As the UK celebrates its first COVID-19 vaccinations, the JPIT enquiry inbox has been receiving emails from church members asking if lower-income nations will be able to access vaccines and, if so, how quickly.
The first hurdle is licencing one or more vaccines for COVID. The UK has given the BioNTech vaccine emergency use authorisation, allowing it to be used widely in the UK. Low income countries however tend to follow the US and the EU regulators who are (exceptionally quickly) going through their normal processes. This means that they are likely to reach a conclusion in the next few weeks.
It appears likely that other vaccines currently in the development pipeline will be licenced but approval takes time and cannot be guaranteed.
Vaccine cold chains
The BioNTec vaccine needs to be stored at -70oC from manufacture until use – although can be kept in a regular fridge for the final few days before use. This is a difficult cold chain to manage in a high-income country such as the UK and would require considerable time and investment to be workable in many lower-income nations.
The hope is other less temperature sensitive vaccines are licenced and, if so, they are likely to be more useable outside of developed nations. Currently the most promising candidate which doesn’t require such a rigorous cold chain is the Oxford University Adenovirus recombinant.
Buying vaccines – COVAX
The World Health Organisation (WHO) and the UN-backed vaccine alliance (Gavi) alongside, the Coalition for Epidemic Preparedness Innovations (Cepi) set up a program called Covax. Its aim is to ensure equitable worldwide distribution of vaccines by providing collective purchasing facilities and mechanisms to expedite research and manufacture.
The hope was that all nations would join and purchase through the scheme with the higher income countries subsidising the lower-income countries. However, higher-income nations led by the US, Japan and the UK preferred instead to buy direct from manufacturers – guaranteeing rapid supply for their nations.
COVAX aims to have suitable vaccines rolled out simultaneously in developing and developed nations, however it is clear that access to vaccines is going to be massively greater in richer nations for some time. This became inevitable when wealthy nations bought direct from manufacturers rather than through COVAX.
Paying for vaccines
The IMF has estimated that the amount of investment required to counteract COVID’s economic damage is between $9,000Bn and $12,000Bn. The estimated cost of vaccinating the world’s population is around $35Bn – a lot of money, but in economic context an extraordinarily good investment.
COVAX has the objective of supplying 2Bn doses of COVID vaccine and distributing them equitably in 2021. It has raised $2Bn to fund the first stage of the plan – the “advance market commitment” which secures access to vaccine supplies. It requires a further $5Bn in funding over the next year to fund the vaccination program.
Coincidently, just over $5Bn was cut from next year’s International Aid budget when the Government decided to break its commitment to spend 0.7% of GDP on Aid.
The World Bank has offered around $12Bn in loans to pay for vaccination, and other financing is arriving. However, it is clear that countries with few resources have been hit hard by COVID. Additional loans and financing will be needed for rebuilding and development, as well as vaccination. Now is the time when wealthy nations are needed to offer support. It is regrettable that the UK government has chosen to step back and cut funding instead.