Unequal COVID-19 vaccine deals could hurt global fight

Copyright: Image by fernando zhiminaicela from Pixabay

Speed read

  • Some countries have advance deals to buy COVID-19 vaccines in the pipeline
  • Recent analysis shows no country in Sub-Saharan Africa has such a deal in place
  • Unequal distribution of vaccines could hurt the global fight against the pandemic

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[NAIROBI] As the United Kingdom launches its COVID-19 vaccination, Africa and other poor countries may miss out on the largest ever immunisation drive expected next year unless enough doses are produced urgently, a group of organisations warns.

High-income countries have bought up the vast majority of the world’s vaccine supply through direct deals with vaccine developers for advance purchases of anticipated COVID-19 vaccines.

The UK became the first country to begin its vaccination rollout on Tuesday, with the over-80s and some health and care workers prioritised to receive the Pfizer/BioNTech vaccine.

“If some countries are protected while others remain vulnerable, this will deepen existing inequities and is likely to lead to further economic damage.”

Andrea Taylor, Duke Global Health Innovation Center

The group that includes Amnesty International, Frontline AIDS, Global Justice Now and Oxfam, says in a statement released today (9 December) that about 70 poor countries will manage to vaccinate only one in ten people against COVID-19 next year.

Data collected and analysed on the deals done between countries and the eight leading vaccine candidates, according to the group, shows that 67 low- and lower middle-income countries are at high risk of being left behind because of rich countries buying large doses.

Of the 67, Kenya, Nigeria, Myanmar, Pakistan and Ukraine have reported more than 1.5 million cases of COVID-19 between them.

“No one should be blocked from getting a life-saving vaccine because of the country they live in or the amount of money in their pocket,” says Anna Marriott, Oxfam’s health policy manager. “But unless something changes dramatically, billions of people around the world will not receive a safe and effective vaccine for COVID-19 for years to come.”

A recent study also found that direct negotiations by some high-income countries with vaccine developers for advance purchases of anticipated COVID-19 vaccines could threaten low-income countries’ access, putting the fight against the pandemic at risk globally.

Lower middle-income countries may not access the COVID-19 vaccine once it is approved for the market until almost the middle of the decade because billions of doses of the vaccine candidates are being reserved for developed countries in advance purchasing deals, according to the US-based Duke Global Health Innovation Center’s Launch and Scale Speedometer Initiative.

“Before any vaccine candidates are even approved for market, confirmed purchases cover 6.8 billion doses, with another 2.8 billion doses currently under negotiation or reserved as optional expansions of existing deals,” explains the Launch and Scale Speedometer Initiative, in an online update last month (20 November), adding that most of the deals are by high-income countries.

Andrea Taylor, assistant director of programmes at the Duke Global Health Innovation Center, tells SciDev.Net: “The risk is that…lower-income countries will have to wait. If some countries are protected while others remain vulnerable, this will deepen existing inequities and is likely to lead to further economic damage, even for the high-income countries.”

According to the Duke Global Health Innovation Center dashboard, which is updated every two weeks, no country in Sub-Saharan Africa had made a deal to buy anticipated COVID-19 vaccines in advance as of 20 November.

Title: COVID-19 advance market commitment by country as of 20 November 2020.   Source: Launch and Scale Speedometer Initiative

Researchers say that advance purchasing deals will undermine COVID-19 Vaccines Global Access Facility (COVAX), a global collaboration aimed at speeding up the development, manufacture and equitable distribution of new vaccines, which was launched in June this year.

Data from the study shows that COVAX signatories including Canada, the United Kingdom and the European Union, are undermining the pact through side deals for large vaccine shipments.

The scientists conducted internet searches using the names of vaccine candidates together with search terms such as deal, purchase, negotiation and doses.

“We reviewed news sources to identify and aggregate data including purchaser, whether the deal was confirmed or still under negotiation, number of doses, price (if available) and manufacturer (if available). Our dataset includes publicly announced deals that provided a specific number of doses,” Taylor tells SciDev.Net.

Samuel Akech, a principal investigator at the Kenya-based KEMRI-Wellcome Trust Research Programme, says that most low-income countries such as those in Africa rely on global funding for their routine immunisation programmes.

“I do not think low-income countries would be able to buy COVID-19 vaccines using their own resources but will rely on multilateral initiatives such as COVAX facility to access COVID-19 vaccines for their populations,” says Akech. “Resource-rich countries that have signed up to COVAX facility but at the same time made advance commitments with vaccine manufacturers should immediately avail some of the vaccines they buy to COVAX facility for the priority populations in low-income countries.”

Akech explains that a whole system that includes financing, human resources, equipment such as cold chain and service delivery is critical to ensuring that the vaccine reaches the target population.

Africa still plays a peripheral role in vaccine development, with few clinical trials taking place in the continent, making it difficult for African countries to negotiate for discounted pricing, which may be possible where a country participates in the development of a vaccine, Akech adds.

“I think this pandemic has taught Africa of the need for greater involvement in the process of vaccine development,” he tells SciDev.Net. “However, this requires long-term investment in education, science and research capacity.”



Mapping covid-19 vaccine pre-purchases across the globe (Duke Global Health Innovation Center’s Launch and Scale Speedometer Initiative, November 2020)