Cross-national accessibility of COVID vaccines – nationalism versus multilateralism
(Part I)
Around the world, great hope is placed on vaccines as an instrument for dealing with the COVID19 pandemic. With the winter flu season in the northern hemisphere and many societies still struggling with containing the spread of the virus, loosening of international travel restrictions continues to be limited, which in turn hampers the world’s return to normalcy.
Much progress has been achieved in the search for vaccines. Yet, vaccine production necessitates a constant process of refinement through research, clinical trials, and gathering of data to prove its safety and effectiveness. Only upon approval by national health authorities can a vaccine be mass-produced and then made available for mass inoculation, with the eventual goal of realizing mass immunity.
Around 40 candidate vaccines are registered with the World Health Organization (WHO), with nine of them — four by Chinese vaccine developers — in the third and final clinal trial phase. For any of these products to successfully reach the state of mass use, there is still a scientific process to complete. Some inevitably are to be eliminated.
Production of a vaccine is a demanding endeavor in terms of financial and technological input. Quality assurance is a necessary precondition, which must result from proven health safety and effectiveness on human participants in the development process. Only a few countries have the resources to produce vaccines to meet demand for immunization of their own populations.
Accordingly, some countries opt to partake in vaccine development initiated in other countries, including bottling and transportation. Some other countries will have to procure from available international pool of successful vaccines.
The WHO’s vaccine prequalification offers a technical reference for such procurement.
Globally, gaps between demand for vaccines and available dosages are a predictable reality, at least in the initial stage, partly due to uncertainty a producer faces in marketable doses of a product. To address this foreseeable challenge, the WHO, in collaboration with the Global Alliance of Vaccines and Immunization (GAVI) and the Coalition for Epidemic Preparedness Innovations (CEPI) offered the Covax Facility arrangement. The facility envisions making available two billion doses of COVID vaccines for use in middle- and low-income developing countries, covering some 20 percent of their total populations.
Against the odds, vaccine nationalism is a common choice of action by developed countries equipped with the scientific and technological capacity as well as financial resources to cover the associated costs. Although no vaccine has yet received approval for use, with only candidate vaccines that meet technical standards for emergency use, several developed country governments have signed advance purchase agreements with vaccine developing corporations to satisfy future needs of their respective domestic populations. The United States, Great Britain, European member states, and Japan are said to have secured right to 130 million doses potential COVID vaccines.
Accessibility is but one of the many challenges the world is facing in vaccine distribution. If COVID vaccines are sold at market price levels, most low-income and some mid-income countries will encounter the predicament of affordability. To be fair, though, even with commonly available vaccines, affordability is a long-standing challenge for developing economies. GAVI, an alliance of vaccine producers, addresses the matter by dividing developing country beneficiaries into two categories, with one having to pay full costs and the other subsidized prices.
Covax Facility is a multilateral arrangement. Its proponents champion it as the biggest effort at international cooperation since the Paris climate agreement. Emergence of the arrangement manifests acceptance of treating international health as a public good, which China champions. Product developers and users negotiate through the platform to realize the goal of mutual protection.
(To be continued)