Hailed this week as a pandemic game-changer, the new COVID-19 vaccine offered countries that had pre-ordered doses a potential escape from a cycle of lockdowns and new waves of sickness and death.
But while richer nations plan their vaccination programmes through the end of 2021, experts warn that poorer and developing countries face hurdles that could deny billions the first proven protection against the coronavirus.
Vaccine developers Pfizer and BioNTech plan to roll out the first doses within weeks, once they receive emergency use permissions from drug agencies. They expect to have 1.3 billion doses ready next year.
The results of phase 3 clinical trials showed their mRNA vaccine was 90 percent effective in preventing COVID-19 symptoms and did not produce adverse side effects among thousands of volunteers.
At the cost of $40 per treatment, which consists of two separate shots, richer nations have rushed to order tens of millions of doses. But it is less clear what poorer nations can expect.
“If we only have the Pfizer vaccine and everyone needs two doses, clearly that’s a difficult ethical dilemma,” Trudie Lang, director of The Global Health Network at the University of Oxford’s Nuffield Department of Medicine, told AFP.
Anticipating the outsize demand for any approved vaccine, the World Health Organization formed the COVAX facility in April to ensure equitable distribution.
COVAX brought together governments, scientists, civil society, and the private sector – though Pfizer is not currently part of the facility.
A company spokesperson told AFP it had “provided an expression of interest for possible supply” to COVAX.
Rachel Silverman, a policy fellow at the Center for Global Development, said it was unlikely that much of the first vaccine batch would end up in poorer nations.
Based on advance purchase agreements signed with Pfizer, she calculated that 1.1 billion doses had been snapped up entirely by wealthy nations.
“There’s not much left for everyone else,” she told AFP.
Some countries that pre-ordered, such as Japan and Britain, are part of COVAX, so some doses are likely to reach less developed nations through their purchase agreements.
Conversely, the United States, which has 600 million doses on order, is not a COVAX member, though this may change under a Joe Biden administration.
Fair share
Benjamin Schreiber, COVID-19 vaccine coordinator at the UN’s children’s fund UNICEF, said it was vital that all nations had fair access to the new vaccine.
“We really need to avoid a situation of rich nations gobbling up all the vaccines and then there’s not enough doses for the poorest nations,” he said.
Ethics aside, epidemiological data underscores the need for equitable vaccine distribution.
This month researchers at America’s Northeastern University published research examining the link between vaccine reach and COVID-19 mortality.
They modeled two scenarios. The first, the “uncooperative allocation” scenario, hypothesized what would happen if 50 rich nations monopolized the first 2 billion doses of a vaccine.
The second saw the vaccine distributed based on a country’s population rather than its ability to pay for it.
The researchers found that the rich nation stockpiling scenario reduced COVID-19 deaths by 33 percent globally. The fair-share approach prevented 61 percent.
Commenting on the study, the Gavi vaccine alliance, which co-leads COVAX, said “the modest gain for high-income countries in monopolising vaccines was far less than the devastating losses for low-income countries if countries don’t cooperate.”