Manila Bulletin

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)


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