Demystifying The Vaccine Crisis — Nur Izzaty Badrol Hisham

It is up to policymakers to advocate and mobilise resources to ensure rights to vaccines for the masses.

The speed at which the Covid-19 vaccine developed is simply astounding. Owing to this achievement are international scientific collaboration, novel technologies and urgent resource mobilisation from the world’s largest economies that have made vaccine development far more feasible.

However, it has not always been the case for previous outbreaks such as MERS, Ebola and SARS, to name a few. The crisis that preceded the pandemic is not all due to limited scientific knowledge. It is also the systemic limiters that remain as barriers to the vaccine industry.

The crisis that the vaccines industry is facing can be summarised into three categories: the complexity of capital funding for vaccine development, diminishing numbers of vaccine players in the market, and the existing business model that places priorities vaccine with larger growth potential.

We urgently need collective efforts to drive international funds and resources to smaller groups internationally in addressing vaccine access barriers efficiently and rapidly. 

To say that vaccine development doesn’t receive financial support is simply untrue. Several private organisations and philanthropic efforts have changed the landscape for combating infectious disease globally.

The Bill and Melinda Gates Foundation, UNITAID, Global Alliance Vaccine Initiatives (GAVI) and Wellcome Trust are some of the well-known private organisations that have made significant financial contributions to smaller non-profits organisations, laboratory groups, biotechnology and licensure businesses. 

However, the attention to infectious disease has been disproportionately given to areas of diseases with a significant return of investment potentials such as the recent coronavirus, HIV, and tuberculosis, to name a few. Unfortunately for other areas of infectious disease that are equally in need and feasible, they do not have vaccines in development past the lab-scale research stage.

The vaccine market is oligopolistic, dominated by a few multinational companies (MNCs) which are Merck, GlaxoSmithKline, Pfizer and Sanofi Pasteur. These companies make up 80 per cent of the vaccine supply in the world.

The fallout of vaccine players began in the 2000s after an active acquisition of vaccine business units by large MNCs throughout the 1980s and 1990s. One reason may be that the vaccine portfolio isn’t as profitable as its biopharmaceuticals and consumer health counterparts.

Typical vaccine development requires high capital injections, around US$500 million to US$1 billion or more, for more advanced vaccine technologies. Yet, only 7 per cent of these funded projects end up at preclinical stages and fully awarded a licence.

The rapid genetic mutation seen in infectious diseases also amplifies the risk borne in vaccine development. The change in viral strains is an added layer to the risk probability more than one might expect in therapeutic drugs for chronic diseases. 

Smaller groups such as government and university laboratories engaged in vaccine developments, there are insufficient resources to carry out early-stage clinical trials. Therefore, these groups remain at the mercy of MNC resources and technical prowess to reach full development.

Recently, the vaccine world has also seen a rise in emerging markets manufacturers across the ‘global south’ region. With more than 41 manufacturers in the emerging markets adopting technology transfers, the cost to develop vaccines stumps low as competition and manufacturing capacities increases.

Not only does this make vaccines much more affordable, but also makes vaccine equity an achievable target. 

This recent trend only affirms that the effective remedy to existing problems is through a Public-Private Partnership (PPP) – a de-risking mechanism through government funding whilst leveraging the private sectors’ knowledge.

More than half of the Developing Countries Vaccine Manufacturing Network (DCVMN) operates on the PPP and state-owned business model.

The world has seen manifold successes that arose from this initiative, from eradicating Polio in India in 2012 to a 60 per cent increment in the global vaccine supply for a cocktail of vaccine-preventable diseases. 

Despite these milestones, the situation for Covid-19 vaccines has been upsetting for many low and middle income countries (LMICs). The LMICs previously relied on DCVMN manufacturers in developing nations to procure vaccines.

However, this platform remains unrealised for Covid-19 vaccines, due to exclusivity practices seen amongst market players in developed countries. The LMICs have to resort to international mechanisms, such as COVAX, or pooled procurement, such as the Pan American Health Organization’s Revolving Fund to aid vaccine procurement as a consequence.

The first year of the Covid-19 pandemic is a historic reminder. Vaccines provide significant relief in ensuring economic productivity and the safety of many.

It is only ethical to share this consolation with the global communities alike. It is up to policymakers to advocate and mobilise resources to ensure rights to vaccines for the masses.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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