OPINION: The fastest way to get out of the pandemic
Every day the Covid-19 pandemic costs the world thousands of lives and billions of dollars. The most efficient way to end this crisis - perhaps already in the next year - is to manufacture a safe and effective vaccine in large quantities and distribute it worldwide.
To avoid unnecessary delays, governments should take advantage of this moment, as researchers develop the right formula to prepare the ground for rapid production and wide and equitable distribution.
The Covid-19 Global Vaccine Access Fund (Covax) is based on this principle. It was created by Gavi, the Vaccine Alliance, the World Health Organization (WHO) and the Coalition for Innovations in Epidemic Preparedness. It is a platform that seeks to distribute at least 2 billion doses of the Covid-19 vaccine by the end of 2021.
This quantity of doses — which will be divided equally among the participating countries, regardless of their ability to pay— will cover approximately 20% of their population. It would then be enough to protect vulnerable and high-risk people, and healthcare workers on the battlefront worldwide. (Doses would also be stored to control any outbreak before it gets out of control.)
There are currently more than 160 vaccine candidates in development, in the preclinical or clinical phase. There is no way of knowing, which one will approve clinical trials and be authorized for marketing (the failure rate of vaccines in the early stages of development is high), but we can guarantee that, when any of them succeed, there is an effective framework for their production and distribution. To this end, governments should invest in Covax, as soon as possible.
The problem is that governments may be inclined to negotiate directly with vaccine manufacturers and request the dose they need rather than cooperate. True, it is the government's obligation to protect its citizens above all else, but this approach carries serious risks. The first is the possibility that a government will endorse the wrong vaccines.
Even if a government manages to get enough doses of an effective vaccine for its own population, part of its people – such as immunosuppressed, who may not be able to be vaccinated – will be exposed, if other countries fail to get enough vaccines. And this without considering the moral imperative to ensure that there are no people left without receiving life-saving medications.
During the swine fever epidemic in 2009, a few countries monopolized the market and left the vast majority of the world's population without vaccines until the outbreak was over. Every effort should be made to avoid this scenario during the current crisis, especially since Covid-19 has a much higher contagion and mortality rate.
By collaborating with global health agencies through Covax, governments can ensure that everyone has equitable access to vaccines. For countries that have signed bilateral agreements with manufacturers, Covax is an insurance policy in case they have bet on the wrong candidates. For countries that have not signed agreements - by far most of the world - Covax is the only way to avoid being left at the end of the line.
Covax ensures that the benefits and risks of vaccine development are widely distributed. With the largest portfolio of candidate vaccines in the world, it gives participating governments the best chance of receiving a safe and effective vaccine as soon as it is available ... and ensures that time comes much earlier.
If pharmaceutical companies bear all the financial risks, they will only invest in expanding production once their vaccine has completed clinical trials and been approved. This approach may make sense from a business perspective, but not in the context of an extremely dynamic global pandemic.
The Covax uses a radically different approach. In addition to using financing to drive — direct investment in research, development, and production — it uses financing to attract: large-dose, anticipated purchase commitments for when marketing is authorized. This provides powerful incentives to the private sector to support the urgent development of vaccines.
Furthermore, Covax combines government resources to finance the large-scale production of the most promising candidates, even before the end of clinical trials. That way, when approval is achieved, there will be large quantities of vaccine doses ready for use. WHO is already working with various stakeholders, including member states and civil society organizations, to develop and implement a mechanism for equitable and fair allocation of vaccine doses when available.
Covax only supports candidate vaccines that have been developed to the highest safety standards. By working with experts from around the world to develop wanted product profiles, share best-practice test models, facilitate multi-country clinical trials, and promote regulatory harmonization, Covax will set a benchmark for rapid, safe development and distribution and effective vaccine.
We cannot afford to leave our economies much longer in the current situation. As world GDP shrinks - the International Monetary Fund and the World Bank forecast a 5% contraction by 2020 - poverty and hunger rise sharply. The world economy is losing more than $ 10 billion every day, shortening the pandemic by even a few days would offset the costs of Covax. Global collaboration - thanks to which risks and benefits are shared equally - has never had a more advantageous value proposition.
About the authors: Seth Berkley is Executive Director of Gavi, Richard Hatchett is Executive Director of the Coalition for Outbreak Preparedness Innovations, and Soumya Swaminathan is Chief Scientist at WHO.