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Widespread vaccination against COVID-19 is the most critical
component in the fight against the disease, and as countries vie
for access to limited initial supplies of a future vaccine,
contrasting approaches from governments and vaccine producers have
emerged. Without global co-operation and utilization of a
comprehensive framework that would address many of the challenges
anticipated in the future, vaccine deployment will likely be far
from equitable. Despite the call for solidarity, some countries are
likely to continue to engage in more explicit acts of vaccine
nationalism, driven by domestic political imperatives.
The pace of COVID-19 vaccine development has gathered
unprecedented momentum, with 17 vaccines now undergoing clinical
testing. Some of these efforts are supported by national government
funding, and others by global initiatives.
Given the challenges posed by interconnected supply chains and
the global demand for a vaccine, some countries have engaged in
activities that have been described as "vaccine nationalism" - a
politicized term that has triggered debate around the ongoing
efforts to secure access to a vaccine. The various initiatives and
deals signed to secure vaccine access are part of a continuum, with
vaccine nationalism - marked by efforts to exclude other countries
from accessing vaccines or to buy promising foreign
vaccine-developers - at one end, and initiatives such as the WHO's
ACT Accelerator, which focuses on sharing limited vaccine supplies
globally in an equitable manner, at the other.
Other national and regional activities, such as the European
Union's and the African Union's joint purchasing initiatives, fall
between these extremes and typically include a nationalist element
- such as advanced market commitments (AMCs) for vaccines for their
populations - that is often balanced by participation in
international fund-raising initiatives to provide vaccines for
low-income countries. Securing revenues through vaccine AMCs is
important for pharmaceutical companies given the considerable risks
of research and development failure, as well as the pricing and
intellectual property protection pressure that any future COVID-19
vaccine will face. These deals are therefore considered crucially
important for accelerating vaccine development.
However, reputational risks for the industry are highly
significant. Most pharmaceutical companies will face incredible
scrutiny over how and where they launch any successful vaccine. In
the current climate, the pharmaceutical industry must follow a
strategy that enables it to remain on productive terms with
governments worldwide by spreading out vaccine access, while also
ensuring that it honors AMCs and advanced purchase agreements.
Outlook and implications
Reputational risks for the industry are highly significant. AMCs
provide companies with critical funds to invest in R&D and are
therefore crucially important for accelerating vaccine
development.
As funding is poured into vaccine development to bring a
COVID-19 vaccine to market, it is important to remember that the
world is facing major challenges. First, the accelerated timelines
may not be sufficient to provide complete data from Phase III
trials to show that a vaccine is safe and efficacious. There are
also various rate-limiting supplies and raw ingredients, such as
glass vials and needles, that are likely to prevent the expansion
of manufacturing to meet global demand, at least initially.
Furthermore, after securing manufacturing capacity, the deployment
of such large quantities of vaccines globally will pose another
major hurdle.
IHS Markit assesses that full approval and wide availability of
a vaccine - on a global scale and with a meaningful impact on "the
return to normal" - is unlikely to be possible until the summer of
2021. There will certainly be a need for several vaccines, which
will be adopted both regionally and demographically, each with its
own safety and efficacy profile, and its own strength of evidence.
Challenges could also arise in vaccine supply further down the
line, even for countries that successfully deployed the first batch
as vaccines may only provide protection for a short period,
potentially requiring periodic boosters. Meanwhile, although it has
been relatively stable so far, SARS-CoV-2, an RNA virus, is
susceptible to mutations and, there is no guarantee that the
vaccines currently in development will retain their efficacy over
time.
Without global co-operation and utilization of a comprehensive
framework that would address many of these challenges in the coming
months and years, vaccine allocation and prioritization will likely
be far from equitable. Despite the call for solidarity, some
countries are likely to continue to engage in more explicit acts of
vaccine nationalism due to domestic political imperatives,
particularly in the run-up to internal elections. Others may do so
more subtly in the pursuit of economic objectives, fully aware that
being the first to successfully use a COVID-19 vaccine could enable
them to lift social restrictions and more quickly restart their
economies.
Posted 07 July 2020 by Margaret Labban, Ph.D., Life Sciences Senior Analyst, IHS Markit and
