreak before it gets out of control.)

There are over  160 vaccines in development, in the preclinical or clinical phase. There is no way of knowing which one will approve clinical trials and be authorized for marketing (the failure rate of vaccines in the early stages is high), but we can guarantee that, when any of them succeed, there is an effective framework for their production and distribution, so governments should invest in Covax as soon as possible.

The problem is that governments may be inclined to negotiate directly with vaccine manufacturers rather than cooperate. True, it is the government’s obligation to protect its citizens above all else, but this approach carries serious risks. The first is the possibility that a government will endorse the wrong vaccines.

Even if a government gets  enough doses of an effective vaccine for its own population, part of its people – such as immunosuppressed, will be exposed if other countries fail to get enough. And this without considering the moral imperative to ensure that there are no people left without receiving life-saving medications.

During the swine fever epidemic in 2009, a few countries monopolized the market and left the vast majority of the world’s population without vaccines until the outbreak was over. Every effort should be made to avoid this scenario during the current crisis, especially since Covid-19 has a much higher contagion and mortality rate.

By collaborating with global health agencies governments can ensure that everyone has equitable access to vaccines. For countries that have signed bilateral agreements with manufacturers, Covax is an insurance policy in case they have bet on the wrong candidates.

For countries that have not signed agreements Covax is the only way to avoid being left at the end of the line.

It ensures that the benefits and risks of vaccine development are widely distributed. With the largest portfolio of candidates in the world, it gives participating governments the best chance of receiving a safe and effective vaccine as soon as it is available.

If pharmaceutical companies bear all the financial risks, they will only invest in expanding production once their vaccine has completed clinical trials and been approved. This approach may make sense from a business perspective, but not in the context of adynamic global pandemic.

Covax uses a radically different approach. In addition to using financing to boost – direct investment in research, development and production – it uses financing to attract: anticipated purchase commitments of large amounts for when the marketing is authorized. This provides powerful incentives to the private sector to support urgent development.

Covax combines government resources to finance the large-scale production of the most promising candidates, even before the end of clinical trials. That way, when approval is achieved, there will be large quantities of vaccine ready for use. WHO is working with various stakeholders,  to develop and implement a mechanism for equitable and fair allocation of doses when available.

Covax only supports candidate vaccines that have been developed to the highest safety standards. and will set a benchmark for rapid, safe development and distribution of effective vaccine.

Shrinking economies
We cannot afford to leave our economies much longer in the current situation. As world GDP shrinks with  a 5% contraction  forecast in 2020 – poverty and hunger rise sharply. The world economy is losing more than $10 billion every day, shortening the pandemic by even a few days would offset the costs of Covax.

 Global collaboration -with risks and benefits are shared equally – has never had a more advantageous value proposition.

(Seth Berkley is Director of Gavi, Richard Hatchett is Director of the Coalition for Outbreak Preparedness Innovations, and Soumya Swaminathan is WHO Chief Scientist