Breaking the glass vial: Women at the forefront of COVID-19 vaccine

While there is still a long way to go for women in global health to get the recognition, respect and relative conditions they deserve – at all levels and in all places – there are some notable breakthroughs. The world might be living the movie Contagion at present, but there is a serious flaw in the metaphor. The movie ends with a scientist using herself as a one sample test to show viability of a vaccine – while a male actor is making the policy and disbursement decisions. For some of us, identification of a potential vaccine is where it all begins. And as for distributing it, it isn’t one man calling the shots.

To get vaccines developed, financed, regulated, manufactured, allocated, contracted, purchased and delivered – while hastily retrofitting a network of supply chain webbing around the world – is a phenomenal undertaking. It may be the biggest logistical effort to get a commodity made, scaled-up and distributed to every country, the world has ever seen.

And guess what? Much of this global health security effort is being run by women. The global initiative for this is COVAX, and for the design, development and initial operational phase, the forces to be reckoned with and women in charge, were the Chair of the Gavi Alliance, Dr Ngozi Okonjo-Iweala and the Chair of the Coalition for Epidemic Preparedness, Jane Halton. Dr Okonjo-Iweala has moved on to head up the World Trade Organization now, but you can bet she will continue a keen interest in vaccine equity.

Gavi and The Coalition for Epidemic Preparedness Innovations (CEPI) work in conjunction with the World Health Organization (WHO), where the leader of their effort is Chief Scientist Dr Soumya Swaminathan. While Gavi and CEPI both have visionary, driven and fantastic male CEOs (Dr Seth Berkley and Dr Richard Hatchett), the Managing Director of the COVAX Facility which is doing the deals, setting up the conditions and bringing together the 186 countries, territories and other assorted participants to make it all happen, is Aurélia Nguyen who has just been listed one of 100 to watch by Time Magazine.

Several billion dollars will pass through Gavi for the COVID-19 vaccine effort and the responsibility sits with Marie-Ange Saraka-Yao, while the accountability for these funds (and the $8 billion dollar Gavi 5.0 programme) in large part falls to Gavi’s Deputy CEO Anuradha Gupta and Managing Director of Finance and Operations, Assietou Diouf. Supporting the Gavi Chair in this undertaking is Vice Chair Sarah Goulding, who also leads the Governance Committee of the Gavi Board.

In CEPI, in charge of the research and development decisions for the nine vaccines to help accelerate them to market is Dr Melanie Saville. At the WHO, the Director of Vaccines and Biologics and on the frontline of the day-to-day COVAX effort covering the policy, regulatory and allocation aspects is Professor Kate O’Brien. She works for Assistant Director General Mariangela Simao who leads the Drugs Access, Vaccines and Pharmaceuticals division of WHO.

But wait, there’s more. Dozens of countries need immediate financial support, and the one who got this rolling was European Commission President Ursula von der Leyen. The World Bank stepped in with $12 billion which, as Vice President of Human Development Mamta Murthi put it when her brief to the board was accepted, is, “To support the largest crisis response the world has ever seen.”

To get vaccines to many countries, UNICEF’s big delivery machine will roll into place under the careful watch of Executive Director Henrietta Fore and Director of their Supply Division, Eva Kadilli. The purchasing effort for Latin America is fronted by Dr Carissa Etienne, the Director of the Pan American Health Organisation, while the WHO Regional Director for Africa is Dr Matashido Moeti. Women are leading in the breakthrough research and scale up of vaccines as well, from BioNTech Professor Katalin Karikó’s visionary development of messenger RNA work to Professor Sarah Gilbert’s architecture of the Oxford Astra Zeneca vaccine.

You want to talk diversity? Bring it on. These extraordinary women are from countries like Nigeria, Australia, India, Vietnam, France, Cote d’Ivoire, Senegal, the UK, Brazil, Germany, the US, South Africa, Albania, Hungary and Dominica.

When this all settles down, and those of us in the thick of it get some headspace, maybe we need to write Contagion 2, starting where the first film left off. We can show how a just-in-time leadership wave met with a just-in-time planetary public health effort. But this time most of the leading roles will need go to women.