Cooperation between countries in public health is complex by nature and made more so by ever shifting calculations of geopolitical implications associated with the ongoing struggle to contain the COVID-19 pandemic. The geographical and demographic reach of the virus is too unprecedented to call on past examples of successful cooperation. But time has come for contemplating equitable access to vaccines, in addition to relaxation of travel restrictions, among all countries.
The good news is that several candidate vaccines have emerged to be promising by delivering medically proven positive results in clinical trials. Along with several decades of sustained harmonization of technical standards for development of vaccines and other medical products, governments around the world have a much stronger scientific basis to either adopt or reference vaccines approved for use by those governments that have indigenous technical capacities. The bad news is that questions resulting from geopolitical sentiments arise in responding to a country’s breakthrough in vaccine development, whereas science ought to be the sole criterium.
Given the contraction of the world economy, in large part thanks to travel and quarantine restrictions for controlling the spread of the virus infections, for virtually all governments, cooperation in worldwide deployment of COVID-19 vaccines is a matter of necessity, not a choice.
The World Health Organization (WHO), together with other United Nations agencies, health charities and the international vaccine industry itself, has a proven record of promoting worldwide access to vaccines and deployment of immunization in the past half century. In responding to the COVID-19 challenges, Gavi, the vaccine alliance made up of mainly medicine developers in developed countries, has succeeded in obtaining pledges by governments, China included, to cooperate in responding to the challenge.
In addition to Gavi, the developing country vaccine manufacturers network (DCVMN) is a ready platform for rapid mass production of vaccines prequalified by the WHO. This will be particularly helpful to those societies that will just have to import vaccines for use. Indeed, as seamless cold chain transportation is a key requirement for keeping a vaccine in good quality, it only makes sense to promote local manufacturing, as it takes advantage of time and costs saved from transportation.
COVID-19 vaccines certainly qualify as a public good for global public health. But the products are by nature capital intensive, while returns on investment need to be met through adequate pricing of final dosage sales. The gap between expected returns and financial capacity on the part of end users, especially those in low income countries, can be formidable.
One remedy is for patent owners of COVID-19 vaccines to be encouraged to make use of patent pooling as an instrument, as has been proposed under the WHO auspices for the purpose of expanding access to essential medicines. Patent pooling, coupled with ease in the usual production licensing process, can help bring down per unit costs as well.
Developing and/or low-income countries can, and indeed must, contribute to reaching the goal through proactively soliciting technical collaboration with vaccine developers – in the product development stage – through means feasible. This is essential, as immunization by vaccination is as much about clinical safety and effectiveness as it is about user trust. Equally essential is for the public health authorities of these countries to provide the required legal cover and administrative assistance, lest unfortunate cases of defect incur legal and financial costs on vaccine providers.
As a cliché goes, where there is a will, there is a way. The world can come together to attain equitable access to COVID-19 vaccines.
