Even before the end of final stage human trials or regulatory approval, several wealthier countries like Britain, France, Germany and the US have entered into pre-purchase agreements with Covid-19 vaccine manufacturers, a development that has come to be known as “vaccine nationalism”. There are fears that such advance agreements will make the initial few vaccines unaffordable and inaccessible to everyone apart from the rich countries in a world of roughly 8 billion people.
This has led to the World Health Organization (WHO) warning that nations that hoard possible Covid-19 vaccines while excluding others would deepen the pandemic. “We need to prevent vaccine nationalism. Sharing finite supplies strategically and globally is actually in each country’s national interest,” WHO chief Tedros Adhanom Ghebreyesus said on Tuesday.
To bring about equitable and broad access, WHO, the Coalition for Epidemic Preparedness Innovations, and Gavi have come up with an initiative known as “Covax Facility”. The facility aims to procure at least two billion doses of Covid-19 vaccines by the end of next year for deployment and distribution mainly in the low- and middle-income countries.
What is vaccine nationalism?
When a country manages to secure doses of vaccines for its own citizens or residents and prioritises its own domestic markets before they are made available in other countries it is known as ‘vaccine nationalism’. This is done through pre-purchase agreements between a government and a vaccine manufacturer.
For example, the United States, the United Kingdom, Japan, and the European Union have spent tens of billions of dollars on deals with vaccine front runners such as Pfizer Inc, Johnson & Johnson and AstraZeneca Plc even before their effectiveness is proven.
Vaccine nationalism is not new
The present race to hoard Covid-19 vaccines harks back to a similar situation that happened in 2009 during the H1N1 flu pandemic. Australia, the first country to come up with a vaccine, blocked exports while some of the wealthiest countries entered into pre-purchase agreements with several pharmaceutical companies. The US alone obtained the right to buy 600,000 doses.
It was only when the H1N1 pandemic began to recede that developed countries offered to donate vaccine doses to poorer economies. However, it must be noted that H1N1 was a milder disease and its impact was far lesser than Covid-19, which has already infected more than 22 million worldwide and killed 777,000.
US, UK, EU have already secured deals worth millions
According to London-based analytics firm Airfinity, the US, Britain, European Union and Japan have so far secured about 1.3 billion doses of potential Covid-19 vaccines. Options to snap up more supplies or pending deals will add more 1.5 billion doses, its figures show. If seen country wise, the US has already agreed to buy some 800 million doses from six drug makers, and the UK 280 million from five.
Last week, the European Union negotiated with AstraZeneca for the purchase of 300 million doses of the vaccine candidate developed by Oxford University. It has also struck a deal with French pharmaceutical giant Sanofi for 300 million doses.
Airfinity has predicted that worldwide supply may not reach 1 billion doses until the first quarter of 2022, Airfinity forecasts.
Aren’t there any laws to prevent vaccine nationalism?
Interestingly, even though vaccine nationalism runs against global public health principles, there are no provisions in international laws that prevent pre-purchase agreements.
What are its drawbacks? What is the alternative?
The major drawback of vaccine nationalism is that it puts countries with fewer resources and bargaining power at a disadvantage. Thus, if countries with a large number of cases lag in obtaining the vaccine, the disease will continue to disrupt global supply chains and, as a result, economies around the world.
“If you were to try to vaccinate the entire US, (and) the entire EU, for example, with two doses of vaccine – then you’d get to about 1.7 billion doses. And if that is the number of doses that’s available, there’s not a lot left for others. If a handful, or even 30 or 40 countries have vaccines, but more than 150 others don’t, then the epidemic will rage there,” Reuters quoted Seth Berkley, chief executive of the GAVI alliance, as saying.
The alternative to arrest vaccine nationalism is global collaboration, which is being done through the WHO-backed COVAX Facility mechanism. So far, more than 170 countries have expressed interest: about 90 low- and middle-income countries and 80 fully self-financing countries.
The countries who join the initiative are assured supply of vaccines whenever they become successful. Moreover, the countries will get assured supplies to protect at least 20 per cent of their populations.
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