Vaccines against Covid-19, a company for the rich?

More than two billion doses of potential future vaccines against Covid-19 have already been reserved by the richest countries. What is left for the others? Not much and it is a problem with many branches.

No vaccine against Covid-19 is yet available, but future stocks are already empty or almost empty. The United States, China, the United Kingdom and the European Union have paid to reserve more than two billion doses of vaccines, a calculated the scientific journal Nature, Monday 24 August. Enough to organize the activities of pharmaceutical companies – Sanofi, AstraZeneca or Pfizer – but much less by poor and developing countries.

The United States is leading the way and has already spent about $ 6 billion to secure nearly a billion doses of six vaccines under development. Washington even provided options to order another billion. In relation to its population, the United Kingdom has been the hardest hit, reserving 335 million doses, or five per capita. The European Union and Japan are not left out, everyone has ordered hundreds of millions of doses.

Optimistic pharmaceutical companies

“What is happening – that is, a group of countries buying all the way – is worrying, because production capacity is not infinite”, emphasizes for Reuters Thomas Bollyky, Program Director for Global Health at the Council on Foreign Relations, an American think tank.

But it still listens to the drug groups. If the ten vaccines currently tested on humans were to prove effective, there could be up to 10 billion doses available by the end of 2021, according to official forecasts from the various laboratories. Developing countries would then still have enough to market to meet the needs of their populations.

But experts warn against the optimism of vaccine manufacturers. Airfinity, a British medical data analysis company, estimates that there should be no more than one billion doses of vaccine by the end of 2021. The Coalition for Innovations in Epidemic Preparedness (Cepi, a foundation the international organization for combating epidemics) estimates that laboratories should be able to produce between two and four billion doses of vaccine before the end of next year.

Projections established based on previous experience, during previous epidemics and on current production infrastructure.

History repeats itself

So there are only a few crumbs left for developing countries. This is hardly surprising: history repeats itself from one health crisis to another. Antiretroviral therapies for the treatment of HIV patients, introduced in 1996, have been reserved for Western countries for more than five years. During the 2009 influenza A virus epidemic, the so-called industrialized countries “first made sure they had enough vaccines for their population before donating 10% of their stocks to less-favored countries”, recalls the journal Science in a vitriol editorial office against the vaccine “nationalism”, released on August 14th.

In the run-up to the Covid-19 pandemic, WHO chief Tedros Adhanom Ghebreyesus also spoke out against this richest law by protect themselves against “health nationalism”. Although he says he understands “the leaders’ desire to protect their populations in the first place”, he recalls that from an ethical and scientific point of view, the behavior of the so-called industrialized countries is not meaningful.

“This actually means saying that a healthy American teenager living in a prosperous neighborhood near state-of-the-art health facilities will have priority to be vaccinated against a doctor who works in unsafe conditions in a country. poor “, sums up Michael Gerson, an adviser to former US Conservative President George W. Bush, in a column published Monday by the Washington Post. The most effective vaccine method to counter the Covid-19 pandemic is “to administer treatment first to healthcare professionals in direct contact with patients, then to populations that do not have access to healthcare facilities and people at risk and only then to the rest of the population”, it recalls scientific journal Nature.

Vaccine diplomacy

The international community believed that it had taken the lead this time to avoid previous pitfalls and adopt a more equitable distribution of future vaccines. The WHO, in collaboration with Gavi (an international vaccine alliance funded by the Bill Gates Foundation), has set up a specific mechanism, called COVAX (Covid-19 Vaccine Access), which in theory would make it possible to reserve one billion doses of vaccines for poor and middle-income countries.

But for it to work, the rich countries must participate in their financing. It does not win: the United States, Russia and China have already indicated that they will move on of the 172 countries that expressed their interest For this initiative, no one has yet made a firm commitment to help increase the $ 18 billion needed to buy and distribute vaccines. “Attempts to persuade richer countries to participate have had little success,” confirms Brook Baker, a specialist in access to health care at Northeastern University in Boston, interviewed by Nature.

There is therefore little chance of avoiding a two-speed vaccination. And this is not all bad news for the global fight against the pandemic. This race of rich countries to reserve the bulk of future vaccines could lead to dangerous vaccine diplomacy, fears Thomas Bollyky of the Foreign Relations Council. “Some countries, such as China or the United States, may retain doses that they will offer to other countries in exchange for benefits or diplomatic support.” he explains to the BBC.

In addition, the fact that poor countries are likely to be the last to be served may increase economic inequality. In fact, these countries will take longer to emerge from the health crisis and will therefore not be able to find the path to economic growth until after the industrialized countries. An economic scenario which, given the zeal of large nations to prevent vaccine stocks, seems to have been decided.