what about poor countries?

In recent weeks, all eyes have been on the frenzied rush of laboratories to find a vaccine against Covid-19. But in the background another race is taking place, that of access to doses. Because even if the vaccine is not yet available, some countries have already rushed to order, to be the first to have it when they are on the market.

In total, 6.8 billion doses of potential vaccines have already been purchased, according to data compiled by a US research center linked to Duke University in North Carolina. Without forgetting the additional 2.8 billion which are in the negotiation phase or in addition reserved.

It is clear that these upfront purchases, which allow the pharmaceutical industry to finance its trials, are largely made by high-income countries. The United States, the European Union, the United Kingdom, Canada and Japan have signed direct agreements with the producers to be the first served (3.7 billion confirmed doses in total).

“Vaccine nationalism” is still prevalent

Some middle-income countries manage to do their best by negotiating broad direct agreements with laboratories because, as the study specifies, they have “the capacity to produce” vaccines or “the necessary infrastructure.” hosting clinical trials “. This is the case of India, whose serum institute has committed to distribute half of the doses produced. Indonesia has joined forces with Chinese laboratories. As for Brazil, it is a partner in the trials conducted from the University of Oxford In total, they got their hands on about 2.4 billion doses.

In this vaccine rush, the study did not identify any direct agreements between labs and so-called poor countries, illustrating the inequality in global health and vaccine nationalism still prevalent.

An observation that is certainly not new. During the 2009 “swine flu” pandemic, the use of such agreements was so widespread that most vaccine manufacturers said they were unable to supply 10% of vaccine stocks. to United Nations agencies.

“The only way out is to provide a collective response”

“Countries’ approach to protecting their populations may seem legitimate, but in a global pandemic like Covid-19, the only way out is to provide a collective response,” said Robin Guittard, spokesman for Oxfam France. interviewed by France 24. “Otherwise, at this rate, two thirds of the world population will not have access to vaccines before 2022”. Faced with this fear, the World Health Organization (WHO), but also leaders around the world, are demanding that vaccines be distributed equally around the world.

“We will not stop at any effort to ensure equal and affordable access (to vaccines, tests and treatments) for all,” the presidents and world leaders write in their final statement at the World Health Organization meeting.

Vaccinate at least 20% of the population

A mutual fund has also been set up by WHO in collaboration with Vaccine Alliance (Gavi) and Coalition for Innovations in Epidemic Preparedness (Cepi). The initiative, which is called Covax, is based on a funding mechanism, aims to guarantee the delivery of two billion doses of the vaccine, so that the approximately 160 signatory countries can immunize at least 20% of their population.

Of this stock, one billion goes to 92 low- and middle-income countries, which represent half of the world’s population. Vaccines will cost these countries little or nothing. The other billion goes to 75 richer countries, which will pay their own doses.

Covax has already placed orders for nine candidate vaccines (over 600 million doses), such as that of the British pharmaceutical company AstraZeneca. But the Gavi budget still lacks 3.8 billion euros. Germany has committed to 500 million euros.

For now, Covax is negotiating with Pfizer / BioNtech and Moderna, but the stock issue is problematic. According to the Center for Global Development, 1.1 billion doses of the German-American alliance have already been reserved by rich countries out of an announced total production of 1.3 billion doses next year.

Transfer excess inventory

Some countries have so multiplied orders that they can benefit from excess inventory. This is the case of Canada, which has bought enough to vaccinate its population five times, and the European Union (EU) which has reserved twice as many doses as its inhabitants.

Faced with the supply problem, Cepi is negotiating with high-income countries to ensure that once a certain percentage of their population has been vaccinated, part of the surplus is transferred to Covax.

NGOs fear that the sharing of planned stocks is not based on egalitarian criteria, which raises concerns that the poorest populations would have lost anyway. “There is a risk of falling into a two-tier approach with rich countries keeping the best vaccines in terms of efficacy and safety and leaving what’s left for others,” predicts Robin Guittard.

“Pool patents”

Like other NGOs, Oxfam believes more needs to be done to ensure global access to future vaccines. The NGO has urged pharmaceutical companies to share information through the WHO’s Covid-19 technology access pool. “All vaccine manufacturers and pharmaceutical companies should combine patents to enable greater production,” says Robin Guittard, who points out that “no pharmaceutical company can guarantee production capacity on a global scale”.

To increase vaccine production, the governments of India and South Africa on Friday asked the WTO to relax regulations to temporarily lift the protection of intellectual property and industrial processes. Therefore, generic drug manufacturers could in turn produce vaccines “until most of the world’s population is immune to Covid-19”.

But the EU’s opposition on this point arouses indignation on the part of Oxfam. Especially when the leaders gathered the day after the G20 call for equal access to the vaccine. Robin Guittard denounces the double speech of European leaders who ask to make the vaccine a “global public good” while maintaining the vaccine race.