Last week, at a video conference convened by the WHO, leaders from the Americas, West Asia, Europe, and Africa agreed to “speed up the development of safe and effective drugs to prevent, diagnose and treat COVID-19”. India, the US, Russia, and China stayed away from the meet. Even so, the conference on April 24 showcased rare global solidarity in the four-month-long fight against the coronavirus. Hearteningly, there was also consensus that a vaccine against the virus should be seen as “a global public good” and should be “distributed in all parts of the world”.
In the second week of January, Chinese scientists developed and shared a full genetic sequence of the coronavirus. This has spurred more than 100 vaccine development projects in different parts of the world, including India. Last week, clinical trials were approved in the UK, China, and Germany. These are remarkable developments, given that the virus was unknown in most parts of the world four months ago. However, vaccines require several rounds of clinical trials and regulatory scrutiny before they are made available to the public. They have to be first tested in laboratories, then on animals, before being tested on a small group of people. Safety protocols in most parts of the world demand the number of people exposed to the vaccine in clinical trials is gradually increased before a vaccine is approved. But the virulence of the COVID-19 pandemic has led to calls for expediting timelines, even deviations from protocols. For example, a paper published in the Journal of Infectious Diseases on March 31 suggested “a human challenge study with fewer participants than a conventional trial”. It recommended injecting volunteers with a potential vaccine and then exposing them to the virus. The paper’s authors, prominent bioethicists, acknowledged the ethical questions such trials would raise. However, they argued that “with proper trial design and processes, the net risk for participants can remain low”. The US Food and Drugs Administration has said that “it will be flexible about regulatory procedures”. There need to be more conversations amongst scientists, physicians, bioethicists and regulators before an accelerated paradigm to approve an anti-COVID-19 vaccine is put in place.
There are also concerns about how much the vaccine will cost, and whether pharma companies will put humanitarian concerns before profits. During the HINI pandemic in 2009, there was criticism that the wealthier countries had cornered the lion’s share of the vaccines. It is reassuring, therefore, that the leaders attending last week’s video conference made a commitment to “ensure equal access to vaccines”.