This is how to distribute a coronavirus vaccine to everyone

Numerous coronavirus vaccine development programmes are currently being run at a fast pace, with some promising candidates going into phase 1 (dosage and absence of toxicity), some advancing into phase 2 (efficacy on small groups of individuals), and some arguably with the potential to move into phase 3 before the summer (use across groups of thousands of patients, across multiple countries).

That said, there is a strong possibility that when closer to licensing and approval, the manufacturing capacity of the programmes with the most promising candidates won't be enough to deliver a global vaccination programme that would meet the principle of universal access, equity and prioritization of supply to benefit the most vulnerable populations.

It is possible that this dilemma will be further exacerbated by the type of public funding arrangements that have been put in place to support vaccine developers in their research and development efforts. Such funding usually comes with obligations for the manufacturers to produce on the territory of the country providing financial resources, which may in turn result in restriction of exports, and limited availability of the vaccine beyond the population of the countries in question.

With no less than 10 vaccines progressing fast along the clinical pathway, the current global market for vaccines is estimated to be 3.5 billion doses (excluding the seasonal flu vaccine). Diphtheria and tetanus (D&T), and measles-containing vaccines represent close to 50% of that overall volume.

The current supply, even if the world were suddenly to switch en masse from manufacturing existing vaccines to manufacturing one for COVID-19, is not commensurate with the need to vaccinate populations in their billions in order to end the present crisis.

Judging by the manufacturing solutions currently being designed for COVID-19 vaccination, the best-case scenario for vaccine delivery outside of the G7 countries is in the magnitude of a few hundred million doses, when up to 4 billion doses could be required to address the needs of the most vulnerable populations on the planet.

There must be a better way.

The Developing Countries Vaccine Manufacturers Network (DCVMN) accounts for the majority of vaccines produced at more than 65% in each WHO region except the European Region (EUR). This network of 40 manufacturers, located in developing countries such as India, Indonesia, South Korea, Brazil, China, South Africa, needs to be put to work.

The World Economic Forum proposes creating a pairing mechanism for vaccine innovators and vaccine manufacturers. It aims to protect both innovators, who will find capacity to produce, and manufacturers, who will access vaccine candidates at the right clinical development pathways – i.e. when they reach phase 3 and no earlier, hence averting the need for innovators to unilaterally and exclusively secure large capacities from individual manufacturers while their vaccines are yet unproven.

A mechanism like the one described in the above would represent a departure from the way traditional market forces are traditionally shaping the vaccine manufacturing landscape, by encouraging bilateral agreements between vaccine researchers and manufacturers. The Great Reset requires those types of mechanisms where the interest of all prevail over the ones of an elite. In the words of President Macron: “A vaccine is a global public good, which is not submitted to market forces."