Vac­cine race might not be fair one

De­vel­op­ing na­tions fac­ing bat­tle with richer coun­tries

Orlando Sentinel - - Nation & World - By Maria Cheng and Christina Larson

LON­DON — As the race in­ten­si­fies for a vac­cine against the new coro­n­avirus, rich coun­tries are rush­ing to place ad­vance or­ders for the in­evitably lim­ited sup­ply to guar­an­tee their cit­i­zens get im­mu­nized first — leav­ing sig­nif­i­cant ques­tions about whether de­vel­op­ing coun­tries will get any vac­cines in time to save lives be­fore the pan­demic ends.

This month, the United Na­tions, the In­ter­na­tional Red Cross and Red Cres­cent, and oth­ers said it was a “moral im­per­a­tive” that ev­ery­one have ac­cess to a “peo­ple’s vac­cine.”

But such grand dec­la­ra­tions are un­en­force­able, and with­out a de­tailed strat­egy, the al­lo­ca­tion of vac­cines could be in­equitable and ex­tremely messy, health ex­perts said.

“We have this beau­ti­ful pic­ture of ev­ery­one get­ting the vac­cine, but there is no road map on how to do it,” said Yuan Qiong Hu, a se­nior le­gal and pol­icy ad­viser at Doc­tors With­out Bor­ders in Geneva.

In the past, Hu said, com­pa­nies have of­ten ap­plied for patents for nearly ev­ery step of a vac­cine’s devel­op­ment and pro­duc­tion: from the bi­o­log­i­cal ma­te­rial like cell lines used, to the preser­va­tive needed to stretch vac­cine doses and even how the shots are ad­min­is­tered.

“We can’t af­ford to face these mul­ti­ple lay­ers of pri­vate rights to cre­ate a ‘peo­ple’s vac­cine,’ ” she said.

At a sum­mit with African lead­ers Wed­nes­day, Chi­nese Pres­i­dent Xi Jin­ping said coun­tries in Africa would be “among the first to ben­e­fit” once a COVID-19 vac­cine is de­vel­oped and de­ployed in China, but no deals were an­nounced to back up his prom­ise.

World­wide, about a dozen po­ten­tial COVID-19 vac­cines are in early stages of test­ing. While some could move into late-stage test­ing later this year, it’s un­likely any would be li­censed be­fore early next year at the ear­li­est. Still, nu­mer­ous rich coun­tries have al­ready or­dered some of these ex­per­i­men­tal shots and ex­pect de­liv­ery be­fore they are granted mar­ket­ing ap­proval.

Bri­tain and the U.S. have spent mil­lions of dol­lars on var­i­ous vac­cine can­di­dates, in­clud­ing one be­ing de­vel­oped by Ox­ford Univer­sity and man­u­fac­tured by As­traZeneca. In re­turn, both coun­tries are ex­pected to get pri­or­ity treat­ment; the Bri­tish government de­clared that if the vac­cine proves ef­fec­tive, the first 30 mil­lion doses would be ear­marked for Bri­tons.

Sep­a­rately As­traZeneca signed an agree­ment to make at least 300 mil­lion doses avail­able for the U.S., with the first batches de­liv­ered as early as Oc­to­ber.

In a brief­ing Tues­day, se­nior Trump ad­min­is­tra­tion of­fi­cials said there will be a tiered sys­tem to de­ter­mine who in Amer­ica is of­fered the first vac­cine doses. Tiers likely would in­clude groups most at risk of se­vere dis­ease and work­ers per­form­ing essen­tial ser­vices.

Last week, the Euro­pean Union moved to en­sure its own sup­ply. On Satur­day, As­traZeneca struck a deal with a vac­cines group forged by France, Germany, Italy and the Nether­lands to se­cure 400 mil­lion doses by the end of the year.

Among sev­eral global ef­forts un­der­way to try to en­sure de­vel­op­ing coun­tries don’t get left be­hind is an “ad­vance mar­ket com­mit­ment” from the vac­cines al­liance GAVI, whose CEO has warned coun­tries about the dan­gers of vac­cines not be­ing avail­able glob­ally.

“Even if a few coun­tries go ahead and have vac­cines, if there are rag­ing out­breaks in other places that is go­ing to con­tinue to threaten the world and the re­turn to nor­mal­ity,” said Seth Berkley, the GAVI CEO.

GAVI and part­ners have inked a $750 mil­lion deal with As­traZeneca to sup­ply 400 mil­lion doses by the end of 2020. The An­gloSwedish pharma gi­ant has also agreed to li­cense its vac­cine to In­dia’s Serum In­sti­tute for the pro­duc­tion of 1 bil­lion doses.

John­son & John­son plans to make its coro­n­avirus shot for poor coun­tries at a not­for-profit price, be­cause of the com­plex­ity of the tech­nol­ogy and ex­per­tise needed, said the com­pany’s chief sci­en­tific of­fi­cer, Dr. Paul Stof­fels. Like­wise, As­traZeneca has pledged to make the vac­cine avail­able at no profit dur­ing the pan­demic.

The World Health Or­ga­ni­za­tion and oth­ers have called for a COVID-19 “patents pool,” where in­tel­lec­tual prop­erty rights would be sur­ren­dered so phar­ma­ceu­ti­cals could freely share data and tech­ni­cal knowl­edge. Nu­mer­ous coun­tries in­clud­ing Aus­tralia, Brazil, Canada and Germany have al­ready be­gun re­vis­ing their li­cens­ing laws to al­low them to sus­pend in­tel­lec­tual prop­erty rights if au­thor­i­ties de­cide there is an over­whelm­ing need given the pan­demic.

But ex­ec­u­tives at Pfizer and some other drug mak­ers say they op­pose sus­pend­ing patent rights for po­ten­tial COVID-19 vac­cines.

Health of­fi­cials worry what that might mean for divvy­ing up sup­plies of a vac­cine ar­guably needed by ev­ery coun­try on the planet.

“We can’t just rely on goodwill to en­sure ac­cess,” said Ar­zoo Ahmed, of Bri­tain’s Nuffield Coun­cil on Bioethics, not­ing that prece­dents of how in­no­va­tive drugs have been dis­trib­uted are not en­cour­ag­ing. “With HIV/AIDS, it took 10 years for the drugs to reach peo­ple in lower-in­come coun­tries.”

African na­tions have al­ready been at the back of the line for med­i­cal sup­plies in the pan­demic and “it will be worse if a vac­cine is found,” UNAIDS chief Win­nie Byany­ima said.

Other ex­perts pointed out that there are bil­lions of tax­payer dol­lars de­voted to ev­ery stage of vac­cine devel­op­ment, but lit­tle over­sight over how the funds are spent and few guar­an­tees the in­oc­u­la­tions will get to those who need them most.

“We don’t know what the process will look like or how trans­par­ent it will be,” said Suerie Moon, co-di­rec­tor of the Global Health Cen­tre at the Grad­u­ate In­sti­tute Geneva.


A pa­tient re­ceives a shot in a clin­i­cal trial for a po­ten­tial COVID-19 vac­cine at the Kaiser Per­ma­nente Wash­ing­ton Health Re­search In­sti­tute in Seat­tle.

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